When you get care, it helps to know what you can expect:
Getting Care at the Doctor’s Office
Present your medical ID card at your doctor’s office. If you're enrolled in the Silver coverage level, you can wait to pay until your insurance carrier processes the claim and you get your doctor's bill.
Have an HSA card or a Health Care FSA card?
You can use your HSA or Health Care FSA debit card at your physician's office, dental provider, and vision provider. If you have funds on your HSA or Health Care FSA card, you can use it to pay for your visit. The funds will be taken directly from your account. If you receive a bill from a provider, you can also use your debit card to pay over the phone or by mail.
Filling Prescription Drugs at a Retail Pharmacy
Present your medical ID card each time you drop off a prescription. If payment is due, you pay out of pocket. Or you can pay with your HSA or Health Care FSA debit card if you have one.
Know When You’ll Owe
If your doctor bills services as preventive care or your medication is listed as preventive on the formulary, you’ll owe nothing. For other types of covered services or non-preventive prescription drugs, you could owe a deductible, copay, and/or coinsurance.
Remember: You’ll Pay Less With In-Network Providers
You can check the provider directory on the ABC at asurion.benefitsnow.com or refer to your insurance carrier’s website.
If a doctor is out-of-network and you still want to see them, check the cost with the doctor before you get care.
Then, ask the doctor to confirm the portion that will be covered by your medical insurance carrier and the portion for which you will be responsible.
That way, you’ll be prepared for potentially significant costs.
Remember: Not all options cover out-of-network care.