It’s that time again! A new year means new insurance cards and resetting benefits. So, I want to take a moment to go over some important information that you may find helpful.
- If you receive a new insurance card, please bring it with you to your next appointment. You can also email a picture of said card to email@example.com. We need the new card in case there has been a change to your insurance ID #. This helps us when we re-verify your benefits for the new year.
- When your benefits reset at the first of the year, so does any deductible or out-of-pocket-max that you may have. If you had previously met your deductible or out-of-pocket-max, you will need to meet them again (whether you have one or the other or both). For example, if you have a deductible of $2500.00 with a co-insurance of 90%/10%, meaning that your insurance covers 90% of the cost of your covered care with you responsible for the remaining 10%, then you will need to meet the $2500.00 deductible again, before your insurance covers the 90%. This typically means that you will pay the contracted insurance rates, out of pocket, which are determined by your insurance provider, until your deductible has been met. This can look very different to what you had been paying the previous year. However, if you are prepared, you can move forward confidently and make an informed decision about what will work best for you. Another example would be a $200.00 deductible with a $25.00 copay. Even though your insurance benefits have reset, you will still only pay your $25 copay and, depending on how your plan works, whatever copayments you make may count towards your deductible.
- Annual Number of Visits – Depending on your insurance plan, you may have a specific number of allotted visits per year. For example, if you had 40 visits to use last year and you used 38, then that number would reset with your other benefits at the beginning of the new year, bringing you back to 0 visits used.
- Wellness Covered Medical Necessity – With the reset of your allotted visits that are covered, it is important to know whether your insurance plan covers maintenance care or if your coverage is based on medical necessity. This can impact the cost of your care and how you may want to approach your visits. If your insurance is based on medical necessity and you have already completed your treatment plan, meaning that you are coming in for once monthly wellness visits, it does not matter that your allotted visits have reset. Your wellness visits will not be covered by your insurance and you will still fall under cash rates. If your coverage is not based on medical necessity, meaning that wellness visits are covered for you, then your annual number allotted visits will reset and you can continue using your health insurance to cover your care.
- Payment Plan Options – At Absolute Health, we never want finances to get in the way of you receiving that care you need. We offer flexible payment plan options that we can tailor to best fit your financial needs. If you have any questions or concerns, please feel free to call in or speak to me at the front desk. I am more than happy to help!
Insurance can be confusing and, at times, even frustrating. Please know that you are always welcome to ask any question related to your insurance and chiropractic care. We will do our best to help you understand your policy and the benefits that come along with it. I hope you find this information helpful!