Whether your employer has changed insurance carriers or you are securing new Long Island health insurance for yourself or your business, it’s important to understand the major changes that go along with this. Specifically, your in network doctors and more importantly, specialists you may need in the future for a major illness or sudden trauma. While it is very common now for employers to change health insurance carriers annually in an attempt to keep health insurance costs as low as possible, the changes “under the covers” may be quite dramatic with regards to your care.
Here are some things you need to research in order to be prepared to deal with a major health issue:
-Is your new plan HMO or PPO based? Meaning, is it an in network or in/out of network plan?
-If your plan supports out of network doctors, know what your out of network deductible is. Meaning, how much do you have to pay out of pocket before the insurance company pays for 100% of your treatment costs?
-If your deductible is high, have you secured a supplemental insurance solution (e.g. Aflac) to help deal with these out of pocket expenditures? Contact us for more information on these types of products
-Is your new plan “gated?” Meaning, do you require a referral in order to see a specialist?
-Have you checked to see if your primary doctor(s) accepts your new health insurance plan?
-Know who your specialists are. For example, the Neurology Institute at New York Presbyterian Hospital is the 4th overall ranked neurology facility in the US. Do the specialists there accept your new plan? You’d be surprised at how many carriers they DO NOT accept. Look into this.
Having a plan in place to deal with major illnesses or trauma is very important for you and your family. Should something onset for you, the last thing you will want to worry about is digging through provider directories trying to figure out the best doctors that can help you, to say nothing about hitting the “We do not participate” brick wall.
Be prepared. Have a plan.