That’s the question that is looming in every patient’s mind before a medical procedure, after a newly diagnosed illness, a hospitalization or worse yet a long rehabilitation stay. Let’s be honest. Healthcare expenses can add up in a hurry making it critically important that people understand (to the best of their ability) what benefits their health insurance plans provide. Unfortunately, that is easier said than done, right?
Group plans are ever-evolving with deductibles creeping higher and the introduction of Health Savings Accounts and Health Reimbursement Accounts to help members fund increased out of pockets costs. Marketplace and short term medical plans change each year making it challenging for members to keep things straight. Medicare is riddled with complexities and often referred to as “Alphabet Soup”; (I’ve made a fun jingle about it!) including BIG differences between Medicare supplements and Advantage plans.
So then, what is the answer? Members have many resources when it comes to exploring their plan benefits. Plan materials and policies are sent out to members either by mail or electronically that contain volumes of information. Insurance carriers provide customer service phone numbers that can help address questions during regular business hours. In most cases, members can register for online accounts to view current benefits, claims history, print new ID cards, premium information and much more. Providers can submit pre-authorization requests to help members plan for future services. Did I mention agents? Reputable agents will help their clients navigate their benefit questions. Local senior service programs such as ENOA and Aging Partners can help provide information and direction. Medicare specifically publishes a new handbook each year titled “Medicare & You” and makes it available by print or online at www.medicare.gov. In addition, Medicare recently developed an app for smart phones that helps determine if an upcoming service is covered.
Ask questions, advocate for yourself and family members and be sure to understand your plan benefits BEFORE you enroll. And remember, what’s good for your neighbor, friend, or relative, may not be what’s best for you.
This article was submitted by Stephanie Swerczek. Stephanie is the owner of Simplified Financial Solutions and may be reach at 402-670-0357 or by email at firstname.lastname@example.org
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Nebraska - Eastern Region
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