Using Your Health Insurance

Written by Carey Olney

Health insurance isn’t just something you use when you have had an accident or become ill.  It can also help you prevent illness for a healthier life.  This guide can help you fully utilize your health insurance. 

Finding a Provider

 

Many plans require you to designate a primary care physician (PCP).  This doctor will coordinate your care and make referrals as necessary.  To find a PCP, obtain a provider directory directly from your insurance company or from healthcare.gov if you selected a plan through the federal website.

 

Even if your plan does not require you to designate a PCP, it is still important to schedule an appointment with an in-network doctor to establish yourself as a patient.  Your PCP will get to know you, your health history, and your unique needs.  Your PCP will monitor your health and recommend appropriate regular screenings.  You can also schedule an appointment with your PCP if you have an accident or become ill. 

Filling Prescriptions

 

Before you fill a prescription, check with your plan to see which pharmacies are in-network.  Also confirm your copayment for the prescription.  In-network pharmacies will record your insurance information to request reimbursement from your insurer and request your copayment when you pick up your prescription. 

Emergency Care and Minor Emergencies

 

If you have an emergency that requires immediate care, you should go to the nearest hospital.  Even if the hospital is not in your network, you will be charged the same as you would if you went to an in-network hospital.

 

Plan in advance for minor emergencies so that you can limit your out-of-pocket costs.  Locate the nearest in-network emergency rooms and urgent care centers.  Since emergency room care can be significantly more expensive than urgent care centers, plans often charge higher out-of-pocket costs if you use an emergency room rather than an urgent care center.  For example, you may pay a $500 copay for an emergency room, but a $100 copay for an urgent care clinic.  Verify your out-of-pocket costs with your plan.  While you should always use an emergency room to address an emergency, it may be much more cost effective to plan to use an urgent care clinic for non-emergency care.