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Coverage Transition/Renewal To-Do’s

Although January 1st is not the start of a new benefit period for everyone, it is for the majority of people, so let’s review the tasks associated with new coverage and coverage renewal. If you have a coverage transition later in the year, please refer back to this list.

Terminating Coverage

  • If you are terminating coverage, notify the soon-to-be former insurer of the last month of coverage to be in effect. Also be sure to terminate any automated payment arrangements associated with that coverage. This does not apply to active group coverage through an employer or union because the employer will handle this task.
  • If there is information on your portal such as pending claim information which you may lose access to when you have new coverage, download and save the most current information which will be available to you.

Transition to New Coverage

  • If you are transitioning to new coverage you pay for, make sure payment is set up and for the correct amount. Auto-debit accomplished through the insurer’s portal is the best way to handle this in our opinion because any change in future premiums will be updated automatically.
  • If you’re expecting a new member I.D., be on the look-out for the new card or cards. If you don’t have cards within 10 to 14 days into the new benefit period, follow-up to determine the status of your enrollment.
  • Register for all new online portals. Many individuals have separate portals for:
    – medical coverage
    – prescription drug coverage
    – a flexible spending account
    – a health savings account
    – a health reimbursement arrangement
    – dental coverage
  • Those on Medicare should have online portal access, as applicable, to:
    – a mymedicare.gov account
    – a Part D Plan account
    – a Medicare supplement account
    – a Medicare Advantage account
    – a retiree medical account
    – a Private Exchange
    – a health savings account
  • If as a result of new coverage you want to change to a new primary care physician (PCP), make an appointment so that you have a relationship with that physician before you need a referral. This is especially important if your new Plan requires a PCP referral to see a specialist. You typically can’t do this before you have a new I.D. card which is why receiving the new I.D. card is so important.
  • When you have new coverage, in addition to informing all doctor’s offices when you have a visit about the new coverage, provide your pharmacy with the updated information when you fill a prescription. If you have medications that will require a prior approval before filling, ask your prescribing physician to put in this request as soon as the plan is active.
  • If you have family coverage with dependents between 18 and 26 years old on the Plan (and older in some states), and you want to be able to communicate with the insurer on their behalf, have the dependent complete and sign an authorization which is typically found on the insurance company website portal, and submit it to the insurer.

We help manage coverage for our ongoing clients but not everyone wants or needs that type of service. However, in our view, there are many aspects of coverage that require your attention to manage properly. Those who do not take the time to set up on-line tools and become familiar with them are at a disadvantage when someone in the family experiences illness or injury or any other unexpected large claim or bill. We implore you to take our advice and be attentive to these issues. .

Please watch the video. We also want to wish you and yours a joyous holiday season. Thanks!