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Tips to remember Medical Benefits

At the doctor’s office, have you been asked about the amount of your copay? Or has the receptionist questioned what is covered under your plan? There are a multitude of medical plans nationally, so it is difficult for the doctor’s office to know all the intricate details. With all the different terminology, it is even challenging for us to remember all our own benefits. However, there are a few simple ways to have your benefits accessible to you at any time.


Most insurance companies have mobile apps now, particularly the larger carriers. You can download the app from the insurance company’s website quickly. The catch is you have to be registered on the company’s main website before you can use the mobile app. It is beneficial to complete this process. On the mobile app, you will be able to lookup participating physicians, most have an urgent care locator. You can easily reference your coverage, benefits, and copies of your member id with the app too.


If you do not have wireless or the insurance company does not offer a mobile app, there are a few other ways to access your medical information easily. Most cells have picture capability, which you can use to your benefit. On enrollment and every year afterwards, the insurance plans send out Summary of Coverage documents. I’ve included an example below of a Summary of Coverage document.  Once you receive the summary, take a picture of each of the pages. This way you can easily forward benefit details to physicians or reference when questions arise. The information will be stored as a picture on your phone.


There is also the option of adding a note to your phone. This is a more manual approach, but completely worth the time to enter the information. You really only need to note a few items, such as member id, deductible, provider network phone line, referral requirements, medical copay, pharmacy copay, outpatient surgery copay, hospital admission copay, co-insurance %, and what’s not covered. Listing the services that are not covered is essential. If you need a service that is not covered under your plan, find out the total cost of the service a head of time, as you may have to pay the full cost in the end. You can work through this issue with your health plan, but always be prepared providers will bill you for services if the insurance company does not.


The last option is to keep your Summary of Coverage or a quick reference guide in your wallet. This information can be folded to fit in a slot for a credit card or in the same area as bills are stored. It might seem odd to carry this information in your wallet, since you don’t need regularly. The problem is when the moment arises you need your benefits, usually happens in emergencies, you don’t want  additional stressed trying to research your benefits. If you keep the information close, there will be little chance of confusion for your physician in regards to your benefits, when you have all your benefits ready in hand.

If you only have time to take away one tip for remembering your medical benefits, my last suggestion is to memorize or store the member benefit number. This information is usually listed on the back of your insurance card. If there is any doubt, it’s better to call your insurance company to check. A quick conversation should clarify any questions or concerns about services.

If you have any questions, please feel free to email me at healthcaredeciphered@gmail.com.

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