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Six Tips for Managing a New Health Plan

Omar Ramos, Certified Oncology Financial Navigator

Calculator with pen and paperGetting acquainted with a new health plan can be intimidating. Everything appears so daunting. Learning the terminology seems like learning a foreign language. Finding a network, doctor, hospital, or convenient care without a trusted word of mouth referral can feel like going on a blind date. Moreover, once the bills begin to arrive, our stress levels can escalate.
So, what can you do? Here are six tips to help you understand your health costs and reign in financial stressors.

1. Create an online account with your plan.
Many insurance companies offer online access to accounts. Set this up as soon as you receive your new ID card. You may want to enlist the help of a friend, family member or financial counselor if you do not feel confident completing this step on your own.  Once completed, you can review the details of your plan, search for doctors in your network and use cost calculators and other tools to make money-saving decisions.

2. Get acquainted with the basics of your plan.
Log on to your member account and review your plan’s basics: deductible, copays, out-of-pocket costs and your summary plan description. These are fundamental in determining what is covered and what your total cost will be for the year.

3. Add important insurance phone numbers to your contacts.
Save your insurance company’s key phone numbers on your phone. Examples include member services or the 24-hour nurse advice line. These will come in handy if you misplace your ID card or need advice in the middle of the night.

4. Locate a primary care physician (PCP).
Most plans, including PPOs, have different tiers of coverage based on networks. There will be a significant cost-sharing difference when you see a doctor out of your network, even if you have out-of-network benefits. Most plans give a discount for using doctors that are part of a “network.” These doctors meet quality requirements but are lower in cost.

Log on to your account and find the doctor or network search tool. You can see if your current doctor is covered by your insurance. If not, you may search for a new doctor who is covered to help you save money. In addition to locating your doctor, find the closest urgent care or emergency room you can visit when needed. Your insurance company can help you with this as well.

5. Download the mobile app, if available.
Take advantage of your smartphone’s features by downloading the mobile app sponsored by your insurance company. You will experience the convenience of checking your explanation of benefits, reviewing your claims, finding a doctor and contacting the company wherever you may be.

6. Make a savings plan.
If you do not have a medical health savings account or flexible spending account, you can still save for health-related costs. Once you are aware of your out-of-pocket costs, you can plan how much you would like to set aside every month to meet them. It may not always be possible, but attempt to realistically set aside funds for emergencies.

A new health plan may seem overwhelming but following these suggestions can help you better understand and manage your plan – and ultimately help to reduce stress.