Making The Most Of Your Healthcare In 2021

The new year represents new beginnings, and gives us the opportunity to hit the reset button. As we turn the page to the new year, perhaps now more than ever people are looking forward to the next chapter. With 2020 in the rearview and significant changes in the healthcare landscape on the horizon, here are some tips to make sure you are getting the most out of your health insurance in 2021 and beyond.

Understand Your Coverage

Combing through your benefit summary is the first step to understanding your coverage. If you have individual insurance, this summary will be mailed to you after enrolling in a plan. If you obtain coverage through your workplace, your employer will provide you a copy. This summary will highlight co-pays for office visits and/or prescriptions, as well as member deductible and coinsurance responsibilities for other healthcare services. The summary will also breakout in and out of network costs, where you will notice substantial savings by utilizing in-network providers.

Take Advantage of Carrier Tools

Regardless of carrier, you will have access to log on and sign up for their member portal to access plan information. Member portals house different tools you can utilize to get the most out of your healthcare. You can access benefit information, view claims status, pay a bill, pull an id card and much more. Most sites allow you to access care on the go by either scheduling a virtual telehealth visit or calling a nurse line. You can search for in-network doctors and facilities, lookup covered drugs, and even select a primary care physician. The majority of carriers will even incentivize members with gift cards or free doctors’ visits for doing so. There are tips and programs designed to help keep you healthy, which are often accompanied by rewards for completing certain goals. Carriers also have cost estimator tools you can take advantage of to maximize the dollars you spend, which leads to…

Tips to Save

If you are paying for the service, it is worth the time and effort to take advantage of carriers cost estimator tools and shop around. Diagnostic lab work, complex imaging, and outpatient surgeries to name a few, represent opportunities to save big by taking the time to look up costs across various providers. As a general rule of thumb, freestanding facilities are cheaper than hospital-based facilities. Take an MRI for example. The exact same MRI may cost $1,500 at a freestanding facility, $3,000 at a hospital down the road, and $5,000 at a hospital across town. It is not a quality of care issue it is a cost of care issue, and the cost can vary substantially across providers.

Knowing your network is also important. Insurance carriers negotiate discounts with providers who participate in their networks. As a result, choosing to see in-network doctors and hospitals will result in lower costs to you as a member.

Understanding all of the avenues for care, and when to utilize each is another way to maximize healthcare spend. Emergency rooms for example, are typically the most expensive place to administer healthcare. Often times urgent care centers or virtual telehealth visits are great alternatives, when appropriate, for unexpected injuries or illnesses. Typically, you as the member will save time and money, while also reaping the benefits of a better customer experience.

Our final tip to save on healthcare spend is to talk with your doctor about exploring generic drug options. Prescription spend as a percentage of each healthcare dollar spent continues to rise. Generic prescriptions approved by the FDA have the same active ingredients as their brand name counterparts, but are usually available at a fraction of the cost. When appropriate, generic drugs represent a great opportunity to save on healthcare spend, while not compromising on care.