It’s That Time Of Year: A Step-by-Step Guide To Reviewing Your Health Insurance Benefits

As the year comes to a close, many of us tend to get caught up in holiday preparations and festivities, often putting other important tasks on the backburner. However, if you’re someone who’s lucky enough to have health insurance through your employer or the marketplace, it’s crucial that you take some time to review your benefits before the year ends.

Reviewing your health insurance benefits may seem like a daunting task, but it’s really quite simple. By following these easy steps, you can ensure that you’re getting the most out of your insurance plan and that you’re prepared for any medical expenses that may come your way.

Step 1: Gather Your Information

Before you can review your health insurance benefits, you’ll need to gather some information. Start by finding your insurance policy documents, which should include a summary of benefits, a policy booklet, and a premium bill. You can usually find these documents online through your insurance provider’s website or by contacting their customer service department.

Next, take some time to review your medical expenses from the past year. This will help you get a sense of what you’ve spent on medical care and what you can expect to spend in the coming year.

Step 2: Understand Your Coverage

Now that you have all of your information in front of you, it’s time to understand your coverage. Start by reviewing the summary of benefits to see what’s covered and what’s not. Look for information on:

• Deductibles: How much you’ll need to pay out-of-pocket before your insurance kicks in.
• Co-pays: How much you’ll need to pay for each doctor’s visit or prescription.
• Co-insurance: How much you’ll need to pay for medical procedures or hospital stays.
• Maximum out-of-pocket (MOOP): The maximum amount you’ll need to pay for medical expenses each year.

You should also review your policy booklet to understand the specifics of your coverage, including any exclusions or limitations.

Step 3: Check Your Network

If you have a preferred provider organization (PPO) or health maintenance organization (HMO) plan, you’ll want to review your network to make sure that your doctors and hospitals are still in-network. This can help prevent surprise medical bills and ensure that you’re getting the best care possible.

You can usually find a list of in-network providers on your insurance provider’s website or by contacting their customer service department.

Step 4: Review Your Premiums

Now it’s time to review your premiums to make sure that you’re getting the best rate possible. If you’re eligible for a premium subsidy through the Affordable Care Act (ACA), you’ll want to review your subsidy to make sure that you’re getting the correct amount.

You should also review your premium payments to make sure that you’re paying the correct amount each month. If you’re paying too much, you may be eligible for a refund.

Step 5: Consider Your Options

Finally, it’s time to consider your options. If you’re not happy with your current insurance plan, you may want to consider switching to a new plan. This is often referred to as the "open enrollment period," which typically takes place in the fall.

You can review your options and enroll in a new plan through the health insurance marketplace or through your employer. Be sure to carefully review the details of each plan before making a decision.

Conclusion

Reviewing your health insurance benefits is an important task that can help you save money and get the best care possible. By following these easy steps, you can ensure that you’re getting the most out of your insurance plan and that you’re prepared for any medical expenses that may come your way.

So take some time this year to review your health insurance benefits and make sure that you’re on the right track. Your wallet – and your health – will thank you.