Have you recently enrolled or been offered to enroll in a group health plan through your employer? If so, this can be a great opportunity for you and your family to enjoy crucial benefits. Of course, when enrolling in group healthcare (or any health care plan, for that matter), making sure you’re making the most of your benefits is a must and by following just a few simple steps, you can make that happen.
Understanding Your Plan
First and foremost, it is important to make sure that you understand every last detail of your plan. In order to do this, you will need to obtain a complete copy of your benefits from your employer. As you read through your benefits, pay special attention to certain factors, such as:
- your co-pays and deductibles
- any waiting periods you may be subject to
- possible dental and vision benefits
- physician choice
By knowing the details of your current coverage, you’ll be less likely to run into unpleasant surprises down the road such as high out-of-pocket costs for a particular procedure.
Always Think Ahead
All too often, once an employee has successfully enrolled in a group health plan, he or she can forget about it—until a medical problem arises and he or she needs to use it. Waiting until you’re facing a medical issue to start asking questions about your coverage can be a recipe for disaster. Instead, being proactive and asking important questions as soon as you have them can prove beneficial in the long run.
For instance, in the event that you become injured during an out-of-state on vacation, will it be possible for you to find care outside of your coverage area? And if you’re admitted for a hospital stay, is there a limit as to how many days will be covered under your existing coverage?
Enrolling In An Adaptable Plan
Life may be unpredictable, but it’s important to do everything in your power to make sure your group health care plan can adapt to your changing needs over the years. For example, you may be single now, but how will your benefits change if you were to get married? What if you had a child? What if you find yourself divorced at some point down the road? Knowing what to expect from your health benefits in these types of situations now will help better prepare you for inevitable changes later in your life.
Denied Claims: What To Do
Lastly, should you run into any issues with your healthcare provider, you should be aware of the proper procedures and protocols available to you to follow. For instance, as a covered individual, you have the right to receive a decision in regard to your claim within a specific time period— if your claim is denied for any reason, there will often be a specific series of steps you will be able to follow in order to file an appeal. Your benefits manager can help you explore these steps if ever necessary.
Making the most of your group health care benefits may require some proactive thinking and effort on your part but will be more than worth it down the road. If you have missed your group enrollment deadline or are losing coverage, there may still be an opportunity to enroll.
To learn more, please visit www.membershealthplan.com.
