Health Insurance Considerations

Health insurance considerations and coverage seem to be changing daily.  Time to do a quick review as you prepare for enrollment or re-enrollment in the fall.

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Health Insurance Consideration #1: Are Your Health Providers Covered?

Insurance providers are making arrangements with specific medical centers and practices to provide care under limited network plans.  In turn, because the insurance provider is better able to control costs and maintain information about your utilization of the health care system, premiums might be lower.

Health Insurance Consideration #2: Know Your Financial Responsibility

Carefully review the health insurance plan in which you plan to enroll.  Make sure you completely understand the monthly premium charges for which you will be responsible, the difference if you are paying as an individual (employee) or for a spouse or family.  Then, make sure you understand the deductible and co-pay out of pocket expenses for which you are responsible. Be familiar with what treatments and expenses will apply toward the deductible.  Learning about all of this when you are in an emergency medial situation is not ideal.

health Insurance consideration #3: Are Your prescriptions covered by the insurance plan?

As the costs of prescription drugs continue to increase, the brand name products which insurance companies cover seem to be changing throughout the year.  It doesn’t matter if it is an “old” drug; on the market and proven effective for a specific disease treatment.  To the insurance company it is about the bottom line. If there is a generic drug for a much lower cost than the brand name, you might  be notified that you will have to switch drugs for the insurance policy to pay for the drug, or, you will be paying out of pocket for the difference in the price between brand and generic products.

If you have tried other drugs with no success, you can obtain a waiver from your physician, asking the insurance provider to grant you an exception and cover the drug which you have been taking for an extended period of time.  Your physician should be familiar with what is required.

Health Insurance Consideration #4: One Spouse Ready for medicare, the other not

The spouse who provides the medical insurance is eligible for Medicare enrollment, the dependent on the policy is not.  Now what do you do?

Here is a great article which provides some information on the questions you should be asking before making any changes in your health insurance coverage.

Health Insurance Consideration #5: Don’t Rush

The health insurance and provider arena is changing daily, and it isn’t getting less complicated.  Take your time to review your current coverage.  Consider what coverage you anticipate needing for the coming year.  Review your budget so that you know in advance what you can comfortably afford.  Don’t be afraid to ask questions. Your health insurance decisions are important in so many ways.  Don’t make any hasty decisions you might regret for the entire year.  It could be costly in many ways.

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