I have learned a lot of valuable lessons about planning and preparing for medical care and insurance. Nick has a family history of medical issues, and is on several maintenance medications, I have Fibromyalgia, and a family history of medical issues, and Aaron has his plethora of special needs, requiring multiple specialist visits throughout the year. In the past, I have waited until September to start gathering information to prepare for the next year’s insurance enrollment, but then, sometimes I’d be rushed to get everything figured out with plenty of time to complete before our deadline. In recent years, I’ve begun to keep a spreadsheet for each family member. This allows me to keep up with how often we see particular doctors, what the copay was, is it a repetitive visit or a one time thing, etc. It makes it SO much easier to make sure we have enough money going into our flexible spending account for the new year. Here are some tips, that work for me, and hopefully will help some of you:
Know What Your Benefits Are: It is important to know exactly what your plan does and does not cover, how much the copay is (percentage or dollar amount), and if there is a limit on the number of visits to a particular type of specialist. Consider medical doctors, eye doctors, dentists, and any mental health benefits you may use.
BUDGET and plan for expected care: Our well check visits are covered 100%, so we just need to plan for sick visits (I include at least 2 per person), specialist copays, shots and vaccinations, blood draws or cultures, eye glasses and lenses, dental care (FREE visits, but budget for 1 cavity each), and prescription costs (I budget the KNOWN amount for meds we take monthly, and then add in some extras for when we’re sick).
Know the cost difference between care facilities: Obviously, the best option is primary care, which for us is $10. However, if something is URGENT and we can’t get in, we have the option of paying $50 to go to an urgent care facility. The ER for us, is a minimum copay of $100, but 10% of the bill. So, if the total bill was $150, we’d pay $100. But, if it was $1500, We’d pay $150. It’s a good reminder to ONLY use the ER for true emergencies.
Prevent: Make sure you get your annual health screenings. We are fortunate that all of our well checks are covered at 100%, for medical, vision, and eye care. By going for your well checks, your doctor can get to know you when you are WELL, so they have a baseline for comparison when you are sick. It’s also essential for early detection of many things, so that they can be treated, maintained, and/or cured..
Resources: Many insurance companies, such as Cigna, offer a 24/7 Nurse line that will answer questions and address concerns 24/7. I have used this service several times, when immediate access to a doctor or nurse through our primary care wasn’t immediately available.
“I participated in a campaign on behalf of Mom Central Consulting on behalf of Cigna. I received a promotional item as a thank-you for participating.”