Getting the Most from Your Insurance Benefits at Year End
The end of the year is almost here. If you have met your insurance deductible and out-of-pocket maximum for 2020, the cost of healthcare services could be reduced by up to 80 percent. That’s a big incentive to follow through on making that first counseling appointment—or to squeeze in a few more before January 1.
Not sure if you’ve met your deductible? The best way to find out is by contacting your insurance provider. If the thought of calling your insurance company is cause for anxiety, you’re not alone. Figuring out your insurance plan can sometimes feel like trying to learn another language.
But the more you know about your plan benefits, the more you can take advantage of them. After all, your insurance plan is there to keep you healthy and well. Make sure that it works for you by following these four steps before calling your insurance company:
Know Your Insurance Terms
Insurance plans can be filled with unfamiliar words. The Center for Consumer Information and Insurance Oversight has a helpful Glossary of Health Coverage and Medical Terms to help you better understand your insurance benefits. This resource also includes a helpful illustration on how cost sharing works between you and your insurer.
Some of the terms to know before contacting your insurer include deductible, co-payment, coinsurance and out-of-pocket maximum. After you meet your deductible, your plan will likely require you to pay a co-payment or coinsurance until you satisfy your out-of-pocket maximum. In other words, there may still be a charge for covered services—but it will be far less after your deductible is met.
Know What Questions to Ask
Contacting your insurance provider can be overwhelming if you don’t know what questions to ask. Here’s a quick checklist to get you started:
⦁ What outpatient mental health services does my plan offer?
⦁ Do I have a deductible?
⦁ If yes, has it been met?
⦁ If it has been met, do I have a co payment or coinsurance?
⦁ If so, what is the amount?
⦁ Do I need a prior authorization before my first appointment?
You may also want to reach out to your Human Resources or Benefits department to see if your employer offers an employee assistance program. If they do, you will want to find out how many outpatient mental health sessions are covered.
Remember to specify that you are asking about outpatient mental health services. Benefits are not the same for inpatient and outpatient care.
Know How to Contact Your Insurance Provider
Speaking with a representative from your health plan is the best way to get the information you need. But it’s not the only method available to you. Many insurance providers offer a chat function on their website. In addition, you should be able to access your explanation of benefits and other information from your insurance provider’s website to check the status of your deductible.
Know That You Can Reach Out to Us for Help
At Compass Point, we are here to support and guide you. If you’re feeling unsure about calling your insurance provider, contact our billing department. One of our billing specialists will walk you through what you need to ask so you can feel more in control. You can reach our billing department at 513-906-5505.
Get Started Today
The end of the year is fast approaching. No matter what method you use to contact your insurance provider, do it soon. Your deductible will reset to zero on January 1. We’ve included links to the Contact Us pages of the top five insurance providers here:
⦁ United Healthcare
Don’t be afraid to reach out to your insurance provider for information. It’s your insurance plan. You deserve to get the most from the benefits that are due to you.
Charles Roberts , Ed.D, LPCC-S, LICDC-CS
United Healthcare: https://www.uhc.com/contact-us
CP blog: https://www.compasspointcounseling.net/blog/october-13th-2020