1. Do your research to know what kind of coverage you can get.
The fall is when most people must make decisions about their health care plans for the coming year. In order to understand your coverage options, it’s important to begin your research well in advance. First, determine who is providing your health insurance. Is it provided through your employers, will you buy it on your own, or are you eligible for Medicare? Once you answer this question, focus on information specific to your situation. You can use our annual health insurance check-up table for tips on deadlines and important questions to ask.
2. This year’s Open Enrollment dates are different.
The open enrollment period for 2020 is October 15, 2019, to December 7, 2019. If you do not elect coverage by December 7, you will be unable to get healthcare coverage unless you qualify for a Special Enrollment Period due to a life change like marriage, having a baby or losing other coverage. Coverage for plans sold during Open Enrollment will start January 1, 2020.
3. 2020 plans will vary from the plans offered last year.
Plans can change from year to year and some plans that were available last year may no longer be available. Review your options closely to decide what plan may work best for you. Even if you choose to stay with the same health plan you had last year, you should be aware that there may be changes.
4. Be sure to check the doctors and hospitals in a plan’s network.
With each health plan you consider for 2020, make sure to check for your choice of doctors and hospitals. Coverage that includes the hospital across town, but not the one down the street, may not be the best option for you. To watch a video on what to look out for, click here.
5. Understand your right to appeal a service denial.
If your health insurance plan denies a medical service because it views the treatment as not medically necessary, you have a right to appeal the decision with the health plan. You also have a right to obtain and review copies of all documents relevant to the claim and to submit comments and supporting documents relating to the claim.
The Louisiana Department of Insurance does not make determinations of medical necessity. If you have questions about navigating the appeals process, you can download Understanding Your Healthcare Rights and contact the Office of Consumer Advocacy and Diversity at 1-800-259-5300.