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Learning your way around a new health insurance policy can take time. Read on for some key points to check off sooner rather than later.
Health insurance is one of those things that might change from one year to the next, whether because you get a new job or you buy a new plan on your own that isn’t sponsored by an employer. If you have a new health insurance policy this year, you need to understand its ins and outs. Here are a few key items to check early in 2024.
1. Your deductible
Your health insurance deductible is the amount of money you’ll need to pay before your insurer starts picking up the tab for your service. If that amount is $800, it means that if you end up needing to see a specialist that costs $650, you’ll generally have to fork over that $650 if you haven’t met your deductible yet. Knowing that number is important because you should always aim to have enough money in your savings account to cover your deductible in full.
2. Whether referrals are needed
Some health insurance policies require you to get a referral from a primary care provider before you’re allowed to see a specialist. Failing to obtain that referral could mean having your insurer deny a claim for treatment, so it’s important to find out how your policy works.
In some cases, you may have to visit your primary care doctor before getting a referral. However, if you’re up to date on your well visits, they may be willing to give you a referral without making you come in.
3. Which providers are in-network
Seeing an out-of-network provider could cost you a lot more money than seeing an in-network provider. Before you start scheduling medical appointments, find out whether the doctors you already go to are in-network with your insurer. If not, you may want to start asking for recommendations so you can stay in-network and keep your costs down.
4. What your insurer’s preferred lab is
Insurers often contract with different labs to provide diagnostic services. It pays to find out what your insurer’s preferred lab is. Going to a different lab could result in higher bills for you.
Information like this is generally available if you log into your account online. But if you’re confused, just call and ask to speak to a live person to get the right details.
5. Whether your plan is HSA-eligible
A health savings account (HSA) is a special account that lets you contribute money on a pre-tax basis to pay for medical expenses. Unlike FSAs (flexible spending accounts), HSAs do not require you to spend down your plan balance every year. Rather, you can invest the funds you don’t need right away and grow your balance.
To qualify for an HSA, your health plan needs to meet certain criteria that can change from one year to the next. This year, your plan is HSA-eligible if it has a minimum deductible of $1,600 for self-only coverage or $3,200 for family coverage. Your plan also has to have an out-of-pocket maximum of $8,050 or less for self-only coverage or $16,100 or less for family coverage.
Learning how your health insurance works could spare you a financial mess. Take the time to get your policy’s details straight if you’re a new enrollee.
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