If you need more information on how health insurance works or how to get the most out of your healthcare, you should click here for tips and facts.

When it comes to you and your family, health is a priority. That’s why you’ve taken the time to carefully choose a health insurance plan that works best for you. But are you fully aware of how health insurance works?

Are you getting the most out of your insurance? Or, are you paying each month for something that you’re not even using? There’s no debate that you need health insurance, but you should be making use of every penny that you put into it.

Continue reading for everything you need to know about how health insurance works and how to get the most out of your plan.

How Health Insurance Works

Health plans come in many varieties that each has its own level of coverage. You’ll have the option to choose a plan that best fits your situation and budget. To begin, we’ll give a brief explanation of how it works.

Health insurance works by paying a portion of the payments when you visit a doctor or when you incur any other type of medical bills. For example, if you were to be involved in a serious accident and have pretty big medical bills, your insurance will cover a percentage of that amount. The percentage that they pay depends on the plan, and you’ll pay the remaining amount.

Before your insurance takes on this percentage, you’ll have to first meet a deductible. The amount of your deductible also depends on your plan. Your plan will also have a set out-of-pocket maximum.

Once this maximum amount is met (meaning you’ve paid this much out of pocket), your insurance pays the rest of any cost for covered services that you receive in the network. Now, let’s break down some health insurance terms.

Network

Your health insurance’s network is the group of doctors, pharmacies, hospitals, and other health care professionals that accept your insurance. They are the ones who will provide you with health care and prescriptions that are covered under your insurance plan. You can contact your health insurance to see which providers are covered.

Premium

The premium is the monthly payment amount for your insurance. In most cases, the lower the premium, the higher the deductible and out-of-pocket maximum.

Out-of-Pocket Maximum

This is the most that you will pay out of pocket for covered services in your insurance’s network.

Health Savings Account

You can use funds in a health saving account for some of the covered health care costs. These funds are contributions that you make into the account before taxes.

Covered Costs

Any services that your plan covers such as office visits, medical tests, medications, treatments, and more.

Coinsurance

This is the percentage that you pay for any covered services. Your insurance pays the other percentage.

Copay

A copay is the flat fee amount that you’re responsible for paying at the time of covered services.

Health Insurance Tips For Getting the Most Out of It

Now that you understand the common terms used in health insurance plans, it’s time to make sure that you’re getting the most out of your plan. Here are a few tips on how to ensure you’re doing just that!

Choose the Right Plan

When choosing a plan, keep in mind what type of services you or your family needs. What medical or dental needs do you or your family have right now? Choose a plan accordingly.

Understand the Plan

Keep all paperwork in a safe place so that you can refer back to it as needed. Know all of the rules of your plan so that you get the best quality care and save as much as possible.

Use In-Network Providers

Stick to doctors and providers who are in your network. This is where you’ll pay the least amount of money for services. It’s also a good idea to check with the hospitals that they work with and ensure that those hospitals are in the network as well.

Consider Hiring an Advocate

Hiring an advocate is best when you receive a large medical bill that you don’t understand. If you believe that there’s something questionable on the bill, an advocate will figure it out for you. However, they will charge a percentage of what the save you.

But it’s well worth it if they end up saving you thousands. If this interest you, don’t hesitate to learn more about healthcare jobs!

Prepare for Open Enrollment

Always prepare for open enrollment. This means knowing when the date is and becoming ready to make any necessary changes to your plan. This is normally the only time you can make changes to your plan.

And if you’re paying for a service that you don’t use or need, then this is the time to remove it from your plan and save money.

Order Prescriptions in the Mail

You can save money and time by ordering long-term prescriptions in the mail. Contact your insurance provider to see what subscription services they cover.

Get the Most Out of It After Meeting Your Deductible

Once you meet that deductible, be sure to get the most out of your insurance. For most plans, once you meet this deductible, you’ll begin paying much less for services. This is the time to schedule eye exams, skin screenings, and any other services.

Use Discounts, Benefits, and Programs

Be sure to always stay on top of the benefits, discounts, and programs that your plan offers to you. You can do so by frequently checking in with their website. Some plans offer discounts on fitness classes, they offer programs for specific medical conditions and many other perks.

Are You Getting the Most Out Of Your Health Insurance? 

Now that you know how health insurance works, it’s time to ensure that you’re getting the most out of your plan. Follow these tips and tricks above to stay on top of your health insurance plan. For more on healthcare information, be sure to visit our healthcare IT section!