Learn tips to ensure changes you make to your family’s health insurance don’t negatively impact your coverage.
Considering a change in insurance? Be thorough in your research.
Typically, most patients are allowed to update or make changes to their insurance coverage once a year, during an open enrollment period. If you are thinking about altering or updating your family’s health insurance in any way, please consider the following:
- Before altering or picking a new plan, always make sure Boston Children’s Hospital and your current Pediatric Transplant Center doctors are covered in the plan’s network.
- Read all of the plan materials thoroughly.
- Evaluate your health care costs when making your annual enrollment decisions, factoring in copays, deductibles, premiums, etc.
- Review the coverage for medication, and make sure you fully understand the cost of copays for prescription medications.
- Remember, once you have enrolled in a health plan, you likely will not be able to make changes until the next open enrollment period.
Referral? Who needs a referral?
If you are enrolled in an HMO plan you will need to get a referral before obtaining medical care from anyone except your primary care doctor. A referral is a written order from your primary care doctor for you to see a specialist or get certain medical services. If you don’t get a referral first, the insurance may not pay for the services. Make sure you know the scope of what your referral covers such as number of visits, time frame of visits, scope of services.
Government Sponsored Insurance
Are you covered by a standard Medicaid or a Managed Care Medicaid Plan from another state? Be sure that the plan allows you to have services at Boston Children’s Hospital. Some plans require that you have your local physician request authorization prior to your visit at Boston Children’s.
If after studying available plans and speaking with representatives from your insurance provider you are still unclear about options available to you, our office may be able to help. Please contact financial coordinator Angie Perry at 617-355-0137 or angela.perry@childrens.harvard.edu, or contact our new transplant financial coordinator Shannon Foley at 617-355-8319 or shannon.foley@childrens.harvard.edu.