Once you’ve enrolled in a new health care plan and you receive your member ID in the mail, a new chapter of your health care journey is ready to begin. It’s important to set yourself up for success.
Having a thorough understanding of your plan, network and benefits can go a long way. And you can start right now! Here’s how you can take advantage of your health insurance benefits and better manage costs.
1. Review your plan online
If your insurer allows, set up your online account once you know your member ID number. This will allow you to familiarize yourself with the platform, search for in-network health care providers and use cost calculators and other tools to make money-saving decisions.
You can also get a refresher on the important details of your plan, such as:
- Whether your regular doctors, clinic and hospital are in network, and whether your prescriptions are listed on your plan’s formulary
- How much you’ll have to pay before your plan starts to help (your deductible)
- What fees you’ll pay for going to the doctor and filling prescriptions (copays)
You can also review the list of services your plan covers (such as in your Summary Plan Description) so you know what services are covered, as well as what you’ll have to pay for specific services like counseling or surgeries.
2. Know your out-of-pocket maximum
Your out-of-pocket maximum is the most you’d have to pay for covered care in a year. Once you’ve reached it, you may be able to get qualifying services and products at no cost to you. And you can make the most of your health care budget for services and supplies, such as:
- Exams, follow-up visits and tests
- Care that isn’t urgent that you’ve put off due to cost
- Non-perishable, medically necessary medical supplies – stock up if they’re covered by your plan
- Larger quantities of your daily prescriptions – switching to a 90-day supply before your policy ends can save you money
3. Save your support team’s contact information
Your support team is an important part of your care. Save your insurance company’s key phone numbers, like Member Services and the nurse advice line. It’s an easier way to reach them when you need guidance or answers.
Some apps and websites have support team emails listed that you can add to your email contacts or even designated chat functions or pages you can bookmark for future access. If possible, make sure to note hours of operation, so you know when you’re most likely to reach a support team member.
4. Choose an in-network doctor
We know how important it is to have a doctor you know and trust collaborating with you on your care. However, sometimes when you switch plans, your network changes. Sign in to your account, and find the doctor or network search tool. Check whether your current doctor is covered by your insurance. If not, look for a new doctor who’s part of your network.
5. Make a plan for potential providers
Sometimes health issues sneak up on us – you never know when you’ll need to get some quick medical advice or take a trip to the closest urgent care or emergency room. Going to care providers in your network can help mitigate cost.
It’s better to prepare in advance. To get started, set up your online account. It will have all the information you need for who to contact or where to get care when you need it. Alternatively, you can contact your insurance company, and your team will help you figure out where to go or whom to contact. Once you get this information, store it in your phone or address book, so if you have a question or need to get to urgent care quickly, you'll be ready.
6. Explore your perks and benefits
Sign in to your member account to find perks that go beyond office visits and copays. Maximize these other health insurance programs to save money and live a healthy lifestyle. From gym discounts to help managing your asthma, there’s a lot you might be missing out on. Common programs include:
- Discounts on vision and hearing services
- Gym membership discounts
- Medical support services when traveling
- No-cost wellness programs
- Mental and behavioral health support
You're reading the "Getting started with your plan" series.
Have a health plan but not sure what to do next? This series can help you get started.
Part 1: How to get the most out of your health insurance
Part 2: How to figure out what your health insurance plan covers