How to make the most of your health insurance

Your plan does more than pay the bulk of your doctor visit and lab test bills. It can actually help you save money while getting or staying healthy.

Step 1: Choose the right plan for you

Make sure you choose a plan that’s best for your needs. If you’re planning to start a family, for example, make sure your plan pays for prenatal and maternity care. On the other hand, if you don’t think that you’ll see a doctor often, you might choose a high-deductible health plan with lower premiums.

Pay attention during open enrollment. If you get health insurance through work, you can make changes to your health plan only once a year during open enrollment. Look at how much you spent on medical costs in the past and think about any life changes you may make in the next year (having a baby, for example). Change your plan or tweak your flexible spending account (FSA) and health savings account (HSA) based on what you discover.

Enroll in an FSA or HSA if they’re offered and it makes sense for you. These accounts help you save on health care by setting some money aside before you need it.

Step 2: Select your PCP

You’ll get a welcome packet when you enroll in a new health plan. Check the packet to see if you need to choose a primary care provider (PCP).

HMO plans require that you have a PCP to act as your main doctor, coordinate your care, and refer you to a specialist if needed. Do some research before selecting your PCP. Talk to family and friends, understand what’s important to you, and make appointments to talk to the doctor.

Use our Find a Doctor tool to start your search.

Step 3: Know your plan benefits

Your welcome packet will include a copy of your plan’s guide to benefits or a link to it online. Look through your guide to find out how much your plan will pay for various procedures, what types of preventive care are benefits of the plan, contact numbers, and other valuable information that you may need during the year.

Your plan may also include the following benefits:

  • Screenings and shots. Thanks to health care reform, you don’t have to pay extra for many important cancer screenings and recommended vaccinations.
  • Education. Many plans offer classes and workshops on fitness, nutrition, and other health topics.
  • Health coaches and health assessments. Your plan may include free blood pressure, cholesterol, height, weight, and body mass index screenings. Sometimes, you can fill out an in-depth health questionnaire, giving you a more complete view of your overall health. You might even be offered a health coach to help you meet health goals.
  • Healthy-living rewards. Many plans reward members for being healthy, fit, and well. You might get money for exercising, eating right, or meeting goals.
  • Help kicking the habit. Your plan may offer quit-smoking coaches, hotlines, support groups, or discounts on products to help you quit smoking.
  • Well-being resources. Many plans offer free counseling, education, and support for people with chronic diseases or mental health issues.
  • Hapai help. See if your plan offers classes, support groups, or educational materials for parents-to-be.

And make sure to look out for ways to save with your plan:

  • Take the freebies. Your vision plan may pay 100 percent for eyeglasses and your health plan probably pays the entire cost of an annual flu shot. Take advantage of important health screenings that don’t cost you extra.
  • Use generic medicine and get it in the mail.
  • See doctors in your network. Learn why it costs less to see a doctor who participates with your health plan.
  • Look at your statements closely. The statement from your insurer for treatment you received, also known as an explanation of benefits (EOB), shows the amount the insurance company paid to you or the provider (or both), and the amount you have to pay. Make sure the statements are accurate and show the treatment you received and any copayments or coinsurance you paid.
  • Stay well! Living a healthy lifestyle and keeping chronic diseases under control can mean lower health care costs.