Changes to expect when you get new health insurance

Health insurance plans have grown increasingly expensive, and many employers shop around regularly in order to save money as well as keep prices affordable for their employees. This could mean that at the start of every new year, individuals have a new insurance card in their pockets and a new plan to learn.

Over the last couple of years, annual increases of around 9 percent in insurance costs have been the norm. While the rate of increase going from 2011 to 2012 was lower, at about 5.5 percent, according to information from CNN Money, that is still around a 2 percent difference in the rate of inflation and salary growth. Due to these rising costs, employees are bearing more of the financial burden of paying for health insurance by paying higher deductibles and co-payments.

When adapting to a new health insurance plan, people can take the following steps to make the transition easier.

Understand the type of plan you have

Health plans are largely broken down into two main categories: HMOs and PPOs. All managed plans contract with doctors, hospitals, pharmacies, and laboratories to provide services at a certain cost. Generally this group of medical providers is known as a "network." HMOs, or health management organizations, require you receive most or all of your health care from a network provider. You also may need to select a primary care physician who oversees and manages all of your health care requirements, including approving referrals for tests or approving visits to specialists.

PPOs, or preferred provider organizations, create a list of preferred providers that participants can visit. You will not need to select a primary care physician and likely won't need referrals to visit specialists. Should you choose to stay in-network, you will pay only the co-payment required. However, you also have the option of going out of your network, and will have to pay the co-insurance, which is the balance remaining for the doctor after the PPO has paid their share. Many plans will cover 70 to 80 percent of the out-of-network bill, and you will be responsible for the rest.

HMOs are the least expensive option, but they're typically the least flexible as well. For those who have a family doctor who is in-network and will not need to see doctors outside of the network, it is financially beneficial to go with an HMO. Those who routinely see specialists or want greater say over when and where they can go to the doctor, a PPO is a better option.

Having said this, understand the type of plan your employer is now offering. If you will be using an HMO, you may have to find an entirely new set of doctors to see and should be ready for this reality.

Take note of co-payment and co-insurance changes

It is generally the patient's responsibility to know what is expected of him or her at the time of payment. Doctors take many different plans, and some prefer not to manage the terms and conditions of each and leave it up to the patient to understand the specifics. As such, you should know your co-payment requirement for tests, office visits, lab work and the like. You will be responsible for making these co-payments at the time of your visit, as many doctors no longer bill for co-payments. Failure to pay the correct amount could result in penalties or even refusal of service.

Also do not assume that a provider is in-network. There may be subtleties and subdivisions of certain insurance plans. It may seem like one doctor takes your insurance, but it may not be your particular plan. Confirm that the doctor is in-network prior to visiting to avoid any unforseen bills.

Notify your doctor of new insurance

Many insurance plans will start coverage at your sign-up or anniversary date, others may begin January 1st. Notify your healthcare provider as soon as possible as to the change in coverage. This protects you if they are behind in billing and paperwork by helping you avoid additional out-of-pocket expenses resulting from billing the wrong insurance company.

Learn about annual exams

A new plan may wipe the slate clean with respect to how frequently you are entitled to yearly physicals or specialized tests, such as mammograms or prostate exams. When your insurance plan changes, investigate when you are able to go for routine exams and if you will have to pay a co-payment. You may want to schedule a physical at this time to start the new year on a healthy note.

Many people find that rising insurance costs necessitate insurance carriers frequently. This can be a hassle, but a necessary chore of today's managed care world.