The salary on your job offer is the most important, and we would argue insurance benefits is the second most important. There is a great quote by Patti Smith: “You can never pay too much for a peace of mind.” Well, with your work benefits, you may not need to pay for a peace at all. Here’s a brief guide to help you make the most out of your benefits.
You started your job and got a list of health plans. What now?
You need to start by selecting the plan that suits your needs. Employers often offer several tiers, and each tier includes different services or levels of coverage to accommodate every employee. For example, if you don’t think you need orthodontic treatments this year, then you should consider a lower-priced tier instead of paying for full coverage. If you need to get orthodontic treatments later on, you can upgrade your coverage when you renew your insurance information at the end of the year. Plan ahead and check your terms to make sure you’ll only pay to get access to specific services when you need them.
Tip: Don’t pay coverage for services you don’t plan on using.
Have a partner? Coordinate your benefits.
If your spouse or common-law partner is also paying for health insurance, pick the coverage that best fits your family’s needs and opt-out of the other one. However, if you’re expecting hefty health-related costs in the future, then you should keep both health insurance plans to take advantage of both benefits. Coordination of benefits allows your family to use both plans and to get reimbursed for eligible expenses when certain costs exceed your maximum coverage.
Tip: Coordinate your benefits with your partner.
Do you need to pay out of pocket for procedures?
Depending on your plan, you might. This is called coinsurance, or co-payment, which is the portion of the costs that you have to pay out of your pocket. Generally speaking, coinsurance can range from 20% of the costs for most plans, up to 50% for specific treatments.
Tip: Read your plan’s documentation carefully to learn which services incur higher coinsurance rates.
Always keep your receipts!
Keep your receipts for claiming costs from your health insurance, but also, you may be able to use them when filing your income taxes to lower your tax payment. Depending on your level of income and total health costs, you may be eligible to deduct the coinsurance portion of your medical expenses.
Here are some common eligible expenses:
· Dental services and implants
· Orthodontic work
· Eyeglasses and contact lenses
· Prescription drugs
· Qualified medical practitioner services (e.g. chiropractor)
Tip: keep your receipts for 1) health claims and 2) tax season.
How can you handle claims?
Some healthcare providers offer direct billing to the insurer so you don’t have to pay up front. But if your clinic does not offer this method, it’s not much of a big deal. Some clinics will instead submit the claim on your behalf, and will let you know whether you owe any amounts due to deductibles and maximums. The advantage of paying up front for your services is that most clinics accept credit cards. This allows you to accumulate a substantial amount of rewards or “travel miles” on your card. You will likely receive your insurance reimbursement before you even receive your credit card bill. In the event you need to submit a claim yourself, insurers now allow you to file online or through a mobile app, expediting the reimbursement process.
Tip: Don’t postpone your claim, there may be a time limit to submit it.
Plan to change jobs?
If you are about to switch employers, use up the remainder of your coverage before you leave. At your new job, you might need to wait a period of time before you can use your health benefits.
Tip: When switching employers, don’t leave unclaimed benefits behind! (Use your free massage benefits!)
Planning is key
Most health insurance plans reset your spending limits on a yearly basis, usually at the end of the calendar year. If you don’t use your benefits, you will lose them. Make sure to plan your appointments ahead, so you can max your benefits every year. You should also keep track of when you last claimed expenses. For example, with eyeglasses or contact lenses expenses, you are only covered for a pair every two years. By keeping track, you could avoid paying 100% of the cost out of pocket.
Tip: Schedule appointments ahead, and keep track of your expenses!
Hope this guide has helped you understand your insurance a bit better. Stay healthy!
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