Know how to use your insurance

You have enrolled in a health insurance plan, now what? Health insurance can be confusing and overwhelming, so here are a few tips to help you use your health insurance correctly.

  1. KNOW YOUR NETWORK! Check doctors, hospitals, and urgent care in-network. Be proactive about your medical needs and check for the doctor’s and facilities that are close to you that are in your health insurance network. Each insurance carrier has an online tool where you can search providers by name, specialty, location. This is useful to have so that you know exactly where you can go in the event of an emergency.
    1. Each carrier has a multiple “networks”, so know what network you are in i.e. Blue Cross Blue Shield Blue Advantage HMO, Aetna Rosebud EPO or HMO, Memorial Hermann HMO or PPO, United Healthcare Choice, PHCS, Humana HMOx San Antonio/Houston, etc.
    2. When confirming your network with your provider ensure that you are using the specific network to confirm. Sometimes it may be best to speak to a providers billing or managed care representative (the person that handles their insurance contracts) to ensure you are receiving the correct information.
  2. Get established with a primary doctor. If you are having to switch doctors or have not established a relationship with a primary doctor in your network get an appointment now.
    1. Some doctor’s will only see new patients on certain days, so it can take a while to get an appointment. You want to be certain that you your doctor is the right fit for you.
    2. If you have enrolled in an HMO we recommend that you find out what your primary doctor’s referral process is like if you need to be referred to a specialist.
  3. CHECK THE FORMULARY FOR YOUR MEDICATIONS!
    1. Make sure that you review your health insurance carrier’s prescription drug formulary for any medications you take. This will give you an idea of what your costs will be.
    2. Make sure that you are also going to pharmacy’s that are in your health insurance carriers network.
  4. Not truly happy with your health insurance? You have until January 31st to make changes to your health insurance. Be certain you know how your insurance works, your benefits and your coverage area. If your insurance does not meet your needs, we can help you explore alternatives. Call us at (512) 847-3164.