When you get care, it helps to know what you can expect:
Getting Care at the Doctor’s Office
Present your medical ID card at your doctor’s office to get discounted rates. If you're enrolled in the Bronze or Bronze Plus coverage levels, you can wait to pay until your insurance carrier processes the claim and you get your doctor's bill.
When it's time to pay, you can pay with your HSA, FSA, or pay another way—it’s your choice!
Filling Prescription Drugs at a Retail Pharmacy
Present your medical or prescription drug ID card each time you drop off a prescription. If payment is due, you pay out of pocket. Or you can pay with your HSA or FSA if you have one.
Know When You’ll Owe
If your doctor bills services as preventive care or your medication is listed as preventive on the formulary, you’ll owe nothing. For other types of covered services or non-preventive prescription drugs, you could owe a deductible, copay, and/or coinsurance.
Remember: You’ll Pay Less With In-Network Providers
You can check the provider directory on NMGbenefits.com or refer to your insurance carrier’s website.
If a doctor is out-of-network and you still want to see him or her, check the cost with the doctor before you get care.
Then, ask the doctor to confirm the portion that will be covered by your medical insurance carrier and the portion for which you will be responsible.
That way, you’ll be prepared for any potentially significant costs.
Remember: Not all options cover out-of-network care.