Selecting a new health plan that is right for your health and budget is an important part of healthy living. Now that you’ve made your selection, there are things you need to do to ensure the transition to the new plan goes smoothly. These steps can prevent disruption to your care, limit out-of-pocket expenses, and help you maximize your benefits.
Revisit Your Benefits
Refreshing your understanding of what’s covered by your plan is a good idea throughout the year, especially at the start of a plan year. Your best source of information is your health plan’s Summary of Benefits and Coverage (SBC). It’s an easy-to-understand overview of benefits and coverage provided by a health plan. Health insurance companies are required to provide this document for all plan types. We know this document can be intimidating so we put together a guide defining terms, sections, and key information. You can view the guide here. Familiarize yourself with your plan’s coverage and benefits for the most value and cost savings.
Additionally, you’ll want to check to see if there are any pre-existing condition rules. The Affordable Care Act (ACA) prevents insurers from denying coverage or charging more for pre-existing conditions. But there are exceptions. Grandfathered health plans — plans in place on or before March 23, 2010 — aren’t required to have the same ACA protections. Check to see if your new plan falls in this category and what that might mean for you.
Take Advantage of Online Resources
You don’t have to worry about bringing your plan materials on the go with you. VEBA members can access their plan information online at MyVEBA or through the MyVEBA app. Download the MyVEBA app for Apple or Android. Use this app to:
- Save ID cards for yourself or your dependents
- See your current health plan(s)
- Review your SBC
Transfer Medical Records
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), only you or your representative has a right to access your medical records. Providers and health plans can send your information to another provider or plan if it’s needed for care or payment — otherwise, you’ll need to permit them. If you’re changing PCPs, you’ll want to submit a Medical Records Transfer form or Medical Records Release form. Call your PCP’s office, and they can get one to you.
Choosing the Right Primary Care Provider
Health happens beyond the doctor’s office, but meeting with your Primary Care Provider (PCP) can make all the difference in managing your overall well-being. Your PCP is your go-to resource for preventive care, specialist referrals, and personalized support, ensuring your care is consistent, coordinated, and aligned with your goals.
If your plan is a Health Maintenance Organization (HMO), your PCP will also help manage referrals, ensuring you only receive medically necessary care.
Here’s how to pick your PCP:
- Use the provider search tool at www.vebaonline.com/benefit-contacts/
- Contact our Advocacy Team at 888-276-0250 or through an online form at www.vebaonline.com/contact/. Be sure to have the following information ready:
- Name
- Date of Birth or Social Security Number
- Medical Group
Is your new plan a Health Maintenance Organization (HMO)? HMOs typically require that you get referrals from your PCP to see specialists. That way, they can coordinate your care and make sure you’re getting what’s medically necessary.
Note: If you don’t select a PCP, one will automatically be assigned to you. You can change your PCP and medical group anytime during the year, but you cannot change your benefits plan.
Update Your Contact Information
Making sure your new plan has the right contact information for you is important. The goal is not to enable the insurance company to contact you unnecessarily. Rather, it’s to make sure that you receive plan information, claims are processed smoothly, and you get timely notifications.
Here When You Need Us
The VEBA Advocacy Team is here to help you navigate the healthcare system—whether it’s accessing care, dealing with referrals and prior authorizations, or making the most of your VEBA benefits for you and your family.
If you have any questions, contact our Advocacy Team at 888-276-0250 or visit us online at www.vebaonline.com/contact. For urgent requests, use the “Urgent” box on the contact form.
Health Happens Every Day
Your wellness journey goes beyond routine doctor’s visits—good health is about daily choices to nourish and care for your body and mind. Whether you’re cooking a nutritious meal, practicing mindfulness, or getting active, every step counts toward building a balanced, healthy life.
To help you on this journey, VEBA offers resources designed to support your daily health efforts. Explore tips and tools for maintaining a healthy lifestyle and staying on top of your wellness goals.
