Set up account online: There are several good reasons to set up an account with your health insurance company’s website. The website gives you access to your billing and payment information. That is the best way to set up recurring payments for your premium. You also can view the details about your benefits and see claims as they are processed. It’s much faster than waiting for the paper forms to come to you through the mail. You just need the member number/policy number from your insurance card to get this set up.
Copay benefit: Many policies offer a copay benefit for services such as a doctor visit, urgent care visit, or prescriptions. Most other services that do not have a copay will be applied to the deductible on your policy. Your deductible always starts over at the beginning of the year.
Don’t forget Form 1095-A: If you received a Premium Tax Credit (PTC) from Healthcare.gov in 2022, then you will be sent a tax form 1095. This form provides details on the amount of PTC that you used. Your tax preparer will need it to complete your 2022 tax return.
DENTAL & VISION BENEFITS
Some health insurance policies offer dental and vision benefits for children. But once your child turns 19, they are no longer eligible for this benefit. You can add a dental or vision policy for them at any time. These policies are not purchased through healthcare.gov. We have several insurance companies that offer dental and vision plans. The most important criteria is to find out which plans are in network with your dentist or vision provider. Cost is the number one reason why people avoid seeing the dentist. An insurance policy can help solve that issue.
INFO ABOUT YOUR PRESCRIPTION DRUGS
What is a formulary? A formulary is a list of prescription drugs that are covered by your health insurance plan. Within the formulary, each medication is assigned to a Tier level. A typical formulary has 5 tiers. Tier 1 is preferred generic drugs, Tier 2 is other generic drugs, Tier 3 is preferred name brand drugs, Tier 4 is other name brand drugs, and Tier 5 is specialty drugs. Formularies will vary and there can be additional Tier levels. Not all medications will be included on a formulary. The cost that you will pay for the medication is usually determined by what Tier it is.
How can you lower costs? Drug manufacturers may offer copay cards or other discount programs to help lower the cost of an expensive medication. There are also many prescription discount websites that may offer a lower cost than your health insurance plan. We frequently hear about Good Rx and SingleCare. Keep in mind that when you purchase a medication through a discount program, it will not be applied to your health insurance plan’s deductible or maximum out-of-pocket.
BEHIND THE SCENES
Enjoy the behind-the-scenes fun we had making videos in 2022.
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!
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