The end of the year brings many things—the holiday season, anticipation for the new year, and for most of us, updated insurance plans. While you may be insured through your employer or have insurance of your own, chances are your benefits for 2020 will differ from your current package.

As your coverage changes, it’s important to understand how to best utilize your new plan as well as where you can find assistance understanding your coverage. 

Frequently Asked Coverage Questions

Health insurance and coverage can bring up a spectrum of questions, especially if your coverage and/or provider has changed. We've broken the most common questions down into three categories: Providers, Prescriptions, and Emergencies

1. Providers 

When it comes to changes regarding a healthcare insurance plan, providers are usually the first topic of conversation.. 

• Will I Be Able to Go to The Same Provider? 
  

Most insurance companies have what's known as ‘in-network’ providers. These providers have contracts with insurance health companies and associated clinics. You’re still able to see ‘out-of-network’ providers but they typically have higher out-of-pocket charges. Check your policy as some plans also offer patients the opportunity to see an out-of-network specialist at an in-network rate if a primary care provider gives you the referral. 

•  How Do You Find A Provider in Your Health Plan? 

The following tips can help you find out which health care plan is covered by your provider:

1. Check out the provider directory on your healthcare plan's website. 
2. Contact your insurance company
3. Contact your provider

•  I don't know the number for my insurance company?

Take a look at your insurance card to see what company your coverage is through. Once you know who your insurer is, you'll be able to find information about what providers in your area you can visit. 

•   Will Voyage Healthcare Cover My Plan? 

Voyage Healthcare accepts most major insurance plans. Take a look at our list of insurance carriers. 

2. Prescriptions

Health care plans can cover a variety of medicines, but should your coverage change, your prescription brands and pharmacy benefits could, too. 

• Am I Still Able to Get My Medications? 

Yes, certain prescriptions are usually on your health care plans’ approved list, although there may be a medication that is no longer covered by your new plan (whether it's a brand name or generic). You should still be able to purchase the medication you want as long as you have a valid prescription, but it could be at a higher rate or cost more out-of-pocket than options on the approved list. Contact your insurance provider, review the contents of your coverage and the summary of your benefits to find out what is part of your plan.

•  My Pharmacy Says My Plan No Longer Covers my Prescription Pick-Up, What do I do?   

Depending on the insurance company you are with, they will decide where you can get your prescription from, but most will offer you a one-time refill after changing your coverage. If you aren't able to get that one-time refill, you can discuss the next steps with your provider. You might want to follow your insurance company's exceptions process — it's recommended to contact your company for information about their exceptions process.

•  My Exception Process Was Denied, Now What?

Most health insurance plans have an appeals process where a decision can be reviewed by a third party if you have been denied your prescription. 

•  Does My Pharmacy Change With My Insurance Coverage? 

Check your insurance website of your insurance company to find out which in-network pharmacies near you offer home deliveries in your area. 

3. Emergencies

Accidents and emergencies can happen when we least expect them. We've compiled a few common questions regarding insurers and hospitals that should help you stay prepared:

• If I have an Emergency, Do I Need to Call My Insurer Before Going to The Hospital? 

No, if you're in a life-threatening situation or dealing with a severe illness or injury, seek attention at your nearest emergency room or hospital, immediately. Insurance companies cannot request prior approval before you find medical care with a provider.

•  I Went to an Out-Of-Network Hospital For an Emergency, Will I be Charged More? 

Whether you go to an out-of-network hospital or an in-network hospital, insurance companies can't make you pay more in copayments. Copayments could be different between in-network and out-of-network hospitals and providers, but this should be listed in your plan.

•  What if You Are on a Plan Without Co-Payments?

You will have to pay out of pocket, but only up to the amount of your out of pocket maximum.

Voyage Healthcare Makes It Easy To Get The Healthcare You Need

We do not accept every healthcare plan, but we have a long list of insurers we work with as well as varying types of programs for those who are not insured. We provide monthly payment plans like PrimaCare Direct for those wanting to access healthcare without having to deal with copays and deductibles. 

We're ready to help you with your healthcare needs throughout the year, whether your insurance changes or not! Schedule an appointment with your provider today!