New Health Plan Checklist: 6 Things to Know When Switching to Affordable Health Insurance
8 Minutes
Team Curative
Feb 23, 2024
Congratulations! You just switched to a new health insurance provider. Now what?
If you’re making the switch to an affordable health insurance provider, familiarize yourself with your new plan's features and benefits to get the most out of your health insurance coverage.
Whether your priority is routine doctor visits, preventive health programs, or specialized care, this six-point checklist will help you ask the right questions to navigate your healthcare coverage. Let’s dive in.
1. Find Providers In-Network
First, confirm which healthcare providers operate within your insurance network. In-network providers provide care to you and your fellow members at a discounted rate through a contract with your health plan. This reduces your out-of-pocket costs.
Most affordable health insurance plans have large networks of providers but double-check to be sure your previous physicians are included. If not, you’ll have to find a new in-network provider to ensure you get the most out of your health benefits.
You can usually find a list of in-network providers on your insurance company's website. Some of the best insurance plans provide in-house representatives to help you search for and find a provider that fits your needs.
2. Call Providers to Confirm Acceptance and Availability
Once you've identified a provider you like, contact their office directly. Verify that your provider of choice will accept your new insurance plan. This step can save you from unexpected costs and ensure you receive the care you need without unpleasant financial surprises.
While on the call, confirm that your new provider is currently accepting new patients. Research has shown that patients with private insurance tend to have high new patient acceptance rates.
3. Transfer Prescriptions to an In-Network Pharmacy
In-network pharmacies have negotiated discounts under your new health insurance plan like providers. If you take regular medications, transfer your prescriptions to an in-network pharmacy. This ensures that your medications are covered and avoids unnecessary out-of-pocket expenses.
4. Request Prior Authorizations
For certain medications and medical procedures, physicians need prior authorization from your insurance provider that your treatment or procedure is considered “medically necessary” and backed by acceptable research. Once your insurance authorizes coverage, the healthcare provider will proceed with treatment.
Without prior authorization, most affordable health insurance plans will bill you for the entire cost of medications and procedures if not in-network. For example, your new pharmacy may have stricter rules regarding prior authorization than your old one. Even if the medication in question is one you’ve been taking for years, understand the requirements before your medication runs out.
Pharmacy prior authorization timeframes range from days to weeks, so start this process early to avoid delays in your care.
5. Schedule Appointments
Once you've confirmed your providers and ensured all necessary authorizations, it's time to schedule your appointments. Some providers book far out, so get started on your appointments now.
Many practices use online self-scheduling systems for convenience and increased access to care. If your provider offers this option, it can be an easy way to take control of your schedule and get the care you need, when you need it.
If you are a new patient or prefer to speak to someone, it is often beneficial to schedule your first appointment by phone so that your provider can inform you of additional requirements for any treatment or procedure.
If you struggle to get connected or have a hard time with the process, don’t worry. Most affordable health insurance companies will help you schedule appointments or services through their member services teams or Care Navigators.
6. Understand Your Preventive Health Benefits
Get well-acquainted with your preventive health benefits. Most affordable health insurance plans cover regular check-ups and preventive care. There are several regular check-ups you should schedule, including:
Primary care check-ups
Dental cleanings
Mental health check-ups
Women’s and men’s care
Eye care and exams
Preventive health is key to maintaining overall well-being, so don't delay in setting up these appointments well in advance.
Curative Checks All The Boxes
Curative is an employer-sponsored health plan that actually delivers better health through affordability, engagement, and simplicity. No copays. No deductibles. No...really.
When you begin a new health plan with Curative, you'll receive all the support you need to navigate your healthcare journey. And yes, we check all the boxes.
Large Provider Network
At Curative, we want to help ensure seamless network participation and no disruption in care. We ensure members are connected to an inclusive list of nationwide providers, including those directly contracted with Curative, as well as through the following networks:
First Choice of the Midwest
Cofinity
Members in Texas who are 18+ have access to Curative Primary Care. Schedule virtual care from the comfort of your home or visit us in downtown Austin for in-person care.
Curative Primary Care services include:
Annual Check-ups
Routine Screenings
Vaccinations and Immunizations
Chronic Disease Management
Acute Illness Care
Mental Health Services
Women's & Men's Health
Medication Management
Referrals to Specialists
Nutritional Counseling
Lifestyle and Wellness Coaching Referrals
As a Curative member, you have access to our online network search tool. You can also reach out directly to your Curative Care Navigator or our member services team to help you find a provider that is in-network.
If your preferred provider is out of network, you can request they join Curative by:
Giving them this flyer
Emailing them this request
Sending them this form
Insurance Acceptance
With Curative, your visits will be completely covered with a $0 copy and $0 deductible cost.* All you need to do is make sure your in-network doctors have your new insurance card.
Curative Care Navigators are also available to help by reaching out to providers on your behalf should you need assistance.
Prior Authorizations
Curative is committed to your well-being and requires prior authorization for certain medical services and treatments. Curative prior authorization is granted by completing the medical and pharmacy prior authorization forms:
We ask for prior authorization to ensure you receive the best possible care, stay safe, and save money.
For a complete list of authorization forms, frequently asked questions, and additional resources, visit our prior authorization page.
Scheduling Assistance
Curative’s member support team is available 24/7 and a Care Navigator can reach out to a care professional to schedule an appointment on your behalf.
Members can receive virtual care through Curative’s telehealth partnerships:
Members in Texas - Access NormanMD for virtual urgent care and Televero for virtual mental healthcare.
Members outside of Texas - Access Teladoc for virtual urgent care and mental healthcare.
Curative telehealth is available by phone or video within 10 minutes, and no appointment is needed.
Preventive Care
Our health plan encourages preventive health from day one by encouraging members to complete a Baseline Visit with a Curative Care Navigator in the first 120 days of your plan’s effective date.
During your Baseline Visit, you will work with your Care Navigator to create a personalized preventive healthcare plan to reach your wellness goals. Prevention is the heart of the Curative plan, and you will love our features including:
One monthly premium
$0 copay, deductibles, and out-of-pocket costs
24/7/365 access to customer support Personal Care Navigator to support plan utilization
Wellness planning
Note that the Baseline Visit does not replace an annual wellness exam with your primary care provider. Be sure to schedule that appointment every year as well.
Our focus is simple — your optimal health. Curative’s health plan offers simple, intuitive, and integrated experiences designed for your needs. Learn more by visiting our website.
To see all disclaimers, please view here.
Resources
Cook, R. (Dec 2023). In-Network vs Out-Of-Network Insurance: What’s the Difference? Health News. https://healthnews.com/health-insurance/guides/in-network-vs-out-of-network/
Jensen, M. (Jan 2024). 14 Remarkable Ways Patient Self-Scheduling Can Benefit Your Healthcare Practice. DemandHub. https://www.demandhub.co/articles/patient-self-scheduling/
Ochieng, N. et al. (May 2022). Most Office-Based Physicians Accept New Patients, Including Patients With Medicare and Private Insurance. Kaiser Family Foundation. https://www.kff.org/medicare/issue-brief/most-office-based-physicians-accept-new-patients-including-patients-with-medicare-and-private-insurance/
Starc, A. Swanson, A. (2019). Promoting Preferred Pharmacy Networks. 1% Steps. https://onepercentsteps.com/policy-briefs/promoting-preferred-pharmacy-networks/
The Yale Wave (2023). 5 Self-Care Appointments to Keep on Your Schedule to Improve Your Health. Yale CampusPress. https://campuspress.yale.edu/wave/5-self-care-appointments-to-keep-on-your-schedule-to-improve-your-health/
