How to Maximize the Benefits in Your Health Insurance Plan
Jake Newby
| 5 min read
The beginning of the year is the best time to think about how you want to utilize your health insurance plan. You can’t put a price on the physical and mental wellbeing of yourself and your loved ones, but you can cut down on expenses if you plan ahead. Here are seven tips to maximize the benefits in your health plan this year.
Understand your policy.
You can’t take advantage of certain benefits if you don’t know they exist. That’s why it’s important to read through your health insurance plan’s policy and summary of benefits at the beginning of the year. You can read the documents you receive in the mail or find them on your health insurer’s website.
Even if you’ve had the same plan for years, read through the coverage limits, co-pays, coinsurance, deductibles, out-of-pocket maximums, and terms and conditions. This helps you not only refamiliarize yourself with your policy, but it also alerts you to any changes to benefits and terms that your health insurer might have made. This is also an important practice in case your health has changed, as aspects of your plan that didn’t apply to you before might be applicable in the new year. Prenatal benefits and specialist coverage are two examples.
Optimize preventive care services.
Be sure to stay on top of the free appointments and screenings you are eligible for under your health insurance plan. If they’re fully covered, why not take advantage of them? You may be surprised to see how long the list of no-cost appointments included in your health plan is. Some preventive care appointments for adults include (but are not limited to):
- Colorectal cancer screening
- Depression screening
- Diabetes (Type 2) screening
- Lung cancer screening
- Alcohol misuse screening and counseling
- Tobacco-use screening
Multiple women-specific preventive care appointments and services for pregnant women or women who may become pregnant and coverage for children’s preventive health services also fall under the banner of federally mandated preventive services that do not require a copayment or coinsurance.
Stay in-network when possible.
Your health insurance plan should include a network of health care providers to choose from. When you visit these providers, your out-of-pocket expenses will be significantly lower than they would be if you shopped outside of your network*. The Blue Cross Blue Shield of Michigan (BCBSM) Find a Doctor tool in your member account allows you to search for in-network primary care providers (PCP) by name, place and type, as well as in-network specialists.
Utilize an HSA throughout the year.
If you signed up for an Health Savings Account (HSA)-compatible health plan, you can use the money saved in your HSA to pay for everything from medical, dental and vision care to your deductible and certain over-the-counter medications. Some people like to save the money on their HSA account because those dollars can be used to offset the costs of medical care after retirement, and that’s a great way to utilize an HSA as well, but if you’d like to save the money in your regular checking and savings accounts this year, don’t forget about the HSA debit card in your wallet.
Strategically plan procedures.
Each health insurance plan has an out-of-pocket maximum amount, which is the threshold in payments you must reach before costs are fully covered by your insurance. Your annual deductible could be a few hundred dollars, or it might be as high as $5,000, depending on your plan.
You obviously can’t plan for an emergency procedure, like an appendectomy, but you can base minor procedures around your deductible to maximize coverage. Some people like to wait until the end of the year once they’ve met their deductible by paying for health care services over the course of the year. Others, who don’t mind spending money up front, will elect to have a procedure early in the year and meet their deductible up front. This can offer peace of mind that the rest of their health care costs – including potentially expensive, unforeseen ones – will be covered by their insurance for the remainder of the year.
Consider behavioral health support.
If you haven’t before, make this the year you invest in your mental health. Mental health and behavioral health services are considered essential health benefits. Just as you can utilize BCBSM’s “Find a Doctor” tool to find a PCP, you can use it to find behavioral health specialists in your network. BCBSM and Blue Care Network members can explore a wide range of behavioral health services, including:
- Virtual mental health care.
- Comprehensive digital program that supports stress management, depression, sleep and more.
- Weekly webinars to help you improve your wellbeing.
- Mental health and substance use disorder support line.
Take advantage of perks.
We don’t always associate the word “fun” with health insurance, but many plans come with some nice perks that incentivize living a healthy lifestyle. This could include discounts on smart watches, fitness memberships and classes, and athletic wear. Other perks might include massage therapy or discounts on chiropractic appointments.
BCBSM’s “BWell” and “Blue365” programs offer these types of perks to members. One of the many programs offered through BWell is the Blue Points program, which rewards you for completing fun health and wellness activities to earn Blue Points. You can then redeem them for Master Card® gift cards. Blue 365 offers discounts on mindfulness descriptions, health and wellness classes, fitness equipment, hearing and vision products and much more. Learn more about these programs by visiting this link.
*Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Photo credit: Getty Images
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