I wanted to take some time and provide some information to support the issue that is going to be critical for a lot of people. A lot of you guys have just enrolled into a new insurance plan that will take into effect next year, and I wanted to provide you guys with some tips and strategies that can be utilized to help you understand what you have gotten yourself into with the new plan.
1. Research what is included in the in-network benefit. What you want to look at specifically are the services that you utilized the most and see if they are covered and see to what extent they are covered if it’s 100% or if you have to pay Co-payment or meet a deductible before it’s covered. One thing a lot of insurance carriers have included due to COVID-19 is having Tele-Med be a $0 cost service to members.
2. You want to ensure that whatever medications that you take are covered. Many insurances use a tier format. And for many insurances, the way they have it set up is that a tier-one is usually $0 -to $4, a Tier 2 can range from $5 to $20, and tier 3 usually requires prior authorization for them. So, you want to look at the medications that you are currently taking and view your selected insurance plan to see where the medication is at. You know from the beginning if the medications will be more costly for you or if there’s going to be additional things you have to do (such as a prior authorization) to get the medication.
3. You are going to want to see what your outpatient benefits look like. Specifically, I am referring to rehab, which can be physical rehab or drug and alcohol rehab. You also want to look at what your mental health benefit looks like. With COVID-19 being what it is, a lot of us have experienced more anxiety and/or depression than usual. You’ll want to see what your insurance plan covers as it relates to those benefits so if you need them, you know what’s available to you. These are just some simple things that you can look at to kind of help yourself prepare for next year. If you are someone that needs additional assistance understanding the paperwork you have received my organization is more than happy to provide free assistance.
My organization is called Craving For Change Foundation Inc. We are located at 2501 Palmer Hwy #260 Texas city TX 77590. And we can be reached at 832-735-0077. And we can also be reached via our website which is www.cravingforchangefoundation.com.
