Make Sure Your Doctor Takes Your Obamacare Plan
The simplest way to test your Health Care Reform insurance plan is to get an annual physical and refill an existing prescription. The annual checkup will require setting an appointment to see your physician, so you will be able to determine if the doctor is in your provider network.
Many people called their physician’s office to find out what networks the office would accept before they picked an Obamacare health insurance plan. However, 90% of Californians have group health insurance through their employer. Simply asking the doctor’s office which networks they accept usually results in getting the name of the group networks, not the individual networks.
When you check in for your appointment, tell them you have new insurance and give them your new card. They may be able to tell you right then if they can accept it. If not, you will find out once you receive a bill from the doctor’s office for any charges associated with your physical.
The new Obamacare health insurance plans all provide no-cost preventive care, including an annual physical exam and typical labs.
Check Your Prescription Coverage
This involves refilling your prescriptions at the pharmacy. Most typical medications will be included on each insurance companies’ formulary. However, some my not be preferred brands, and could result in a larger co-pay.
If you have a Bronze health care reform plan, do not expect to have a co-pay for your prescriptions. Bronze plans provide no benefits until after you reach a $5,000 combined medical and prescription deductible. If this is not what you were expecting, then perhaps you should look at getting a Silver plan.
With a Silver, Gold, or Platinum plan you will get immediate coverage for generic drugs, and after you reach a small brand name prescription deductible ($250 to $500), you will then have a co-pay for brand name drugs..
What If Your Plan Does Not Provide The Coverage You Thought It Would?
After you’ve had your annual physical and refilled your prescriptions, you can now see how your current Obamacare insurance will work. If you had problems with the coverage, your Physician did not accept the plan, or your prescriptions were not covered, then it’s time to get a different plan.
During the initial open enrollment period, from October 1st, 2013 to March 31st, 2014, you can change plans to find one that fits your needs. The plan that is in-force on April 1st, 2014 will be the plan that you must keep until January 1st 2015.
There are a number of qualifying events that allow you to change coverage outside of the enrollment period, however disliking the plan is not one of them.
Test Your Obamacare Health Insurance Before It’s Too Late
The best time to make sure your new health insurance works is right now. This way you have time to schedule a visit to your physician, get the explanation of benefits statement from the insurance company and any bills from your doctor’s office, and determine if the Obamacare plan will meet your needs for 2014. If not, then you have till March 15th to apply for different coverage that will start on April 1st.
If you are not sure how to find a plan your physician accepts and which covers your medications, then you can ask us at SPF Insurance. Our advisors can make this an easy transition for you that won’t take much of your time.