Health insurance

Health Insurance Plans Offer Added Benefits, But Using Them Can Be Challenging – Milford-Orange Times

By Trish Pearson
Insuring Your Future

Trish Pearson

Health insurance plans often include “extra benefits.” They can range from weight loss or smoking cessation in employer sponsored plans to dental, eyewear and over-the-counter medications for Medicare Advantage plans.

Reading through the brochures it all sounds great, but when it comes to using them it can be another story. It can be particularly challenging when the process for the benefit involves a computer.

The following are some tips to decrease the aggravation factor and make it easier to take advantage of the perks included in health insurance plans.

Medicare Advantage plans generally offer dental and eyewear benefits. Here are some items to consider when comparing plans: Does the provider need to be in network? Is the credit processed by the provider or do you need to pay and then be reimbursed? Is the benefit amount different if you use an out-of-network provider? Is the benefit limited to cleanings or does it include other dental procedures, such as root canals or crowns?

The over-the-counter medications and supplies benefit can be the most challenging. Some benefits can be used in a retail store such as Walmart or CVS, but some require you to order over the phone or online. The first step is to request an OTC catalogue. There may be different catalogues depending on the type of MAPD plan. These are available from your agent, or you can request one by calling customer service. They are generally available on the company website, but you can request a printed version.

Make sure that all retail locations of a particular pharmacy will allow you to use the OTC benefit. Bring the catalogue with you to the store. There are generally blue stickers that identify products that are eligible for the OTC benefit, but it is easier if you use the catalogue.

The most efficient way to order is over the phone or online. Recently there have been some issues with data security involving the third party that administers OTC benefits. Policy holders were sent a letter informing them of the incident. They are required to notify any party who could potentially be impacted by the event. It is not necessary to cancel your credit cards or change accounts. However, you should be vigilant about your credit activity by reviewing monthly statements and monitoring your credit report for unauthorized purchases. If you see any suspicious activity, notify the credit card company immediately and they will investigate for you.

Under federal law you are entitled to one free credit report every 12 months from each of the nationwide credit reporting agencies. You may receive a free credit report by going to or by calling 877-322-8228.

Many group plans offer a variety of wellness benefits such as diet and nutrition programs, exercise classes online and smoking cessation programs. These can be valuable benefits both for the employee and the employer as the company receives “credits” for participating which can turn into financial rewards for employees. It is not only good for your health to know about added benefits, but it can also be good for your pocketbook.

Trish Pearson is a licensed independent insurance agent and certified long term care specialist. Contact her at 203-640-5969 or [email protected].

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