The Ultimate Guide to Using Your Health Insurance Coverage

February 9, 2017

Now that you have health insurance, you can start using it!


Even if you’d had health coverage before, every plan is different. If you’re new to health insurance, it can be an overwhelming process to figure out how it all works.

This guide will show you how to use your coverage, from start to finish.

1. Get started.

Even though you have coverage, you can avoid having to use it at all if you stay healthy. Eat right, exercise, and put your health insurance to work for you by getting preventative care and screenings. If you have a chronic condition, see your doctor regularly to control your illness.

2. Understand your plan.

To avoid unnecessarily paying for services, get familiar with the services covered on your plan. Understand your costs, such as deductibles, premiums, coinsurance and copayments. Make sure you know the difference between in-network and out-of-network providers. Your plan will usually cover in-network services and providers at a higher rate than out-of-network –  which means you’ll pay less if you go with in-network.

3. Know where to get care.

If you go to the emergency room, you’ll usually pay a lot more for services. Be sure you visit the emergency room only for life-threatening situations. In non-emergency cases, visit your primary care doctor. And know if your plan requires a referral to see a specialist.

4. Find your care provider.

If you don’t have a primary care provider, ask friends and family for recommendations. Then check your plan’s list of in-network providers to make sure the provider you want to see is covered. If your plan automatically assigns a provider to you, get in touch with the health insurance carrier to make a change.

5. Make your appointment.

Call the provider and set up an appointment. The office will usually ask you for some information over the phone, such as your name, address, phone number and carrier.

6. Get ready for the visit.

Before you leave your home, make sure you take your health insurance card with you. The doctor will usually have you fill out a form that asks questions about your family history and medications. Be ready to answer these questions by taking some time now to think it through and make a list of medications you’re taking.

If you have questions for the doctor, write them down. You’ll be less likely to forget to discuss health concerns if you have them in writing. If you need help evaluating the physician or talking about your health issues, bring a friend or family member with you to act as your health advocate.

7. Evaluate the provider.

If this is your first visit with the physician, keep in mind that you can evaluate the experience. Do you feel comfortable with her or him? Are you able to communicate with the doctor? Do you feel understood? If you’re not comfortable in any way, you have the right to change your provider.

8. Take steps after the appointment.

If you’ve been prescribed a new medication, get the prescription filled. Review the provider’s instructions and follow them to the letter. Talk to your health insurance carrier and make sure you understand your payment obligations, medical bills, and your benefits.

As soon as your policy is “active,” you can start using your health insurance coverage. Be sure you understand the steps to using your policy so you can plan appropriately for expenses and health care.

For help selecting a health insurance plan or understanding your benefits, contact InsureOne Benefits today.