Insurance 101 — Get to Know Your Coverage in the New Plan Year February 13, 2025 As the new year rolls in one thing that should be high on your priority list is reviewing your health insurance plan and understanding your coverage. Whether you’re continuing with the same policy or starting a new one, take time at the beginning of the year to assess your plan. This can ensure that you are making the most of your coverage, avoiding surprises and staying on track with your health care needs. Here are key things to keep in mind: Review Your Policy for Changes Health insurance plans can change year to year. New premiums, deductibles, copays and coverage limits can affect how much you pay and what services are covered. At the start of the year: Check for Premium Changes: Make sure you know how much your monthly payment will be. Understand Deductibles: These reset annually, so it’s important to know how much you will pay out of pocket before your coverage begins. Look at Network Providers: Health plans can update their list of in-network doctors and hospitals. Verify that your preferred providers are still covered. If you are a Samaritan Health Plans member, visit the Find a Provider page and select your plan to search for a specific provider. Understand Your Benefits & Coverage Every year, insurers are required to provide an updated Summary of Benefits and Coverage. These documents are usually found on the benefits page for your plan. It’s crucial to read through this document to understand: What’s Covered: From routine visits to specialized care, review what services are included. Preventive Services: Many plans offer no-cost preventive care, including vaccines, screenings and annual check-ups. Schedule these early in the year to stay on top of your health. Coverage Limits & Exclusions: Be aware of services that may have limitations or aren’t covered at all, so you can plan accordingly. Check for New Programs & Discounts At the start of a new year, health plans sometimes introduce new wellness programs or incentives that encourage healthier living. These can include: Fitness Reimbursement: Some plans offer partial reimbursement for gym memberships or fitness classes. Wellness Incentives: Programs that reward healthy behaviors, like smoking cessation or meeting fitness goals, may provide financial benefits or discounts. Reevaluate Your Prescription Coverage Prescription drug coverage can change annually, and certain medications may no longer be covered or could have increased copays. At the start of the year: Review Pharmacy Networks: Make sure your preferred pharmacy is still in network to avoid higher costs. Check the Formulary List: Ensure that any regular medications you take are still covered. Consider Generic Options: If brand name medications have increased in price, talk to your doctor about switching to a generic option. If you have a Samaritan Health Plan and would like to check your prescription coverage in greater detail, visit the Find-a-Drug page and select your plan.
