Be proactive on annual insurance renewals. Losing your insurance benefits can be very detrimental to yourself or your loved one. Those with Medicaid must complete forms yearly to stay active or your insurance will “lapse” or be “termed.” These are both terms to indicate you no longer have an active insurance plan. Ask your insurance company if you can be assigned to a case manager (or benefits manager) – this is someone who works for the insurance company who helps to oversee and coordinate your case, so that things don’t get lost. A good case manager acts as an advocate for you because, over the years, they will learn what medications you have tried that have worked or that haven’t. A case manager who has a good relationship with you can advocate for you when things come up like denials of payment for medications or procedures. Also, a case manager can help you to understand your co-pay and deductible requirements toward your insurance – which is vital information! Some of the medications for complex disorders are quite expensive and understanding your deductible requirements can make a huge impact on your health and your wallet.
Lastly, ask if your clinic has access to a social worker or case manager you can work with to help you to sort out issues with insurance rejections, applying for disability if necessary, or for looking into other resources in the community. Be proactive annually when looking at your benefits and coverage! Make sure you reach out to the representative for your insurance plan during open enrollment to discuss any questions upfront and how to navigate if coverage of a specific medication or test will be changed. Furthermore, understanding co-pays and deductible plans is essential. Remember, co–pays are forever so do not be shy if a higher deductible is cheaper over the year. There are benefits to both. For those with commercial plans, your human resources benefits department should be able to answer most questions you have, too.