Health insurance is not just for when you are sick—it also helps you stay healthy. After you buy a health plan, take these steps to use your insurance to stay healthy and pay less for services. These steps will also make it easier for you to use your insurance in case of an emergency.
Choose a Primary Care Provider
A primary care provider may be called a family doctor, a general practitioner, an internal medicine specialist, or something else. Your primary care provider will get to know you over time and become familiar with your medical history and health needs.
The Role of Your Primary Care Provider
- Helps you prevent health problems
- Teaches you how to improve your overall health
- Helps you get care when you need it
- Don’t wait until you are sick to find a primary care provider
Find out from your insurance company which primary care providers in your area take your insurance. Then, check with the provider you chose to find out if he or she is seeing new patients (some providers already have a full schedule and will not accept new patients).
Make an Appointment with Your Primary Care Provider
It is a good idea to make an appointment with your new primary care provider even if you are not sick. This visit is sometimes called a “well visit.” Having a well visit with a new primary care provider will make it easier to get an appointment with that provider when you are sick. At this visit, the provider will ask questions about your medical history, do a routine check-up, screen for health problems, and give you any immunizations you need to help you stay healthy.Your primary care provider may also need to draw your blood or do other tests. Your provider should know which laboratory accepts your insurance, but if you are not sure,call your health insurance company to check.
Have This Information with You When You Call for an Appointment
- Is the provider taking new patients?
- Does the provider accept your insurance, and is he or she in your plan’s network? This is important because some providers will accept your insurance, but they will charge you a lot more if they are not in your plan’s network.
- How much will you pay for the visit?
- How will you be billed for the services, and what are your options for paying?
- Does the provider have appointments during hours that are convenient for you, such as on evenings or weekends?
- When is the next open appointment?
- Does the provider offer services in your preferred language? Will an interpreter be provided for you if your preferred spoken language is not English?
- If needed, does the provider have an office, facilities, and medical equipment that are physically accessible for people with disabilities?
- What information will you need to bring with you when you go to your appointment? For example, will you need to bring forms you filled out that were sent by mail or email before the visit?
- Will you need to bring your medical records or a list of the medicines you take? What is the provider’s cancelation policy?
- Will you be charged if you are late or miss an appointment?
- If you need to reschedule an appointment, how long before your appointment do you need to call to avoid being charged?
Get Information about Free Preventive Services
All health plans that are sold in the health insurance marketplaces must cover certain preventive services for free when you use providers that accept your insurance. Preventive care includes, but is not limited to, services such as checking your blood pressure, testing your cholesterol level, screening for depression and diabetes, giving immunizations, doing mammograms, providing well-woman care, and counseling about weight issues. Get more information about these free preventive services by contacting your health plan. You can find a customer service number for your health plan on your insurance card and on billing statements or other documents from your health insurance company.
Know When to Use Emergency Care
When you are sick or injured, you need to know how to get the care you need quickly. Many primary care providers offer same-day appointments or have a provider who is on call for urgent care. Seeing your regular provider is generally much cheaper than visiting an emergency room. Hospital emergency rooms provide fast, life-saving care and are open 24 hours a day, seven days a week.If you go to a hospital emergency room when it’s not a life-or-death situation, it may cost more money, and you may have a longer wait than if you go to your primary care provider. In most situations, when you are sick, you will save time and money by seeing your primary care provider. But in a true emergency, go to the emergency room. Be sure to find out which hospitals in your area are in your new insurance plan’s network so that if you need emergency care, you know which hospitals to go to.