New Year’s Day is the busiest time for health plan changes, with an estimated 50% of all commercial health plans starting coverage on January 1. Whether or not you have a new health plan for 2025, here are three things you should do to ensure your Alma eligibility in January:
1. If your health plan is changing on January 1, let us know as early as possible.
- We will be sending reminder emails throughout December with a unique link to the Alma portal for your insurance — the sooner our team has your insurance details for 2025, the sooner we can verify your eligibility for care. Prompt eligibility checks will reduce the risk of inaccurate invoices or denied insurance claims due to out-of-date coverage.
- If you have a new plan but you won’t get your new Member ID or group number until after the new year, don’t worry — you can either save one of our December emails and use the link when you have your insurance details in hand, or you can wait for our follow-up insurance reminder email on January 6 to update the Alma portal.
2. Even if your health plan isn’t changing, contact your insurance company in December to confirm your 2025 benefits and deductible.
- Health plans can restart deductibles and update benefits (including copay amounts) at the start of a new policy year — even if your member ID and group number don’t otherwise change.
- As a reminder, a deductible is the annual amount you must pay out-of-pocket towards medical expenses before your plan begins to cover some or all of your costs.
- If you owe a deductible for 2025, you will be responsible for 100% of the session cost with Alma until that deductible is paid down.
- You can call your health plan directly to ask about your 2025 deductible and benefits by contacting the number on the back of your insurance card. You can find additional tips for contacting your health plan here.
3. Health plan verification can take extra time in the first two weeks of January, so plan your appointments accordingly.
- The very high volume of insurance transitions on January 1 means it can take extra time for health plans to make benefits information available, both to you as a client and to Alma.
- If your health plan has not updated their benefits information as of the beginning of January, we will notify both you and your provider via email of the delay to your eligibility check.
- If you choose, you can continue your sessions with your Alma provider while we work with your health plan to verify your benefits. Please note that you may be responsible for 100% of the session cost during this period.
- As soon as we can confirm your health plan eligibility for 2025, we will update your invoices and future payment responsibility accordingly.
What about other types of health care benefits?
- Just as insurance plans often reset on January 1, so do other types of benefits, including HRAs, HSAs, FSAs, and EAPs. To learn more about what these plans are and how to apply them to sessions with your Alma provider, read: