Making the most of your health benefits
Katie Carpenter | 01.20.14
In Pennsylvania, over 81,000 people have enrolled in new health insurance plans at the federally-run Health Insurance Marketplace. And, many of those who have signed up have already begun using coverage that kicked in on Jan 1.
Make the most of your health benefits by understanding what's covered and partnering with your doctor to manage your health.
Andy Seebold, Director of Business Services at WellSpan Health, says that newly-covered Pennsylvanians should educate themselves about how to make the most of their new health benefits. Because, health insurance not olny protects them financially in case of an emergency, but it can actually help them stay healthy and save money in the long run.
Seebold says that it's really about patients taking action and being in the driver’s seat of their own health. That means understanding what’s covered and what’s not, establishing a relationship with a primary care doctor, taking advantage of preventive and wellness benefits, and managing chronic conditions.
“A lot of people think of insurance as sickness benefits. And yet, it should be looked at as health benefits, and as a great opportunity to maintain and improve health instead of only seeking care when ill.”
He explains how to make the most of health benefits in the three short videos below:
Understanding your heath benefits:
“Health insurance is such a key benefit that protects us financially in case of illness, sickness or accident.” But, Seebold says that aside from financial protection, health insurance can also help you stay healthy and save money.
Tips for understanding your health coverage:
- Look at the Summary of Benefits document to better-understand what’s covered.
- Look at the explanation of benefits to see if you care matches your medical bill.
- Establish a relationship with a primary care doctor.
- Show your health benefits card every time you seek care.
- Look at your test results and ask your doctor questions if you don’t understand something. Many health systems have electronic medical records that allow you to view your results securely online.
- Take advantage of the benefits your insurance company may offer, like reduced gym memberships and wellness websites.
Using your benefits to stay healthy:
He says, “Our lifestyle and behavior choices impact overall health and the Affordable Care Act places an emphasis on preventive care. It’s believed that if we can properly manage healthcare and chronic conditions, in the long-term, it will reduce costs for us.”
- Find a family doctor. He says, “Having a relationship with a family doctor to help you navigate your care and understand benefits is really key.”
- Know your numbers (blood pressure, cholesterol), your health risks, and your family history.
- Understand the new preventive benefits under the Affordable Care Act, like free tobacco cessation classes, free health screenings, and free breastfeeding counseling and pumps
Reducing your healthcare costs:
Seebold explains that there are many ways in which you can control healthcare costs for yourself.
- Manage your health risks and take medicine as prescribed by your doctor.
- Avoid unnecessary care. Seek out the appropriate level of care with a primary care or urgent care doctor (if covered) before seeking care at an emergency room. ER costs will be 3-4 times more expensive.
- Seek out generic drugs over brand name drugs when possible.
- Get a 90-day refill on prescriptions instead of filling them every 30 days.
- Seek care from in-network providers to save on healthcare costs.
Want to learn more about how to make the most of your new health coverage? Explore the "Now what?" section of Transforming Health and WellSpan Health’s new multimedia guide: Getting Covered.
If you're uninsured and still need to enroll, the guide will also help you explore your coverage options, the costs, and how to navigate the Health Insurance Marketplace. Open enrollment ends on March 31st 2014, so now's the time to educate yourself about the plan that's right for you and sign up.
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