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Section A: General News


Determining your health-care coverage




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March 5, 2014 | 1,947 views | Post a comment

Determining the benefits and costs for plans on the Affordable Care Act’s health-care Marketplace can be confusing. Even after choosing a plan, many patients are still unclear about what kind of coverage they have and how much it will cost, and the insurance company isn’t always helpful. Here’s one common question.

My doctor can’t get a straight answer from my insurance company. How do I know what kind of coverage I have and if I can use my insurance?

There are a few things you can do before you visit the doctor’s office to prepare so you know what your benefits and costs are.

First, you want to make sure you’ve paid your premiums on time so that your insurance takes effect. Just signing up is not enough.

You can call your insurance company to get details on the plan you bought. Representatives at healthcare.gov should be able to provide you a contact phone number. Talk to a representative by calling 1-800-318-2596. Or you can use a list of Marketplace plan websites the Texas Medical Association compiled to find the phone number you need.

If you’re just now enrolling in a health plan through the Marketplace, either online or by phone, make sure you write down the member ID number you receive. You’ll need that number to check on your benefits when you call your insurance company. Or if you already received a member ID card, you can use that information when you call. Your insurance company also should send you a welcome packet after you enroll. That should explain what type of plan you bought and what your benefits and costs are.

Lastly, some health plans also have special websites you can use to verify your coverage with your member ID.

Information provided by the Texas Medical Association, www.texmed.org.
 

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Section A: General News Archives


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