Archive for January, 2017

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Immediate steps to take after you have enrolled in health insurance

You are enrolled in health insurance, so what is next? If you have chosen an individual health insurance plan or a group health insurance plan and completed your health insurance application these are important steps to take:

  1. Make you’re your health insurance first month’s premium payment. Typically, your first month’s premium payment is collected at the time you complete your health insurance application, however some insurance carriers will allow you to make the initial premium payment after you submit your application. Contact your insurance carrier to pay your first month’s premium immediately. Your individual health insurance policy WILL NOT go into effect until the initial payment is received and processed. Confirm that your bank records show that your health insurance premium payments have been received by your health insurance carrier.
    1. Initial premium payments MUST BE received before the effective date for your policy to be issued. Health insurance carriers will not send insurance cards until they have received the first premium payment. Keep in mind that during the annual open enrollment period processing times are longer. This means it takes longer to process your payment and longer for you to receive your insurance cards.
    2. Your monthly health insurance premium payments must be received and processed prior to the month that you want coverage. This means that if you go to see your in-network doctor on April 1st, then your premium for April must be submitted and processed by your health insurance carrier no later than March 31st. If you do not make payments on time you take the risk of not being able to verify your insurance when you need to use it and potentially take the risk that your insurance policy will be terminated for non-payment.
  2. Terminate other insurance. Just because you received a letter that your plan is going away or premiums are going up does not mean that your other insurance will automatically cancel and that they won’t draft your account.
    1. If you are on automatic payments call the insurance carrier or login to your online member portal and cancel those immediately. Usually this request must be received several days before the draft date in order to cancel the automatic payments.
    2. Cancel your old policy with your previous health insurance carrier for the day prior to your new health insurance effective date. For example: if your new health insurance policy with Blue Cross Blue Shield of Texas starts January 1st then you need to cancel your old Blue Cross Blue Shield of Texas health insurance policy and make sure they have stopped any automatic payments.
    3. Some carriers will automatically renew your policy into something similar, so it is important to make sure that they are not “mapping” you into another plan. You may need to request that they cancel the policy they are “mapping” you into as well.
    4. If your health insurance is through healthcare.gov, also known as the Marketplace or the Exchange then depending on your application selections you may be automatically rolled into another plan each year. This plan may or may not meet your medical needs, so we advise that you actively reviewing your health insurance every year. Your application answers may also affect tax credits received. It is important that you are updating your application each year to ensure it is correct and current.
  3. Create an online account. Most insurance carriers have a member website or member phone app where you can create an account. Member online accounts allow you to access you and your family’s health insurance information. This information can be temporary ID cards, provider networks, online payment options, and claims information. Providers like Blue Cross Blue Shield have even added a “call a doctor” benefit through MD LIVE that you can access online. It may seem like a pain to add another account to your array of accounts, but these online health insurance tools are truly beneficial. You have almost everything regarding your health insurance at your fingertips. This allows you to avoid long hold times to contact the insurance carrier.
  4. Not truly happy with your health insurance? You have until January 31st to make changes to your health insurance. Be certain you know how your insurance works, your benefits and your coverage area. If your insurance does not meet your needs, we can help you explore alternatives. Call us at (512)847-3164.
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Know how to use your insurance

You have enrolled in a health insurance plan, now what? Health insurance can be confusing and overwhelming, so here are a few tips to help you use your health insurance correctly.

  1. KNOW YOUR NETWORK! Check doctors, hospitals, and urgent care in-network. Be proactive about your medical needs and check for the doctor’s and facilities that are close to you that are in your health insurance network. Each insurance carrier has an online tool where you can search providers by name, specialty, location. This is useful to have so that you know exactly where you can go in the event of an emergency.
    1. Each carrier has a multiple “networks”, so know what network you are in i.e. Blue Cross Blue Shield Blue Advantage HMO, Aetna Rosebud EPO or HMO, Memorial Hermann HMO or PPO, United Healthcare Choice, PHCS, Humana HMOx San Antonio/Houston, etc.
    2. When confirming your network with your provider ensure that you are using the specific network to confirm. Sometimes it may be best to speak to a providers billing or managed care representative (the person that handles their insurance contracts) to ensure you are receiving the correct information.
  2. Get established with a primary doctor. If you are having to switch doctors or have not established a relationship with a primary doctor in your network get an appointment now.
    1. Some doctor’s will only see new patients on certain days, so it can take a while to get an appointment. You want to be certain that you your doctor is the right fit for you.
    2. If you have enrolled in an HMO we recommend that you find out what your primary doctor’s referral process is like if you need to be referred to a specialist.
  3. CHECK THE FORMULARY FOR YOUR MEDICATIONS!
    1. Make sure that you review your health insurance carrier’s prescription drug formulary for any medications you take. This will give you an idea of what your costs will be.
    2. Make sure that you are also going to pharmacy’s that are in your health insurance carriers network.
  4. Not truly happy with your health insurance? You have until January 31st to make changes to your health insurance. Be certain you know how your insurance works, your benefits and your coverage area. If your insurance does not meet your needs, we can help you explore alternatives. Call us at (512) 847-3164.

PO Box 1270 Wimberley, TX, 78676
15577 RR 12 Wimberley, TX, 78676

Get in touch with us at
TexasMedicalPlans@health-quotes.com

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Phone: (888)750-3164
Fax: (512) 847-3663