• Margie Mason

Navigating Insurance: Picking a Course and Setting Sail


HAPPY NEW YEAR!! Did you know that many insurance plans reset annually? Instead of being caught by surprise or allowing this to take the wind out of the sails let me give you some practical tips on how to navigate insurance plan changes and how to maximize your insurance benefits.


There are more options than ever before when choosing insurance. Many tend to choose the least expensive plan which can often time offer an affordable monthly rate. This is a great option for many who do not utilize their insurance much. If you need to make use of your insurance more regularly, though, I suggest taking a closer look at plan specifics to help make sure you avoid unexpected financial obligations.

First, I recommend familiarizing yourself with some basics. Insurance plans are typically set up with annual deductibles, co-pays or co-insurance, and out-of-pocket maximums. These can range from a couple of hundred dollars to thousands of dollars depending on the plan- making the amount you are responsible for or the amount you have to pay before the insurance kicks in extremely high. These details are important to review each year as plan details change from year to year.


Second, get familiar with what providers your insurance covers in your area. “Providers” is a broad term that includes people like doctors, therapists, chiropractors, etc.- basically, it stands for any individual providing you a physical or mental health service.


As the population grows throughout North Carolina, you want to make sure you have plenty of options for any medical services you may need. Otherwise, it might be hard to find providers with availability. I strongly recommend you familiarize yourself with who the providers are nearest you.


Finally, make sure you understand if you have in-network benefits and/or out-of-network benefits. Some providers can accept your insurance and file claims directly with your insurance while others are what is known as out-of-network. You *may* have to pay more out of pocket if they are not in-network. Also, it’s important to be aware that some insurance plans will not cover any provider who is not considered “in-network” with your insurance plan. You will want to call member services or review the insurance benefits packet your insurance company provides you.


Insurance changes are inevitable, but I hope this outline helps you consider some of the important details you may want to consider when looking at your insurance plan, so you can make the most informed decision- setting you up for “smooth sailing.”



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