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7 Health Insurance Questions to Ask in the New Year

The vast majority of insurance plans start “new” on January 1. Because of this, there are some really important health insurance questions you need to ask to make sure you’re prepared for the new year and your new plan.

1. Is your Telemedicine set up?

Your 2020 plan may have added or changed your telemedicine account. Be sure to check and set it up right away. Especially during flu season, you don’t want to wait until you’re sick to rummage through old emails to find login information. Most often, you or anyone in your family is eligible to use your telemedicine account if you set it up.

Telemedicine is one of the most innovative tools developed over the past decade in health insurance. With real doctors, 24/7 hours, and low-cost or zero-dollar copays, there is nothing more useful for your sick family. And, you don’t have to be around more sick people when you’re already sick!

2. What is your new Max Out of Pocket?

Some things in life are guaranteed: death, taxes, and your max out of pocket increasing every year. Don’t get caught off guard by this number. The number one cause of bankruptcy in America is actually medical debt, and this is largely because people don’t even know what their actual “exposure” really is!

It is so important to protect yourself and your family from becoming a statistic by understanding your actual risk, and designing a healthy strategy to manage these potential expenses. No matter what you set aside, what steps can you personally take to plan ahead in case of an emergency?

3. Did your Rx tier change?

Often, insurance companies will change what “tier” your prescription falls under, meaning you may pay a different amount than before. It is essential for you to make sure of these details before you get the refill on your Rx to ensure you don’t get overwhelmed by an unexpected cost.

The good news is that you can almost always find quality, generic alternatives. The reason insurance companies do this is because they want to encourage members to explore and choose less expensive options. They provide their list each year for Rx updates and shows generic alternatives. If this happens to you, be sure to talk with your doctor soon and get started on something new.

4. Do you need to assign a PCP?

If you are on a new plan, it may require you to assign a “Primary Care Physician” or PCP. This is a method used by HMO-style insurance plans as a gateway to manage costs and allow everything to be coordinated from one source. But if you already have a primary doctor, this may cause confusion.

Most often, you can still go to the same doctor if they are considered in-network with the HMO. You can usually use the online portal to assign your normal doctor as your PCP; if your current physician is not in-network, you can often assign someone else and let your new PCP know your medical history so they can “refer” you to your old PCP doctor.

Pro Tip: If your old doctor is not in your new network, you can often keep seeing them. If this is the case, you will need to “self-pay” for your visits. This just means you get billed for the entire cost of the visit. However, be sure to note you will pay in cash and negotiate your bill down instead of using a payment plan.

5. Is your plan HSA-eligible?

Do you feel like your deductible just skyrocketed? This may be because you have a High Deductible Health Plan now (HDHP). The intent of these “consumer-driven” style plans is to encourage you to pay out of pocket for more and use it only when you actually need to. To incentivize this, you may put money, tax-free, into a special savings account (HSA). And, you can add money to your HSA throughout the year.  

6. Any extra discounts with your plan?

Many health insurance plans come with a host of additional discounts and programs that members don’t even know about. This could include a discount to your local gym, coupons for supplements, and even online codes to purchase flowers! (No, I’m not kidding). When it comes to saving money, this is a great health insurance question to ask!

Generally, these extra discounts are tucked away in the “additional member resources” area of the website. If you can’t find them, call the support line and ask. Insurance companies are usually very proud of their partnerships for these discounts, and they’ll be more than happy to help you use them. If you were wondering how you might be able to save money to be prepared for unexpected medical costs, maybe this will help!

7. Did you start eating better or exercising?

There is no better way to improve your health insurance than to improve your own health. While you may not be able to improve the costs and coverages, you can always improve yourself. With that said, don’t feel ashamed if you’ve already ‘missed” your goals for the new year. It’s never “too late” to start a new health journey!

Whether that’s mentally, physically, or spiritually, taking little steps every day can help you reach a healthier version of yourself. And generally, the healthier you are, the less you spend on doctors and insurance! So if you haven’t asked yourself these 7 health insurance questions yet and evaluated your coverage for the new year, don’t let January fly by before you’ve done it!