What is the most appropriate word to describe researching health insurance? “Confusing”, “Frustrating”, “Bewildering”? Or perhaps something like “Brain-tingling”, “Interesting”, or “Enthralling”?
Health insurance information certainly isn’t the most exciting literature to read. It doesn’t replace Tom Clancy, that’s for sure. Nevertheless, the subject matter is critical to your healthcare and to your bank account.
In this blog, HealthMarkets reviews Health Insurance Tips to make the Affordable Care Act Work for You.
1. HealthMarkets Reviews ACA Tips: Plan Information
When looking for new health insurance, read the plan information regarding benefits and coverage. Read every word of it, including the fine print. And, carry your membership card with you everywhere you go, along with a list of any and all medications you take. The card helps to prevent any insurance hassles should something come up. The list of current medications could especially come in handy if an emergency happens. In a moment of stress you might not remember every pill you take.
2. HealthMarkets Reviews ACA Tips: Prescription Drug Coverage
As far as Prescription Drug Coverage is concerned, plans vary widely and uniquely – even if they fall under the same metal level. It’s extremely paramount that you do your homework and discuss your specific prescription drug coverage needs with a licensed health insurance agent. If you take prescription drugs routinely you should check with the insurance company to determine if the drugs are covered under your plan and by how much. You can find out if your health plan covers the medicine you take by checking the plan’s “formulary”. Now, you’ll need to know the exact name of the medicine, the strength/dosage, and the amount of medicine you’re usually prescribed by your doctor.
It’s also worth noting that formularies can change and prescription drugs can be added or taken off the formulary at any time.
As for prescription drug costs, with some plans you may pay a percentage of the drug cost such as 30%, and with others you may be charged a fixed amount or “copay” per drug. Generic medicines cost the least while non-preferred and brand name drugs cost more, followed by specialty medicines such as chemotherapy drugs, which cost the most. Because generic drugs are copies of brand name drugs and have the same effects, you’re better off sticking with generic when you can.
You should also take into account that you might have your medical deductible and a separate deductible for prescriptions drugs. Sometimes, medicine and medical deductibles could be integrated. Such is sometimes the case with an HSA plan. With an HSA plan you may pay most of your medical expenses yourself until the deductible has been reached. At that point, you would either have your prescription drugs covered 100% or you might pay a copay at in-network pharmacies. Again, this is why it is critical to consult with a licensed health insurance agent and read over the plan’s summary of benefits to understand what your cost responsibility would be.
3. HealthMarkets Reviews ACA Tips: Plan Coverage
It’s crucial that you check with all of your doctors and specialists to make sure that they take the specific plan you’re looking at. There is a chance they don’t accept it so it’s smart to check first. Also, you should do your best to stay in-network, even for emergency services. Non-network hospitals charge a lot more than in-network hospitals and you’ll be forced to pay a greater percentage of that bill on your own.
4. HealthMarkets Reviews ACA Tips: Children Under 26
If a plan covers children, they can stay on a parent’s health insurance policy until their 26th birthday. Whether they are married, not living with their parents, attending school, not financially dependent on their parents, or even eligible to enroll in their employer’s plan, they can still stay on their parent’s policy.
That said, if they don’t enroll in health coverage within 60 days before or after their 26th birthday, they won’t be able to get new coverage until the next Open Enrollment period – unless they have a qualifying life event that triggers a Special Enrollment. Moreover, they will be subject to the penalty tax if they’re without health coverage for more than 3 months.
5. HealthMarkets Reviews ACA Tips: Emergency Services
This is vital. Emergency services can cost an arm and a leg. It’s absolutely urgent that you consult with an agent to find out what you would need to pay for a visit to the ER and what’s in the plan’s fine print. Don’t go to the ER unless it is really an emergency. If you cut your finger off while slicing vegetables – go to the ER. If you sprain your wrist however, I suggest waiting until the care clinic is open. Some plans, under certain circumstances, even require that you get permission from your Primary Care Physician BEFORE you go to the Emergency Room.
6. HealthMarkets Reviews ACA Tips: Supplemental Coverage
Supplemental insurance can be a real life saver. There are a wide range of plans to choose from and they can be used for a variety of things. From out-of-pocket medical expenses and deductibles, to replace lost income, or even to just pay for your everyday living expenses, supplemental insurance can provide you money to spend how you want on what you want.
7. HealthMarkets Reviews ACA Tips: Save Paperwork
Save all your paperwork from the doctors, hospitals, and the insurance company. Keep your receipts, bills, notices, everything. That way, if you ever have any problems, you’ll have a paper trail to go back to. Then you can ask any questions if you’re confused about something.
8. HealthMarkets Reviews ACA Tips: Pay on time
Without payment your coverage will be terminated. Therefore, it is imperative that you pay your premium on time or else the insurance company will have to terminate your coverage. So if you forget to pay, not only will you lose your health insurance coverage, you also won’t be able to get insurance again until the next Open Enrollment or your Special Enrollment.
9. HealthMarkets Reviews ACA Tips: Signing Up
Health Insurance can be complicated. Just trying to make sense of it all can be a real headache. Even if you research and you research you might still not end up with the perfect plan because life comes at you unexpectedly sometimes.
But, you don’t have to be a lawyer or a doctor to make sense of it all. Help is available free of charge – why not use it? HealthMarkets reviews your options with you. And talk about convenience, a licensed insurance agent can get you signed up over the phone, or in person
Call a HealthMarkets insurance agent at (800) 429-5058 and get someone on your team to help provide you with answers to your questions and unbiased advice tailored to your unique needs and budget.