1. Check your coverage every year.
When you were selecting your health insurance plan, you may have used the Summary of Benefits and Coverage (SBC) to compare plans, coverage and costs. Now that your selected coverage is in force, read through your policy to make sure you understand what is covered under your insurance policy and how much your costs will be throughout the year. Even if you didn’t make any changes to your coverage, plans can change year to year.
There can also be changes in your provider network. Find out why it’s important to check your network periodically and how to do it. Download our convenient coverage checklist to keep all of your information in one place.
2. Know the terms used in your policy.
The formal tone and unusual words in your policy may be daunting at first, but it’s worth taking the time to learn the definitions. Commonly used terms like “formulary”, “co-payment” and “deductible” will sometimes be defined within your policy, but if they are not, you can check out our list of commonly used terms.
3. Know your healthcare rights.
If your health insurance plan denies a medical service, you have a right to appeal the decision. Also, mental health conditions and substance use disorders must be treated equally as other health disorders. If you have questions about these or other policyholder rights, please contact the Louisiana Department of Insurance at 1-800-259-5300.
4. Work with your doctor on any prescription changes needed.
Just as your coverage can change year to year, an insurance company’s formulary (the list of prescription drugs they cover) can change at any point (usually month to month). As new drugs are created and older drugs are released as generics, you can work with your doctor to ensure that you are taking the best drug for your needs and situation.
5. Keep your contact information up to date with your insurance provider and the Marketplace.
Your insurance provider and the Marketplace will need to communicate with you throughout the year regarding statements, your subsidy if you receive one, and possible changes to your policy. Both your insurance company and the Marketplace should make every effort to contact you with necessary information, but it is ultimately your responsibility to keep your contact information updated and to read and address all communication sent to you.
If you purchased insurance through the Marketplace (healthcare.gov) be sure to keep your contact information up to date.