Health Insurance 101: How to Make the Most of Your Insurance Plan

Knowing these tips can help you save money on your health insurance.

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Health insurance can help you save money on health care—but it’s not always easy to navigate. Each plan comes with unique benefits, costs, and regulations. If you don’t know your plan very well, you might miss out on free or low-cost benefits, or get stuck with surprise bills that you weren’t expecting.

How to Save Money on Health Insurance

To make the most of your health insurance and maybe even save money in the process, it’s a good idea to know these quick tips.

1. Take advantage of free preventative care

Many health insurance plans offer free or low-cost preventative services. These are things like annual wellness checkups, dental cleanings, flu shots, and certain cancer screenings. Taking advantage of these free or low-cost services can help you catch health problems early, or possibly even prevent them altogether.

For example, your doctor will check your blood pressure at each checkup. It may seem like a simple thing, but if they notice that your numbers are increasing, they can suggest treatment options. Lifestyle changes may help bring those blood pressure numbers down, which may reduce your risk of heart disease or heart attacks later on. Not only are those serious health issues, but they can also be more expensive to manage.

2. Choose in-network providers

An in-network provider refers to a doctor or healthcare specialist who has a contract with your insurance company. Depending on what type of insurance plan you have, you will usually pay less money to visit in-network providers (as opposed to out-of-network providers).

For example, if you have a PPO plan, your insurance may charge you a little more if you visit an out-of-network doctor. If you have an HMO plan, your insurance company typically won’t cover an out-of-network doctor at all, and you may be stuck paying full price.

3. Know the difference between urgent care and the ER

The emergency room is for life-threatening health issues, such as:

  • Heart attack
  • Stroke
  • Severe or deep wound with heavy bleeding
  • Severe traumatic brain injury
  • Trouble breathing
  • Serious burns
  • Severe allergic reactions

Urgent care is for health concerns that are urgent—but not life threatening. For example, let’s say you are having symptoms of strep throat on a Saturday morning. You may want to get tested and access treatment and not wait until your primary care doctor is available the following Monday. It’s not a life-threatening emergency, but you want prompt treatment. (Learn more about the difference between urgent care and the ER here.)

How does this help you save money on your health insurance? Well, urgent care costs tend to be significantly less expensive than emergency room costs. If it’s not an emergency, you’ll save money by going to urgent care instead.

If your health concern is neither urgent nor life threatening, wait until you can make an appointment to visit your primary care doctor. A copay (set fee) for your primary care doctor is usually even less than urgent care. Plus, you’ll get the added benefit of visiting a doctor who already knows you and your health needs well.

4. See a primary care doctor before seeing a specialist

In general, it costs more to see a specialist (compared to a primary care doctor). Sometimes, people will book an appointment with a specialist when it’s an issue that your primary care doctor could treat. For example, you don’t necessarily need to see an otolaryngologist for an ear infection. Your primary care doctor can diagnose it and prescribe medicines that can relieve it. However, if you don’t get better after antibiotics, or if you have ear infections repeatedly, then it might be time to see a specialist.

5. If you max out your deductible, take advantage of it

Your deductible is the amount you pay for health care before your insurance kicks in. Before you reach your deductible, you may have to pay full price for services (such as an MRI or wisdom teeth surgery). After your deductible, you’ll likely only pay small fees for these services (such as copays or coinsurances).

Once you reach that deductible, take advantage of it. Schedule that root canal you’ve been putting off, or book a checkup with your optometrist, dermatologist, or ob/gyn.

6. Use up your Flexible Spending Account (FSA)

Money that you put in your FSA does not roll over to the next year. That means you have to “use it or lose it.” If the end of the benefits year is approaching and you have money left in it, find ways to drain the account. For example:

  • Buy new contacts or eyeglasses
  • Refill your first aid kit
  • Buy supplies for managing your disease, such as new test strips for diabetes
  • Submit receipts for copays from previous doctor appointments

Different insurance plans have different rules about what you can buy with FSA money. It’s a good idea to check your plan’s rules before you purchase items.

7. Choose the best plan for you

You’ll save money by picking a plan that meets your healthcare needs. Some people benefit from low-premium plans, while others save money on high-premium plans. It all depends on what types of healthcare services you anticipate needing throughout the policy year. For example, a couple that is anticipating having a baby may benefit from a high-premium, low-deductible plan. Pregnancy and childbirth costs can be expensive, so a low-deductible plan can help them get insurance coverage sooner.

Making the Most of Your Health Insurance

You might be wondering if you’re letting insurance benefits go to waste. The best way to get all the details about your plan is to talk to an insurance representative. They can explain the different aspects of your specific plan and help make sure you’re not wasting money or missing out on opportunities.