Over the past year, there has been much cause for concern for anyone who is chronically ill or at high risk for medical care. I think we can all agree that healthcare is costly, but detrimentally so if you do not have insurance. I could argue the points of whether or not everyone should have a plan of coverage. However, today it is on my heart to talk to you specifically on KNOWING your BENEFITS.
In three years, our family has had three different insurance providers. The plan we had after COBRA changed and left the state at the end of 2014. At the end of 2015 and 2016, our family experienced the same thing again. With 2017, I chose to stay with our provider but update the plan. Friends know that those years were critical to the care of three members of this household. Had we not had proper coverage…I don’t know. That being said, our benefits plan wasn’t ideal. My goal, as the parent who researches all of these things, is to find the plan that meets our needs the closest.
Researching plans is intimidating. You are not the only person overwhelmed or whose eyes are going crosseyed scrolling medical terminology on the screen. Many of the terms used, and when (and how) they apply to your coverage are quite confusing. DO NOT be afraid to ask questions via customer service or someone else you know who is well-versed in member benefits. Reading comments on facebook is not a reliable way of getting answers to your questions.
Now, when I am looking for a plan there are several things I consider:
- cost (monthly, total yearly expense, and copays)
- coverage of specific illnesses in the home (asthma, diabetes, heart conditions, etc)
- coverage of “likely” or potential needs (i.e. xrays, urgent care for kids playing sports)
- coverage of testing supplies or devices needed with chronic illnesses
- if you travel often… out-of-area coverage
- prescription coverage
I know. I probably should have written this a few months ago.
Take the points of consideration (yours may be different) and put them in order of importance. Use that to help guide your decision on a plan. But that is not the end of it.
You need to know the fine print. Keep a copy handy of the Plan Benefits. There are conditions to almost EVERYTHING that come in the form of words like “deductible”, “referral”, “out of pocket”, “medically necessary”, “in-network”, you get the point! I have a download on my computer as well as a printed copy in my office. I have learned that you cannot rely on what other’s tell you. Know what is in print. Don’t wait until a medical emergency to be surprised by conditions. Do your research and be well-prepared for life’s unexpected turns.