6 Questions after "I have insurance. Now what?"

Hey there! My name is Matt Bickley, and I’m the Director of Operations at Apollo Insurance Group. Apollo is a fantastic group of advisors that can help you find the best health insurance plan for your budget and needs. Honestly, our agents are the best of the best. However, my concern today isn’t with them. My concern is with all the questions you may have after they help you.  

Apollo’s clients can always call our office for any help that they need – we have an entire support staff just for them. Even if you don’t want to call, though, we can still answer some of your burning questions. Here are six of the most common questions we get asked and their answers. 

1. When will the money come out of my account/who do I pay? 

Unfortunately, each carrier is different when it comes to payments. Some carriers have specific payment dates; no matter when your effective date is, the draft date won’t change. Other carriers allow you to choose the exact date you would like to have the money withdrawn. Some carriers will even let you mail a check. It is always best to check with your agent and the carrier to make sure your payments/bills are posted and withdrawn on a date that you are aware of. 

2. Where do I get my ID cards? 

Most carriers will mail out physical copies of your ID cards. One important thing to remember is that they will NEVER mail your ID cards until AFTER you make your first payment. If you're worried about having access to it, then you can create a portal through the carrier’s website to access an electronic copy. 

3. What doctors/hospitals can I go to? 

It will depend on the carrier, but it’s easy to find out. Each insurance carrier has what’s called a “provider search”- here is Ambetter’s as an example. A provider search will let you find all covered providers under your plan in a specified area. For example, I can plug in my zip code and put a 20-mile radius around my location. Then, I can search for hospitals that are near me that are in-network with my insurance plan. That will create a list of all the available in-network hospitals within 20 miles of the zip code I plugged in. 

4. Will my plan cover my prescriptions? 

Every single insurance plan on the market is different. Some cover prescriptions, some do not. It is always recommended to ask your agent/broker if the plan you have includes prescription benefits. Another important thing to remember when it comes to prescriptions is that not all prescriptions are eligible for certain plans.  

Every carrier has what is called a “drug formulary”- here are the formularies for UnitedHealthCare as an example. This allows you to search the specific prescription, dosage, and frequency to see if it is covered. There are also different tiers of prescriptions. You have generic, brand name, non-preferred brand name and specialty drugs. Each one has a different level of coverage which is subject to the summary of benefits of the specific plan you have. 

5. What do I do with this insurance bill? 

The first thing you want to do if you receive a bill that does not look correct is contact your health insurance agent/broker. At Apollo, we have a dedicated claims team that would be able to step in and assist in the event where there were claim issues. Our claims team does not cost our clients any money to utilize, and we like to be hands-on in assisting with the claims process. If you are a client of ours and are having claim issues, then please reach out to your agent so we can step in. 

6. Can I get coverage outside of open enrollment? 

YES! Depending on the coverage you are seeking you may have to have what’s called a Qualifying Life Event (QLE) in order to apply. Different examples of these QLE’s are moving, losing group coverage, having a child, getting married or divorced, becoming a US citizen, leaving incarceration, and several others. If you ever have questions about whether you qualify for one of these QLE’s, then please reach out to us through our contact form here. We will happily help you in any way we can. 

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