Make the Most of Your Health Insurance Benefits

Health Insurance Benefits

1. You are paying for health insurance, not sick insurance
Sudden illness and accidents are out of our control, but you can take charge of your own health by making both big and small changes to live a wholesome and healthful life.

Take advantage of preventative health insurance benefits that are already built into your plan i.e. free annual health checkups, flu shots, gym, etc.

2. Talk to a nurse, before you head to the doctor’s office
If you are feeling unwell, try calling a nurse hotline like Teladoc, or E-med On Call. It can potentially save you time and money, as well as an unnecessary copay and trip to the doctor’s office.

3. Clearly describe your symptoms to get tests you need
If you think you need a test, make it a point to discuss the relevant symptoms with your doctor. Your insurance carrier does not want to pay for anything that is not necessary, but if you talk to your doctor and show how the symptoms warrant testing, they are more likely to approve it under your health insurance benefits.

4. If you are in good health, but your rates are going up—shop around
Like car insurance or credit cards, health insurance plans sometimes offer lower initial rates and raise their premiums every year, thereafter.

Do you know what your rates are next year? If your premiums are increasing, contact a licensed insurance agent at to get free health insurance quotes, and possibly find a cheaper plan.

5. Your surgeon is covered…but not your anesthesiologist
Before you have a procedure done, verify that your insurance takes every doctor involved. Otherwise, your insurance could bill you for services rendered by the radiologist or anesthesiologist, who just happened to be out of network.

6. Surprise! You’re eligible for increased health insurance benefits
Did you know that based on which state you live in, you may be eligible for increased coverage? For example, under a given state’s law, your carrier has to include costly infertility coverage. It might not be the case for your neighboring state. You can find out more by contacting your state insurance commissioner or going to FamiliesUSA, a consumer advocacy group that keeps tabs on state and federal health care coverage laws.

7. Don’t keep paying for health insurance benefits you don’t use
Services such as unlimited doctor visits and maternity care are often built into plans and increase your premiums. If you don’t use these, consider switching to a cheaper plan.

8. A letter is always better
Although it might seem dated, a letter is actually the best way to communicate with your insurance provider. Unlike phone conversations, which take forever, writing a letter allows you to keep a record of your communication with your carrier. You’re also more likely to get a response this way, which is only sometimes the case for emails.

Go through your carrier’s appeals process when sending a letter, and send a copy to your state insurance commissioner for added security.

9. An advocate can help you win
A growing industry of patient advocates uses their knowledge of health insurance benefits, laws, and regulations to push for what the patient needs. For example, an advocate might be hired to help you deal with an insurance conflict, or communicate with your doctor – saving you precious time and energy.

10. Your doctor can be an advocate too
Let’s say you get some acupuncture for back pain, following your doctor’s recommendation, but your insurance carrier says they won’t cover it. Your doctor can help by threatening to report the carrier to the state board, which is in charge of regulating health plans.

Note: don’t actually do this if a claim is denied. Rather, mention that you’re considering doing so while going through your plan’s appeal process.

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