New Year’s Day, January 1st, is the busiest time for health plan changes. Nearly half of all commercial insurance plans renew or switch on January 1st. Whether or not your plan changes, it is important to confirm your coverage each year to avoid gaps in care or billing issues.
Here are three steps to make sure your Alma eligibility is up to date before January.
1. Let Alma know if your health plan is changing.
If your insurance plan renews or changes on January 1st, update your information as soon as possible.
Throughout December, Alma will send reminder emails with a unique link to the Alma portal where you can add your insurance details. For more information, see: Adding insurance details in the Alma Portal
| Note: The sooner our team has your updated information, the sooner we can verify your eligibility for care. This helps prevent delayed claims or incorrect invoices made by outdated coverage.If you’re waiting on a new Member ID or group number, log into the client portal and add future or active policy information once you receive your new card. |
2. Even if your plan isn’t changing, confirm your new-year benefits.
Most health plans reset benefits, copay amounts, and deductibles at the start of a new policy year, even if your ID and group number stay the same. You can confirm your policy information is renewing in the Alma Portal.
A deductible is the annual amount you must pay out of pocket before your insurance begins covering medical expenses. If your deductible resets in January, you’ll be responsible for the full session cost until it’s met.
Call your insurance company in December to confirm:
- Your deductible amount for the new year
- Whether mental health visits apply to your deductible
- Any changes to your copay or coinsurance
You can reach your insurance company by calling the number on the back of your card. For tips on what to ask, see Contacting Your Insurance Carrier.
3. Expect delays during the first two weeks of January.
Because many health plans renew on January 1, health plan systems may require extra time to update benefits information. If this happens, Alma will email you and your provider to let you know that your eligibility check is delayed. During this time, we will mark you as ineligible until we can verify your benefits. Once we receive the Explanation of Benefits (EOB) and confirm your updated benefits, Alma will adjust your invoices and your payment responsibility as needed.
You can choose to continue sessions during this time but do note that if you choose to continue sessions without verified benefits, you may be responsible for the full cash rate.
Other Benefits to Review
Other benefits, like HRAs, HSAs, FSAs, and EAPs, often reset on January 1st as well. To learn how these apply to your sessions with Alma, see: