After You Enroll, Review These Things
Once you’ve enrolled in a health insurance plan through the BeWell Marketplace we recommend taking these four steps to make sure you understand your plan and get the most out of your benefits.
- Watch out for your health insurance ID card in the mail. This card will be mailed to you and includes information about your health plan. Carry the card with you when you go to the doctor, hospital or pharmacy. The card may arrive a few weeks after your coverage kicks in. If you need care before then, call your insurance company. Generally, the insurance company can print out a temporary card or make another arrangement with you.
Review your Summary of Benefits and Coverage (SBC) document. This document gives you an overview of what your 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.
Generally, your insurance company will mail you this information, but you can also find it online. Learn how to read and understand your SBC.
- Get familiar with the costs you may pay. You will find all of this information in your Summary of Benefits and Coverage (SBC). Here’s a primer on the basic terms you will see:
- 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 maximum annual out-of-pocket limit is a limit on the amount you have to pay for covered health services annually. 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. Your insurance company will provide you with a list of in-network providers. Make sure you’re choosing from this list when you schedule appointments.
