The average person in the U.S. spends approximately $3,400 on health insurance coverage every year. If you’re going to spend thousands of dollars on health insurance, it’s important to make sure you are getting the most out of your coverage. Here’s what you need to know to maximize your health insurance benefits.
Many people fail to take advantage of the benefits offered by their health insurer simply because they don’t know they exist. Or even worse, they end up paying out-of-pocket expenses that may have been covered by their insurance. One of the keys to maximizing your health insurance coverage is understanding your benefits.
Insurers are required to provide you with a Summary of Benefits and Coverage (SBC), which is a brief overview of your benefits.
Some insurance companies provide a glossary of terms that you can use to decipher industry jargon, such as “deductible,” “copay,” “co-insurance,” and “network provider.” Keep this glossary handy while you review your SBC, so you fully understand what you are reading.
One way to maximize your coverage is to stick to in-network healthcare providers since an out-of-network physician will charge more for their medical services. Make sure all of your physicians are part of your insurance company’s network so you don’t end up with a surprise bill.
A deductible is the dollar amount you will have to pay out of pocket each year before your health insurance kicks in and starts covering expenses. If you meet the deductible, any additional expenses you incur should be covered by your insurance company. However, note that your policy may also have co-insurance, which is the percentage of medical costs a patient pays after they meet their deductible until they reach their out-of-pocket maximum.
Make the most out of your benefits by waiting until you meet your deductible to schedule non-urgent appointments. This is a great time to schedule elective procedures, get your skin checked for moles, get your eyes tested, or seek medical attention for a lingering injury. Your deductible (and out-of-pocket maximum) will reset at the beginning of each year, so don’t miss the opportunity to get these services covered while you can.
Many insurance companies offer discounts and special health-related programs to their policyholders. For example, health insurers often partner with fitness centers to offer policyholders discounted monthly membership rates. Insurers may also give policyholders exclusive access to apps or online portals that contain valuable educational resources.
If you want to get the maximum benefit from your health insurance coverage, make sure you take advantage of discounts and special programs like these. Rocky Mountain Health Plans (RMHP) Members can learn more about their plan and benefits by visiting our Learning Center, and our friendly Customer Service team is also available to assist — you can reach them via phone, email, or an in-person visit.