Using your healthcare benefits can seem a little confusing at first, but once you understand the basics of how health insurance works, you can start to make informed choices about how to get the most out of your coverage.

Peace of Mind, but Customizable to Meet Your Needs

At its essence, health insurance provides financial protection for you by covering high medical costs. The terms of this protection vary based on what kind of healthcare plan you choose when you enroll with the insurance company. Generally, if you choose a plan where you pay a smaller monthly fee (premium), the amount you must pay when there is a medical bill (this is called the deductible) is high. If you choose a plan with a higher monthly premium, the deductible will usually be lower. Sometimes insurance companies cover all costs once the deductible has been met, but with other plans, they may only pay a percentage of the costs beyond the deductible. There is also generally an out-of-pocket-maximum for your plan, which is an upper limit on the amount of money you would ever have to pay before insurance would cover the additional costs completely.

Valuable Benefits

Fortunately, you don’t have to meet your deductible to get benefits from health insurance. There are certain costs that are pre-negotiated at a set rate, for example, the costs of a primary care visit, a specialist visit, prescription medication, some medical procedures like x-rays, and more are discounted to a certain rate based on your plan. There are other details about types of plans and unique terms which you can learn more about from your human resources representative or by contacting your health insurance company. Health insurance truly is a “benefit” because it provides peace of mind and tangible financial assistance in the case of a medical emergency, and it can also help you maintain your health by keeping wellness checks, minor medical problems, and preventive care affordable.

If you have questions about your coverage, don’t hesitate to reach out to the individual in your organization who handles insurance/benefits coordination. It’s far better to understand your coverage before you begin to use it, than to make a potentially costly mistake by assuming you have aspects of care covered when according to the “fine print,” you don’t.