Choosing your health insurance plan is a crucial decision because, as everyone knows, living with and treating diabetes is expensive. Here are some things to consider during the Open Enrollment Period.
It is important to preview and compare plans to ensure that your current plan is still the best fit for you. Many insurance plans change their coverage benefits and premium costs each year, and may also change their preferred in-network providers and preferred medications. Utilize any tools that your employer or plan provides to help you analyze your out of pocket costs. If you have options, pay attention to monthly premiums and maximum out of pocket costs when comparing plans.
The cost of doctor visits, lab tests, insulin, test strips, meters, pump supplies, continuous glucose monitors, and so on adds up fast. The sooner you reach your deductible; the sooner your insurance company will pay a larger share of your medical expenses in most cases.
When considering your 2020 health insurance options, it is important to ask your benefits administrator or a plan representative the following questions:
What supplies and medications are covered?
What tests and medical services are covered?
What is the yearly deductible (the dollar amount you have to spend on your medical bills before your insurance company starts to help pay)?
What are the copays (a fixed dollar amount that you pay for each doctor visit and prescription drugs)?
What is the coinsurance (the percentage you pay for certain healthcare services once you hit your deductible)?
Does my physician of choice participate in the plan?
Do I need a referral or authorization for specialist (i.e. endocrinology) services?
Is my endocrinologist considered a specialist?
Can I see multiple providers in one day?
Are coordination of benefits properly arranged if I am insured by more than one active medical plan?
How can I open a health savings account (a tax-advantaged savings account used to help pay high deductibles) or flexible spending account (a tax-free spending account for certain out-of-pocket medical costs)?
Do I have access to a health advocate or diabetes case manager?
Other helpful insurance-related resources for people with diabetes include:
American Diabetes Association
National Institute of Diabetes & Digestive & Kidney Diseases: Financial Help for Diabetes Care
The Center for Consumer Information & Insurance Oversight
Staying on top of your diabetes management means staying on top of your insurance coverage. Picking the right plan might be one of the most important decisions you make for 2020.