As coaches, we get a lot of questions from people trying to understand their insurance coverage. From prior authorizations to deductibles, coinsurance, and patient assistance, many moving parts need to align to maximize our healthcare benefits.

To help gain some clarity around all things insurance, Tami is joined by Doctor of Pharmacy Dr. Chelsea Liebowitz. A pain patient herself, Dr. Chelsea also works for an insurance company making determinations on prior authorizations and helping with self-funded plans.

In this conversation, Dr. Chelsea and Tami discuss her pharmacy background, understanding the open enrollment period, defining common insurance terms such as deductible and copay, the relationship between your premium and your deductible, recognizing that the best plan really depends on how you utilize healthcare, differentiating between an HMO and a PPO and why a PPO is often better for someone with chronic illness, why insurance plans vary widely from one employer or individual to another, how to find out if your medications and treatments are covered when choosing your insurance, when a secondary insurance plan can be helpful, understanding drug tiers and how copay cards work, applying to a drug manufacturer for patient assistance, why you might need prior authorization for certain medications, getting insurance on the exchange, the benefits of working with an insurance broker, the prior authorization process, how you can increase your odds of having certain medications and procedures approved by your insurance company, Dr. Chelsea’s advice for reducing your headache woes, options to consider when insurance doesn’t cover your medication, and more.

While this discussion focuses on the US healthcare system, many of the ideas and concepts apply to other countries and healthcare options. If you’re confused and overwhelmed by all the insurance options, this episode is for you.

 

 

Note: This episode is not meant to be medical advice. Every person and every situation is unique. The information you learn in this episode should be shared and discussed with your own healthcare providers.

To learn more about the resources mentioned in this episode, visit the show notes.

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