Health insurance is one of those services that many people really don’t use until they’re actually in danger of dying, yet they pay an arm and a leg monthly to have it just in case.
But health insurance is actually there for more than just emergencies. You can use it to your advantage to live a healthier life and help prevent major illnesses and conditions from happening in the first place.
Utilizing certain health insurance benefits, such as preventative screenings and exams, is like taking your car to get routine maintenance, like an oil change. Except with certain benefits you don’t even have to pay extra.
Although it will depend on your type of insurance, there are some basic benefits for medical, vision or dental insurance that you can take advantage of in order to maximize your monthly premium.
The tips in this article apply to medical insurance. However, it's a good idea to do some research on your vision and dental insurance in order to find out how many exams and teeth cleanings you are entitled to for free per year.
For vision insurance, you may also be able to get discounts on sunglasses if you don’t wear glasses. Vision insurance/discount plans are more for people who have vision problems. Otherwise most medical insurance plans cover at least one eye exam per year.
Nora Zuniga, the owner and a health insurance broker at Healthful Insurance Agency, has a few tips for getting the most out of your health insurance:
1) Use preventative care services. These do not require a co-pay or deductible to be met, and are covered 100 percent. These services are used to monitor your health.
2) It is cheaper to go to a doctor that’s in-network. You can find out from your health insurance company which specialists and doctors are in-network (usually they have a search tool on their website as well).
3) Keep track of your current benefits and make sure you’re using what you’re paying for. Talk to human resources or a health insurance broker if you think you need to downgrade or upgrade, depending on your needs.
For example, if you rarely go to the hospital or doctor, you may want to get insurance with a higher deductible and a lower monthly premium.
4) Keep a list of urgent care centers in-network so that you can visit them if it is not an emergency. Be careful to determine whether or not it's an emergency room situation because emergency rooms are expensive.
5) Oral contraceptives should be covered 100 percent as a result of the Affordable Care Act. This includes the pill, patch, ring and diaphragm. Breast pumps are also covered, sometimes with provider restrictions.
6) Utilize any wellness discounts that your carrier provides, such as gym membership discounts, weight loss programs, nutrition and health products. Do some research with the help of a broker or insurance carrier.
Jean Tkachyk is the chief operating officer of Meritus, the only insurance cooperative (COOP or consumer oriented and operated plan) in Arizona. Tkachyk offers a few options that people with health insurance can take advantage of:
7) Make sure you find a primary care provider (either in or out of network depending on your insurance) so you can start making appointments right away for preventative services.
8) Many specific services should be 100 percent-covered by your insurance. You should be able to have an annual physical, annual gynecological exam, and a mammogram. You ought to be covered for gestational diabetes screening, human papillomavirus (HPV) screening, and counseling for sexually transmitted infections (STIs).
Coverage should also be available for screening and counseling for HIV, and free contraceptives (types and brands may be restricted) and counseling. You should be able to get breastfeeding supplies, support and counseling, and screening and counseling for domestic/interpersonal violence.
9) If you’re allowed the option to choose your insurance carrier and type, different private health insurance plans tend to cost more or less. For example, HMOs are typically cheaper although they are more restrictive on the providers you can use and sometimes provide fewer benefits. PPOs allow more freedom to choose the provider you want at a higher cost.
Catherine Basu, an ACE-certified personal trainer and owner of Fit Armadillo, offers the following suggestions:
10) Find out if your carrier provides discounts for a gym membership, and then choose a gym close to work. Get a group of co-workers together to work out together. Remember, exercise is a great preventative care tool.
11) Keep an eye out for a wellness reimbursement credit that your insurance carrier may provide. Basu stated that some companies will provide around $250 to use on a fitness option that meets their standards. Many require proof of the health option you choose in order to cover it.
12) If you have a wellness reimbursement credit, some places to search for discounted fitness programs include Groupon and LivingSocial. You can also look for a personal trainer online or in person. They can help you get the most out of your gym workouts as well by creating a fitness plan for you.
Sources:
Tkachyk, Jean. Email interview. June 27, 2014.
http://www.meritusaz.com/node/3
Zuniga, Nora. Email interview. June 25, 2014.
https://www.linkedin.com/pub/nora-zuniga/5a/839/30b
Basu, Catherine. Email interview. June 26, 2014.
http://fitarmadillo.com/about
Reviewed June 30, 2014
by Michele Blacksberg RN
Edited by Jody Smith