Open Enrollment – How to Use Your New (and Old)

Health Insurance Plan

Healthcare is changing. The industry is trying to

offer as wide array of products and services as possible, while still

keeping costs attainable.

Still, there are a few things you can do as a

customer of your health insurance provider to

make the most of what you purchase with each

payroll deduction.

The list:1. Understand what is in network2. Know whether you need a PCP3. Know what requires pre-

authorization4. Don’t forget your drug benefits5. Understand your co-pays,

deductibles, and max out-of-pocket charges

6. Make sure your expenses are processed by your health insurance provider

7. Keep your insurance card handy

1. Understand what is “in network” and what

is “out of network.” “In network” means your

insurance company has contracted with the

doctors or facilities for discounted rates

2. Know whether you need a Primary Care Physician (“PCP”). Some insurance plans require the referral

of your PCP to see a specialist. Make sure your existing PCP participates

in your plan.

3. Know what requires pre-authorization.

Certain treatments, like surgery, often require pre-approval by your insurance carrier.

4. Don’t forget your prescription drug benefits.

Most health insurance carriers will have preferred

list, called a “formulary” for drugs they will cover,

often at a discount.

5. Understand your co-pays, deductibles and

max out-of-pocket charges. Your specifics

may change from year to year even within the

same plan.

6. Make sure your doctor visit is processed (and

correctly) by your insurance carrier. Mistakes happen, millions each year by some estimates. Make sure your insurance carrier sends you an EOB. Then look at it.

7. Keep your insurance card handy. Call your health

insurance provider when in doubt or have a question. They staff centers just for you, and likely know how

you can get the most benefit for your health

dollar.

Take a moment this open enrollment season to think

about how you use your health insurance product. There may be ways to use

it better, ways that are likely to save you money.

Thank You!