A woman speaking with two doctors.

Seven tips for using your health insurance effectively

January 19, 2022 By Maria Pippidis, Extension Educator, Family and Consumer Sciences

For many people, January starts their health insurance coverage year. Now that you have it, how do you use it to keep you and your family healthy and minimize financial surprises? This article will provide you with suggestions to effectively use your health insurance.

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  1. Review Your Evidence of Coverage – The Evidence of Coverage is that thick document you might get that provides the details of your plan, from the definition of terms to the costs to the rules you need to follow to have health services covered. For some, it might be a URL provided on the back of your insurance card. Either way, you receive the information, be sure to review it, especially around topics such as your network, what health services might need pre-approval, the health services covered. You are looking for any information about services you may not have used before, changes in costs and information that might be new. Sometimes, plans change just a little bit from year to year, even if it is a plan you've had in the past. It's important that you keep up to date.

  2. Carry Your Health Insurance Card at All Times – You never know what might happen or when you might need health care services. Insurance cards have information that a health care provider needs to provide service and the co-payment or co-insurance amounts that could be charged. The card also has contact information in case you have questions.

  3. Use Preventive Services to Stay Healthy – Most health insurance plans offer preventative services; some offer them at low or no cost to encourage individuals to go to the doctor for their annual physicals, well-child visits, annual gynecological care, and in some cases, dental cleanings. We know that people who take advantage of these preventive services help you avoid certain diseases and catch others in their early stages, to limit the harm they can cause.

  4. Choose In-network Doctors and Health Care Services – Most health care insurance companies have a network of doctors and health care services with whom there is a contract. When you use providers from the network, it costs less money. If you have an HMO or EPO type of health care plan and use out-of-network health care services (unless in an emergency), you will have to pay the full cost; health insurance will not cover any of the costs. So, it is important to choose doctors and healthcare services in your health insurance network. Check their website or use the number on the back of your health insurance card to verify if your providers are in the network.

  5. Track Health Care Related Expenses – Use your Explanation of Benefits document mailed to you or visit your information online to track your use of health care services and your costs. You'll want to do this to make sure information and costs are correct and also to be able to plan for your out-of-pocket costs.

  6. Plan for Health Care Costs – Health insurance is designed to share health care costs with you. Depending on the plan, that may be more or less money. It's important to understand your plan, what it doesn't cover, and estimate those costs. Use the Estimating Your Health Care Costs publication to help you determine how much you need to set aside to cover out-of-pocket costs.

  7. Use Tools to Solve Problems  - Sometimes things go wrong. Use information from the health insurance company website or the Evidence of Coverage booklet to find information about resolving any issues regarding billing or health care services.

 

These suggestions will help you use your health insurance effectively as you start your plan year!


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