Just about everyone will experience at least one of these two events in their life: a change in health status or losing a loved one. These life events are already difficult on their own, but they can also cause complications to your health coverage. Having a new diagnosis or change in your health status can mean new doctors, more appointments, and additional costs. Likewise, losing a loved one can change your access to coverage at the worst time, when there are a million other things on your mind. If you are faced with either of these situations, here are a few things to keep in mind to help you avoid any added distress:
Change in Your Health Status
- A new diagnosis might mean you have new doctors or specialists you need to see. It is essential that your care team, particularly your primary care provider, is aware of all the other doctors who are treating you and what medications you have been prescribed. Additionally, it’s important that everyone on your care team is communicating with one another before changing your course of treatment or prescribing new medications. In addition, double-check that each new doctor you see is in-network with your insurance plan to help mitigate financial surprises.
- A new course of treatment may require pre-authorization with your insurance plan. Ask your doctor what services they anticipate you needing, and then call your insurance prior to treatment to ask about coverage details or requirements.
- With additional prescriptions, ensure there are no conflicts with your current medications. You should notify the pharmacist or your doctor if you are getting medications from multiple pharmacies so they can cross-reference all your prescriptions for safety.
Loss of a Loved One
- You will need to notify your HR, or health insurance plan, in order to remove a family member from your coverage. Failure to do so can result in premiums at the current family rate for a period that is longer than necessary. If your family member was on their own insurance coverage, you will want to notify the insurance plan as soon as possible to ensure their healthcare claims are processed correctly and that their account does not go into default for a missed premium payment.
- If you are insured under a deceased loved one’s medical coverage through an employer plan (with more than 20 employees), you will be offered COBRA coverage via a letter in the mail.
- Loss of your coverage is a qualifying event to open up a ‘Special Enrollment Period’, which allows you to purchase individual health insurance through the Marketplace.
- Finally, you will want to consider updating your beneficiary information and privacy permission settings. For example, if you had a spouse listed as your emergency contact with all the doctors and your insurance company, you may want to now list a child or sibling with these organizations.
Hopefully, this list of considerations will help you avoid any financial surprises in addition to the changes you are already navigating. Caribou is always happy to assist with healthcare planning when you are faced with complex choices or big changes.
Last Revised September 9th, 2022
