Obtaining coverage is the first part of the process. Whether you have an employer plan or purchased an individual one, it is important to know what it covers and how to use your benefits.
- Summary of Benefits: It’s beneficial to ask for the summary of benefits and read through it. This will explain what is covered, how it’s covered, and any exclusions on the plan. You may find that some services are covered that may pertain to an issue you’re dealing with for example hearing aids or chiropractic services.
- Telemedicine: Does your plan have telemedicine? If so, I urge everyone to review the company’s process for accessing it. Some companies want you to log in and create an account while others have a number for you to call when you need to speak to a doctor. If you are required to set up an account for telemedicine, I recommend everyone set that up as soon as possible. Why? Imagine you have an ear infection and it’s 2 a.m. You will have direct access to telemedicine without worrying about where to go to create an account and how to schedule a call with a doctor. Most health insurance plans provide this service for free, saving the client time and money.
- Primary Care Physician: If you have a PCP (primary care physician) make sure they are in network. If you don’t have a PCP, knowing which ones around you take your insurance and are accepting new patients will help when you need an appointment.
- Urgent Care: Knowing which Urgent Care’s are in-network and where they are located is always helpful. We can’t plan when things happen but we can have a plan for when things happen. This will help you save time when you need a visit. It also helps prevent out-of-network charges when possible.
- Pharmacy Benefits: Prescription plans are different on all insurance plans. This is a common area that is overlooked. Most people are used to going to the local pharmacy and picking up their prescriptions. Some plans offer mail-order options that may save you money but could also save you time. On the other hand, if your generic and brand name copays are on the higher end, prescription discount plans may help reduce the costs.
These are a few topics I go over with every policy review I do with a client. It seems basic but has proven to be of help when a client is seeking help. Regardless of whether you purchased a plan through me or someone else if you would like to do a policy review, contact me via phone or email or fill out a contact form on my website. I will be the only one contacting you.
