Understanding How To Make The Most Of Your Coverage

Jim Scheihing,  Agent

It's important to know how Health Insurance works to get the most value from you policy.

Here is some information to help you better understand to use your coverage and save the money.

How most Health Insurance Works:

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 health care professional outside your network it will cost more that visiting an in-network provider and in some cases you will be responsible for the full amount.  health plans.  
  • 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's 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's not covered.  
  • Understand the cost. Health insurance terms and costs can be confusing.  Understanding premiums, deductibles, co-payments, out-of-pocket maximums  and how they work are important to best using your plan benefits.   

You can help control your health care expenses at home or while traveling. Here are tips to help keep costs down whenever you need care:

  • Build a relationship with your Primary Care  Physician.  Your PCP 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 it's 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 traveling.  If you experience  and illness or life threatening injury while traveling go to the nearest hospital.  Keep in mind  that if the hospital is out of network, your costs may be higher. If you have questions before getting care, call the number on the back of your card.   

If you have questions about how your coverage works please give us a call.  We're happy to help.  405-585-0648

Having a good Insurance Agent to rely on doesn't cost you anything and In Return;

  • You get better information
  • You're more likely to find a "best fit" plan.
  • Save more because of that fit.
  • Have more all around benefits.
  • Be more on top of the insurance game as changes come... and they will.