For people with eczema, it is especially important to have health insurance that will help cover expected and unexpected healthcare costs. Learn the basics, understand what type of insurance will work best for you and how to make the most of your insurance plan.
Guide to Selecting an Eczema-Friendly Insurance Plan
There are many factors to consider when choosing a healthcare plan while managing a chronic condition like eczema. Since everyone’s eczema is different, it’s important to consider what your individual management approach looks like long term in addition to treating active flares as they arise.
Understanding the resources available to you and choosing the most cost-effective plan tailored to your situation can help ensure your eczema-specific needs are covered. Below are some key insurance tips to consider as you review your health plan options.
Figure out your open enrollment period.
This is a set time period once a year when you can enroll in a new health plan or make changes to your existing plan. Jot down when your specific enrollment period is so you can plan ahead and review plans.
Learn more about open enrollment and other insurance terms you should know
Estimate how often you go to the doctor in a year.
Based on the previous year, how many times a month are you visiting a provider? How many different providers are you visiting? Get a baseline for how much medical care you need regularly over the course of a year. This will help you know what you need your insurance coverage to actually cover for your personal needs.
Estimate your current prescription needs and costs.
How many prescriptions do you have and how often do you need to fill them? Get a sense for how much you spend on prescriptions over the year.
Look closely at the cost for deductibles, copays, coinsurance and other expenses.
Review plan costs for deductibles, copays, coinsurance, prescriptions, urgent care, hospital stays, etc. How much is the deductible, also known as the amount you will have to pay before the health plan pays? What are the copays, the fixed amounts you will pay for certain services? Will you have to pay coinsurance (a percentage of the costs) for certain services? Using your personal estimates for prescription costs and doctor visits, you can get a better idea of how much each plan will cost you.
Additionally, eczema is associated with several known comorbid conditions, including a significant impact on mental health. These additional considerations can add to your list of anticipated healthcare services and out-of-pocket costs.
Learn more about financial resources for prescription and medical costs
Review the list of available doctors and other healthcare providers on each health plan.
Make sure you check that your current doctors and providers are covered under the plan you’re interested in. Or if there is a new provider you want to visit, check to see if they are covered under the plan — and if they are accepting new patients.
You can find this information on your selected insurer’s website. Or, if you are already insured, you can call the phone number on your insurance card to confirm. You may also call your doctor’s office or check their website to see which plans they accept.
Make sure your current prescriptions are included in your plan.
When shopping for a health insurance plan, it’s important to check the prescription drug coverage. This is especially important for people with eczema. It is important to note that while a prescription may be included under your health insurance plan, your insurer has measures in place to assess whether they will provide coverage for the medication. These measures, which can delay access to the drug, include prior authorization, step therapy and drug tiering.
Be sure to consider this when changing or selecting a new health insurer and how their policies may affect your prescription costs. You can find this information on the insurer’s website. Or, if you’re already insured, you can call the phone number on your insurance card to confirm.
Learn more about common insurance roadblocks and how to overcome them
Consider if you might be changing prescriptions in the future.
Have you been talking with your healthcare provider about changing your eczema treatment? If you’re considering making a change in your therapies it’s a good idea to discuss with your provider before open enrollment. This will give you time to review the prescription coverage in your plan.
Make a list of anticipated expenses and/or diagnostic tests that you need.
If you have any anticipated or planned medical procedures or diagnostic tests, it’s critical to make sure they’re considered in the plan you select. If they’re not covered, you may have to pay out of pocket. If possible, you should select a plan that covers these anticipated needs (regardless of if they’re for your eczema or something else). Have a conversation with your healthcare providers to have a better understanding of your healthcare needs for the upcoming calendar year. You may also consider any changes they may anticipate to your treatment approach within the next year to help you assess your needs.
Take advantage of tax-free dollars for health expenses.
This can be done through a flexible spending account (FSA) or health savings account (HSA). Each of these options lets you set aside money on a pre-tax basis to pay for qualified medical expenses such as deductibles, copayments, coinsurance and prescriptions. You can estimate the amount of money you may want to contribute to one of these accounts to cover qualified medical expenses.
Start early and compare your plan options.
Start reviewing open enrollment materials as soon as you get them. Review the details of each plan and see what makes sense for your needs. It’s a big decision to make — so give yourself plenty of time!
Download our “Checklist for Selecting an Eczema-Friendly Insurance Plan” PDF
