Your health insurance plan uses a network of doctors, hospitals and other providers. It is extremely important to use providers that are in your network. If you go to someone that is not in the network, and it is not an emergency, your policy probably won’t cover the charges and you will be responsible for the fees associated with the service that you received.
It may be possible to get approval to use a doctor that is not in your network. A request must be submitted to your insurance plan. If there are no providers in the network that can provide the care that you need, then an out of network doctor may be approved.
The easiest way to find out who is in the network for your plan is to search the online directory of providers. The URL is provided on the back of your insurance card.
IMPACT OF MEDICAID “UNWINDING”
The Public Health Emergency (PHE) for Covid-19 has ended. During the Covid-19 PHE, Medicaid suspended its guidelines that required people to verify their eligibility to continue their benefits. That meant most people stayed on Medicaid until the end of the national emergency. Now Medicaid has reinstated the eligibility verification process.
There will be individuals that no longer qualify for Medicaid and will be notified that they are losing their benefits. This is happening across the country and is identified as “Medicaid Unwinding”. Those who lose Medicaid are eligible for a Special Enrollment Period to apply for health insurance coverage through Healthcare.gov. If you know anyone that is losing Medicaid benefits, please refer them to a ComPro agent to help them find an affordable health plan.
PROTECTION FOR HIGH OUT-OF-POCKET EXPENSES
Most of the policies that are available in 2023 on Healthcare.gov have a maximum out-of-pocket expense of $9,000 or more. “Maximum out-of-pocket” means that this is the maximum you would be responsible to pay for your own medical expenses. The most for a family is usually $9,000 X 2 = $18,000. OUCH!! Thankfully, most people don’t pay that much, but it can certainly happen when anyone must be hospitalized, has surgery, or is dealing with a chronic medical condition. Most of the time, the hospital bill is the biggest issue.
There are ways to protect yourself by reducing the risk of having to pay $9,000 with a Hospital Indemnity Plan. This is a separate insurance policy that will reimburse you for hospital expenses. Paying a small premium for this coverage can save you thousands.
MEET JEFF JOHNSON
ComPro welcomes our newest agent, Jeff Johnson, to the team. He will be servicing our Individual and Senior Benefits clients. Jeff is a lifelong resident of Lincoln and has been in the insurance industry for over 20 years as a multi-line agency owner and as a servicing agent. He has a great love for the outdoors. And has enjoyed the honor of being the Master of Ceremonies for multiple Ducks Unlimited events!
HOW CAN WE HELP?
Got questions about or need assistance with your health insurance? We’re always happy to help! Just give us a call at (402) 488-5100 to set up an appointment with one of our licensed insurance agents.
WE’RE HIRING!
Know someone that would be a good fit for our ComPro Team? We’d love to meet them! For info about our current job openings, click here.
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