Helpful Insurance Tips for 2018

posted in Office News

As the New Year approaches, it’s always a good idea to take an inventory or review of your health insurance and note any changes that may affect your coverage. Some will have a new insurance company altogether, while those that stay with the same company may have some subtle policy changes. That’s why we always recommend a review of your health insurance coverage for the New Year.

Some simple steps that have been recommended to make your New Year transition easier are:

1. Review your new or updated health insurance policy carefully. This document will tell you which services are covered, to what degree they are covered, as well as any exclusions.

2. Make sure you have your new insurance card if your plan changes. Even if your insurer has not changed, you may have a new group number. It’s also a good idea to keep your old card, in case you have any questions on any claims from the previous year.

3. Check to make sure your doctors are still participating in your network. You can always call ahead or send us your new insurance information, so we can assist you with your insurance questions. Although we always strive to get the most current information, it is ultimately the responsibility of the patient to verify your insurance coverage.

4. Check to make sure your co-pay/co-insurance has not changed since last year. A co-payment is the amount you are responsible for at each office visit. The co-pay is to be paid on the day of service. For example; some plans may have a flat co-pay per visit, while other plans may waive your co-pay after your annual deductible or out-of-pocket has been met. Co-insurance is the percentage of allowed charges that you are responsible for at each office visit. For example, if your policy has a 70/30 co-insurance, the insurance will pay 70 percent of the office visit leaving the remaining 30 percent for the patient.

5. As more and more insurance companies are offering policies with higher deductibles, it becomes very important to know and understand what your total deductible is. Being that a deductible is the amount that the patient must pay before any insurance benefit is paid, it’s easy to see why knowing your deductible becomes paramount. For example: if your policy has a $1000 deductible, the patient is responsible for the first $1000 in medical expenses before the insurance will start to pay.

6. For those who receive their medical coverage through Medicare, there are a few changes on the horizon as well. The most glaring of these is that as of April 2018, Medicare will no longer use your social security number on your card. The social security number will be replaced by a new Medicare Beneficiary Identifier (MBI). These new cards will be mailed to the address on file with the Social Security Administration. This number will need to be provided to the office in order to process claims.
For additional information on what is new for Medicare in 2018 please refer to the following link or call 1-800-MEDICARE (1-800-633-4227).
Also, standard Medicare Part B premium and deductibles for 2018 will not change. However, there have been changes to the Part B premium for individuals and couples with higher incomes. For more information refer to this link,

These are just a few suggestions that might make navigating your health insurance policy a little easier this year. Keep in mind we are always here to help. We wish everyone a healthy and happy New Year!!

Practice Manager