How to Use Health Insurance



so you bought health insurance now what you should receive a welcome packet from your insurance company which will generally include a welcome letter instructions for paying your premium and selecting a primary care provider and your insurance card keep this card with you at all times you should create an account on your plans website where you can find important information on your plan if you haven't selected a primary care provider do this right away check the list of doctors in your health plans network found on their website after you've chosen a primary care provider set up your annual appointment for a wellness visit a critical part of your routine care routine and preventive care catch health problems before they occur or in their early stages also make appointments for preventive services such as vaccinations mammograms and prostate exams when needed these services are now free depending on your plan visits to specialists may require a referral from your primary care provider always make sure these providers are in network here are some things you may want to bring to your wellness visit your ID and social security number your insurance card and a list of questions for your doctor if you have a new primary care provider contact your former doctors and have your medical records transferred if you see a specialist it's a good idea to request that they share your medical records with your primary care provider after your visit you'll receive a receipt of your claim in the mail or online called an explanation of benefits or EOB your EOB will look something like this it usually says this is not a bill it lists the services you received how much your insurance paid and any payment you owe the provider the provider will send you a bill for that amount your EOB will also have instructions for filing a grievance or appeal if a provider is out of network you may owe the entire balance of charges you can call your provider to negotiate these charges or ask if you can set up a payment plan in this section your Yobe shows your deductible and out-of-pocket limits for the year once you meet the limits you'll no longer pay these costs most people don't pay a full deductible or reach the out-of-pocket maximum in a year unless they've been in the hospital had an emergency or are under treatment outside of routine care if you don't feel well you should call your primary care provider for guidance on whether it's more appropriate to go to the ER an urgent care center or make an appointment the ER should only be used in a true emergency if you buy insurance through the marketplace you should purchase during open enrollment usually at the end of the year even if you have a plan you like you can always explore new options on healthcare.gov if you don't have insurance you may have to pay a penalty when you file your taxes the Pennsylvania insurance department reviews changes and planned costs every year visit the department's website to see proposed rate changes for the next year and find out more about this process do you think you're ready let's review keep your insurance card with you choose a primary care provider understand which providers are in and out of network and whether you need a referral go to the appropriate places for care don't visit the ER for non-emergencies make preventive care appointments check your explanation of benefits to verify services and amounts you owe and to track your yearly costs pay your monthly premiums and check the marketplace during open enrollment always visit the insurance department website for more information including annual proposed rate changes

3 Comments

  1. Professional Insurance Brokers are here to help answer all of your questions and provide guidance on these and many other issues , not just at open enrollment but all year long. Usually this is at no cost to the consumer or small business! If you don't have one, get one! http:///.totalbenefits.net (215)355-2121

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  3. I know this is an old video, but can you answer something for me? What am I looking at paying on the day of a visit to a specialist? If my deductible is 2,250 and copay is 20% does that mean I have to fully pay the deductible AT the appointment…or does it come from the insurance provider in the mail?

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