Making The Most Of Your Coverage And Low Cost Health Insurance Plan
It’s important to know how Health Insurance works to get the most value from your policy. Here is some information to help you better understand how to use your coverage and save the money.
How most Health Insurance works:
Health insurance is essentially a shared financial safety net for medical costs. Every month, you pay a fixed membership fee – called a premium – to stay covered, whether you visit the doctor or not. In return, the insurance company agrees to pay for a large portion of your healthcare expenses when you get sick, injured or need routine care. To get the best rates, you typically visit doctors and hospitals within your plan’s network, which are healthcare providers that have agreed to lower, pre-negotiated prices with your insurer.
When you actually receive medical care, you and your insurance company split the bill using three main concepts: Deductible, Co-pay and maximum out-of-pocket.
As with most things in life, planning can help you save money when it comes to your health. Take full advantage of your health insurance with these helpful tips:
- STAY IN THE RIGHT NETWORK: Very Important! If you visit a healthcare provider outside of your network, it will cost more than visiting an in-network provider and in some cases, YOU will be responsible for the full amount.
- STAY IN THE PHARMACY NETWORK: Choosing a pharmacy in your network is just as important as choosing an in-network doctor. You will likely save considerably by visiting an in-network pharmacy.
- KNOW WHAT IS COVERED: Make sure treatments and/or services are covered before you schedule them. In some cases, you may need pre-authorization from your insurance company before you get certain tests or services performed. You or your doctor must call the pre-authorization number on the back of your member ID card to confirm. This allows them to make decisions about what is covered and offer other options if it is not.
- UNDERSTAND THE COST: Health insurance terms and costs can be confusing. Learning about premiums, deductibles, co-payments, out-of-pocket maximums is integral to properly using your plan’s benefits.
You can help control your health care expenses at home or while traveling. Here are tips to help keep costs down, where ever you need care:
- BUILD A RELATIONSHIP WITH YOUR PRIMARY PHYSICIAN: Your PCP (Primary Care Provider) can help keep you current on annual exams and will know who you are if you call with general, non-emergency questions. They can also refer you to a specialist. Keep in mind that it is easier to get an appointment if you’re already a patient with your PCP.
- USE THE ER FOR EMERGENCIES ONLY: Using the ER is very expensive and only should be used in the event of a serious emergency. If that’s the case, by all means, call 911 or go to the nearest Emergency Room. For things like colds/flu, minor sprains and other less serious conditions consider using your PCP or local Urgent Care facility. This could potentially save you thousands of dollars.
- COVERAGE AWAY FROM HOME: Be sure to pack your member ID card when travelling. If you experience an illness or life threatening injury while travelling, go to the nearest hospital. Keep in mind that if the hospital is out of your network, your costs may be higher. If you have any questions before getting care, call the number on the back of your card.
If you have ANY questions about how your coverage works, please give us a call at 405-585-0648. We’re happy to help!