Tis’ the Season – and not just to celebrate the holidays!

My Patient Rights > Tis’ the Season – and not just to celebrate the holidays!

Tis’ the Season – and not just to celebrate the holidays!

Every year at this time, it is also open enrollment season. A time when you should evaluate your current health plan, making sure it meets your needs and those of your family.

You might ask, “Won’t my health plan stay the same if I just continue with the one I had last year?” Not necessarily.

To help you make informed choices, the California Chronic Care Coalition, as part of its My Patient Rights program, created the ‘Choose Smart California’ health plan checklist. This guide gives you the necessary tools to ask the tough questions that must be answered before selecting a health plan.

Health plans regularly make changes to coverage, which may have a big impact on your care and raise barriers to treatment. These changes can include restricting access to specialists, limiting physician networks (such that your doctor may no longer be part of the plan), or removing your drugs from coverage.

For instance, Express Scripts and Caremark, companies that handle pharmacy benefits for more than 200 million Americans, are removing more than 90 prescriptions from their list of covered medications at the end of 2018.

Could your medications be on that list?

The Choose Smart California checklist is easy to use and provides a simple outline of the questions you should be asking before you select a new plan, such as:

  • What ongoing care do I need, and is it covered?
  • Are my current medications covered?
  • Can I afford the care I need?
  • When do I need prior authorization for treatment?
  • Are there caps on my benefits?

It is important that you, as a consumer, carefully scrutinize the details as to what is and what isn’t covered in your health plan before you make a choice.

And while you are in the process of selecting your health plan for 2019, you should also familiarize yourself with the rights you have as a patient.

Just as health plans routinely change what they will and won’t cover, they often times inappropriately deny patients medicines, treatments and testing prescribed by their doctors.

Whether it’s choosing your health plan for 2019 or knowing your rights as a patient and getting help filing a complaint when those rights are violated, you should visit the My Patient Rights website at www.MyPatientRights.org.

Do it today to ensure you get the health plan you need!

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Know Your Rights

State and federal law protects your rights. When you sign up for a health plan and/or if you have problems accessing care through your health plan, it is important to know your rights.