7 Tips to Get the Most Out of Your Health Insurance

Your health insurance can help you keep your healthcare costs manageable. But many families may not be maximizing the benefits their insurance provides—and could be paying significantly more than they need to for healthcare as a result. Here’s how to ensure you get the most out of your insurance policy.

1. Choose the right plan for your family. Before you simply stick with the same insurance plan each year, make sure that you look at what kinds of medical and dental needs your family currently has. If you have orthodontal work on the horizon, or someone in your family was just diagnosed with a chronic illness, make sure you choose the plan that covers those best.

2. Make sure you understand your plan. Keep those benefits documents you get when you sign up for your insurance plan handy. They can provide great info on what you’ll pay for different types of services, and what the rules of your insurance plan are—like whether you need to choose an in-network primary care physician or if you need referrals to see a specialist. Following the rules will help you ensure that you get quality care at a significant savings.

3. Ask an advocate to work for you. “If you receive a large bill for services—following an ER visit or surgery, for example—and you don’t understand how to read it, hire a medical billing advocate to assist you,” suggests Ruth Linden, founder of Tree of Life Advocates in San Francisco. “She or he will not charge you if everything is in order. On the other hand, if errors or a questionable charge is found, the typical billing advocate may charge you one-third to one-half of the amount they save you. Your cost savings could run into thousands of dollars.” This can be especially important if you’re dealing with a complex medical issue that requires significant—and expensive—care. Some insurance companies have even begun offering their own advocates, such as UnitedHealthcare’s Advocate4Me program, which provides a single point of contact with an expert who can help you understand your coverage and find the help you need.

4. Stick with in-network providers. “The lowest charges are for doctors and hospitals who participate in your insurance network,” says Adria Goldman Gross of MedWise Insurance Advocacy in Monroe, New York. “Check to make sure that the doctors who are treating your children are on your insurance plan. It’s also best to be confident that the doctors are affiliated with hospitals that are covered on your insurance policy.”

5. Make the most of it when you max out your deductible. Once you’ve met your deductible in most plans, you’ll pay significantly less out of pocket for any healthcare you use above and beyond that. So if you’ve already met your deductible for the year, that’s the time to schedule appointments to get your skin screened, your eyes checked, and any other services you need at a decreased cost.

6. Get your prescriptions via mail order. For medications you use long-term, you’ll reduce hassle and cost if you order pills on a subscription service through your insurer. “Utilizing 90-day supplies and mail order can decrease dispensing fees,” says Diana Graalum, clinical pharmacy manager at MedSavvy.

7. Max out any discounts, programs and benefits. Insurance companies sometimes offer health and wellness programs, including discounts on fitness classes, programs dedicated to help with specific medical conditions, apps to help you track medications and health records, or other perks. Make sure you check your insurance company’s website regularly for new benefits.

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1 Comment

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