Have you ever tried to find out what health insurance you have only to find that you’re not sure where to begin? You might be surprised to learn that there are many steps involved in order to even figure out what your health plan is, let alone how it works.
In this article, we’ll discuss all of the different options available to you when it comes to discovering what health insurance coverage you have, as well as how each step can help you to feel more confident and secure when it comes to your health care.
Let’s start with the basics.
What does Medicare cover?
Medicare is a Federal program to help older Americans with their medical costs.
You may be eligible for Medicare if you are at least 65 years old and/or disabled, or you may qualify under certain specific circumstances, like if you were receiving Social Security disability benefits when you turned 65.
Medicare does not cover all medical costs, but it does provide coverage for significant parts of your healthcare expenses including some prescription drugs and inpatient hospital stays.
To learn more about your specific situation call 1-800-MEDICARE (1-800-633-4227).
What does my employer offer?
The most obvious way to get a handle on your health coverage is to contact your human resources representative.
He or she will usually know exactly what sort of health benefits are offered by your employer.
If not, they should be able to tell you how you can get in touch with someone who does.
You can also visit your employer’s website, since most large organizations post employee handbooks online for public access.
This way, you can compare notes with fellow employees and see if anyone has any inside information about changes that might be coming down the line.
Plus, it’s great practice for doing research for future posts!
Is my health plan real insurance or just a supplement?
The big question that you need to ask yourself is, Is my health plan a real insurance policy or just a supplementary policy? If your answer is that it’s a supplement, then you’re still responsible for paying 100% of medical expenses out-of-pocket.
Unfortunately, most consumers don’t know whether they have supplemental or comprehensive policies because their employers and/or agents don’t tell them.
And if you didn’t buy your own policy through an exchange, chances are good that you don’t know either.
Find out for sure whether your coverage is a supplement or an actual health insurance policy so that you’ll know how much protection you actually have when disaster strikes.
What are the Healthcare Insurance Terms to Know?
If you’re confused about your healthcare coverage and bills, you are not alone.
It’s important to understand how healthcare insurance terms such as co-pay, co-insurance, deductible and premium apply to your specific situation.
Here is a breakdown of these terms. – A co-pay is a set dollar amount that you must pay each time you visit a doctor or fill a prescription for certain services.
Some plans require you to make a copayment for most visits; others don’t require one at all. – Co-insurance means that you must pay part of a bill before your health plan pays its share, up to its limits.
Am I Eligible for Health Insurance from My State?
Your state’s insurance website will tell you if you’re eligible for free or low-cost coverage through Medicaid and CHIP.
These plans are open to everyone with a household income at or below 133% of poverty.
If your income is too high, apply anyway, because they may still cover you based on your household size, family situation and employment.
You can also use Findlaw’s eligibility estimator tool to see if you qualify for Medicaid.
Even if your state doesn’t offer coverage that applies to self-employed people (some don’t), check with an independent agent who can fill you in on different plans available in your area.
Do I Need to Buy Health Insurance From My State or can I Keep Mine from Before Obamacare?
Even if you had healthcare before 2014, you may need to purchase additional coverage to avoid a tax penalty.
If you’re on Medicaid, or just below 100% of your state’s poverty level, most individuals will receive free coverage under Obamacare.
Check with your state’s exchange to see what subsidies are available and how much they cost (i.e., whether or not they’re tax deductible).
Keep in mind that if your income is less than 400% of federal poverty level—$47,080 for an individual; $62,040 for a family of four—you won’t be required to buy any kind of coverage at all.
The Doughnut Hole in Medicare Supplement Plans.
It can be frustrating when you aren’t sure what kind of health insurance you actually have.
With all of your other work- and home-related stresses, why worry about something as tedious as an insurance policy? However, taking a few minutes to find out more about your healthcare plan could end up saving you money.
That’s because some plans may cover certain things—such as medications—that others don’t.
The best way to know for sure is to call your company and ask about specific coverage details for both inpatient and outpatient services (which include drugs).
Insurance policies often differ from one company to another, so it pays to know exactly what you’re getting into if you decide to switch providers.
10 Questions to Ask your New Health Insurance Provider
- Do you provide coverage for all of my doctors, hospitals and other health care providers? Even if your plan includes one or more of your current doctors, check to make sure that there are no exclusions in their network.
- What is your patient satisfaction score? The J.D. Power and Associates 2012 U.S.
Health Insurance Provider Customer Satisfaction Study found that Satisfaction with cost of claims processing had the highest weighting in its scores for commercial plans (16 percent) and Medicare plans (18 percent).
- Does my plan pay or reimburse me for specialists who are not in your network but who are important to my care? 4.
How to check if your health insurance is active online
You probably know that you need health insurance, but there’s a good chance you don’t know what type of coverage you have or how to check if it’s active.
You may also not be sure where to go for more information about signing up for Obamacare or deciding which healthcare plan is best for your family.
In fact, according to recent studies, only 10 percent of those in America today claim they fully understand how healthcare is funded and provided in their country.
When it comes to your own medical care, however, understanding these issues is vital—but where do you start?
Best individual health insurance
The best way to get an answer to what is my health insurance? is to call your provider.
If you can’t get an answer, you can always request a copy of your EOB or Explanation of Benefits from your insurer or agent.
The EOB will clearly indicate whether or not you’re insured for a specific service and any associated costs for that service.
Keep in mind that sometimes information found on an EOB may be dated as well, so if you need an immediate answer it’s best to call and ask directly.