REVIEW YOUR HEALTH PLAN DETAILS

First things first

You completed your application through HealthCare.gov and signed up for a plan. What’s next? 
  • Pay your monthly premium. If owe a premium for your health plan, you’ll get a bill from the health insurance company. You must pay the amount every month to maintain your coverage.
  • Find out when your coverage starts. If you enrolled in a health plan during open enrollment, your coverage may start on Jan. 1, Feb. 1 or March 1. If you enrolled during a special enrollment period, your coverage may start sooner.
  • Watch for your health insurance ID card. This card is mailed to you and it includes information about your health plan. Carry this card with you when you go to the doctor, hospital or pharmacy.

Learn about your health plan

After you sign up for a health plan, you’ll receive information about your new health plan from the health insurance company. Be sure to check the following:

  • Read your plan’s Summary of Benefits and Coverage (SBC). It gives you an overview of what the plan covers. For example, you’ll find a list of health services and the costs you may pay if you use an in-network provider or an out-of-network provider. Where to get it? You can find this information online or view the printed copy sent out by your health insurance company. To help you access this information when comparing plans, beWellnm’s Plan Finder has links to the following documents:
    • Summary of Benefits
    • Plan Brochure
    • Provider Directory
    • List of Covered Drugs

Note: If you have any trouble viewing these documents, please call your health insurance company to request your Summary of Benefits and Coverage.

  • Be familiar with the costs you may pay, including the monthly premium, annual deductible, copays and coinsurance. Learn more about health insurance costs.
    • A premium is a monthly fee for health insurance. 
    • The deductible is the amount of money you pay before your plan starts to help you pay your bills. 
    • A copay is a payment you make at the doctor’s office, urgent care clinic, ER or the pharmacy. Example: A $20 copay for doctor visit. 
    • Coinsurance is a percentage of costs you pay for your health services. Example: A bill for 20 percent of the cost of surgery. 
    • The out-of-pocket limit is a limit on the amount you have to pay annual for covered health services. Once you reach this limit, the plan will pay 100 percent of the cost of covered services.
  • Learn about in-network vs. out-of-network care. If your health insurance plan has a network of providers, you’ll pay lower costs when you get your care from a provider in the network. Learn more about choosing a provider in the network.