Feb. 11, 2015
This week, Texas Medical
Association’s (TMA’s) “Hey, Doc” educational campaign about the health
insurance marketplace addresses one part of insurance that many people don’t
like: Paying premiums. People with health insurance must pay their monthly bill — the premium — to keep the policy in
force. Once you pay your premiums, you can think about using your insurance for
a doctor visit, but how do you know what
kind of coverage you have, and whether
you can use your insurance? TMA’s “Hey, Doc” explains:
Why is it important that I
pay my marketplace insurance premium on time?
you buy your insurance, you pay a set monthly fee, called a “premium,” to make
sure it’s there for you when you need it. But for your insurance to actually
work, you have to pay that premium on time.
you don’t, you could be responsible for paying your entire health care bill out
of your own pocket. Not paying your premiums on time also means you could miss
out on other financial help for your medical bills.
up for an insurance plan is step one. And having a marketplace insurance ID card
does not necessarily mean you have active insurance coverage unless you are
paying your premiums. Once you sign up, your insurance company will tell you
when your payment is due. It will usually be the same time each month,
depending on when you first signed up. Most health plans also offer different
ways to pay your premiums, like by check, money order, mail, or automatic
How do I know what kind of
coverage I have and if I can use my insurance?
are a few things you can do before you visit the doctor’s office so you know
what your benefits and costs are.
you want to make sure you’ve paid your premiums on time so that your insurance
takes effect. Just signing up is not enough.
health plans in the marketplace must provide a summary of their benefits and
coverage, which you can review on Healthcare.gov,
or talk to a representative by calling (800) 318-2596. You can also call your
insurance company to get details on the plan you chose. TMA has a list of
marketplace plan websites and phone numbers to help.
you’re just now enrolling in a health plan through the marketplace, either
online or by phone, make sure you write down the member ID number you receive.
You’ll need that number to check your benefits when you call your insurance
company. Or if you already have a member ID card, you can use that information
when you call. Your insurance company also should send you a welcome packet after
you enroll. That should explain what type of plan you bought and what your
benefits and costs are.
some health plans have special websites you can use to verify your coverage
with your member ID.
Marketplace Plan Websites
and Phone Numbers
See each week’s “Hey, Doc”
Q&A and a lot more at texmed.org/Heydoc as well as in TMA’s patient
blog at MeAndMyDoctor.com. TMA produced
“Hey, Doc” videos to help people understand how to navigate the marketplace.
TMA is the largest state medical society in the nation, representing more than 48,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.
phone: (512) 370-1381
cell: (512) 656-7320
phone: (512) 370-1382
cell: (512) 650-5336
Click here to follow TMA on Twitter. Or visit TMA on Facebook.
Check out MeAndMyDoctor.com for interesting and timely news on health care issues and policy.