Your guide to supplemental insurance & prescription enrollment
As a PRN clinician, your schedule, finances, and health coverage are in your hands.
Sound daunting?
No need to worry. This Open Enrollment guide is your financial check-up to help you lock in protection for your health and your hard-earned money.
Take this opportunity to enroll in a new healthcare plan or update your existing coverage. The right plan can help protect your health and budget.
Save the date: Open Enrollment check-up
Open Enrollment is officially here, running from Nov. 1 to Jan. 15 for most major individual health plans. For you—the dedicated RN, LPN, CNA, or other clinician working per diem shifts—this period is about more than just checking a box. It’s a crucial financial review.
As a clinician, you value the flexibility of controlling your schedule and, just as importantly, controlling your income. Protecting that income from unexpected financial pitfalls is paramount.
The challenge lies in the fine print.
Even if you secure primary health insurance, high deductibles and unforeseen medical costs can still create significant, budget-crushing financial strain.
The deductible trap: Guard your wallet from unexpected costs
The single biggest financial shock for many insured individuals is the high deductible.
A deductible is the amount you must pay out-of-pocket each year before your insurance company begins to pay for covered services. Many popular plans, such as those found on the ACA Marketplace, feature deductibles that can range into the thousands.
Imagine working a busy shift when an unforeseen accident occurs. Even something as common as a fractured ankle can be a budget buster if your deductible is unmet.
Case study: The cost of a fractured ankle (out-of-pocket)
Consider a clinician with an ACA Marketplace plan that has a high, unmet deductible of $14,000. If they fracture their ankle, the typical costs for treatment can total $5,865.
Here’s an estimated breakdown:
- Emergency room visit: $2,715
- MRI: $650
- Brace: $500
- Crutches: $500
- Physical therapy: $1,500
Because the deductible has not been met, the clinician is responsible for paying the entire $5,865 out-of-pocket. This unexpected cost could force a per diem nurse to deplete their savings or take on debt.
The solution: Supplemental accidental injury coverage
Here is where supplemental accidental injury coverage offers a powerful layer of financial peace of mind.
These plans are designed to pay you a direct benefit (often up to $7,500 in accidental injury coverage) upon a qualifying covered accident. This money is a cash benefit you can use to immediately pay the high deductible, cover an ER copay, or even offset lost wages while you recover.
In the case above, a supplemental plan could reduce that $5,865 out-of-pocket expense down to $0, thereby protecting the clinician's income and savings.
Your 5-point prescription checklist for open enrollment
After deductibles, prescription drugs are the second major expense that chips away at your income. Use this quick 5-point prescription checklist to minimize your drug costs:
- Verify covered prescriptions and generic options: Check the plan's formulary (the list of covered drugs). Tip: Generic versions often cost much less than brand names. A quick online search can show if your medicine has a generic equivalent.
- Understand drug tiers and costs: Medicines are grouped into tiers. Higher-tier drugs (like brand-name or specialty drugs) typically mean higher copays for you. Look for lower-tier options whenever possible.
- Confirm pharmacy network: Check if your usual, preferred pharmacy is considered in-network. If your usual pharmacy is not, switching could save you money.
- Explore mail-order savings: For long-term or chronic medications, see if your plan offers a mail-order pharmacy. It can save time and may lower costs for long-term prescriptions.
- Review for prior authorization/step therapy changes: Know if you need prior authorization (insurance approval before filling) or if your plan requires you to try a lower-cost drug first (step therapy) before it covers a more expensive one.
Maximizing your savings as a healthcare professional
Understanding two key financial terms is essential for budgeting:
- Deductible: The amount you pay before your insurance starts covering costs.
- Out-of-pocket maximum (OOPM): The absolute most you will pay in a year for covered healthcare services. Once you hit the OOPM, the insurance plan pays 100% of all covered costs for the remainder of the year.
Real-life savings example
Even with insurance, prescription costs can be high. Consider Tyler’s story:
Tyler needed a new blood pressure medication. At his usual pharmacy, it cost $71. By using his Hooray Health Discount Rx card and the app to check nearby pharmacies, he found it for just $17. That’s a savings of $54 a month, or over $650 a year—money that stays right in his pocket.
This demonstrates the power of checking prices and utilizing savings tools bundled with supplemental plans.
Protect your health and your wallet today
Don't let your insurance plan roll over without a detailed look. Remind yourself to look for yearly changes in drug coverage, tier placements, and pricing.
Open Enrollment is the time to protect your cash flow.
Take action today to review your coverage, check your deductibles, and safeguard your income with supplemental insurance.
Want to keep even more money in your pocket? Take a look at Hooray Health’s supplemental insurance offering.
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