How to Use Health Insurance
Now that you have health insurance, you are able to get the health care you need, when you need it. You won’t have to wait until your medical issues are really serious to seek treatment.
You can pick a medical provider you like who is located in a place that’s convenient for you, and build a relationship with him orher that helps you take charge of your health. Your health is now in your hands.
This booklet explains how to get started using your health insurance. If you have more questions, remember that you can always call your health insurance company or your medical provider directly. They can help you.
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Your Good Health Matters
Good health means that you take care of your body and mind by exercising, eating right and taking time to relax. When you are healthy, you are more able to do things you enjoy. You feel good, and that helps your mood and your relationships.
An important part of staying healthy is getting regular check-ups. At check- ups, your doctor will make sure that your heart, lungs and the rest of your body are in good shape.
Check-ups are a way to catch medical problems before they get worse, and to help manage medical problems you may already have. They are also a good time for you to ask questions about both your mental health—how you are dealing with your emotions—and your physical health—how your body feels.
Understand Your Health Insurance
Every health insurance plan is different, so it’s important to check your insurance plan to see what services it covers. You can also review your “Summary of Benefits” which provides you with written information about your plan’s costs and benefits, including preventive services that are now offered to you at no cost. If you have questions about your plan or benefits, you can call the insurance company and ask that a person explain them to you. You can also use the form at the end of this booklet to write down some helpful information about your insurance plan and doctors.
A primary care physician is your main doctor. He or she takes care of your general health and may refer you to specialists for help with specific illnesses.
A specialist is a medical provider with extra training in a specific type of medical condition. For example, a cardiologist is trained in heart health, while a psychologist is trained to evaluate and treat mental and emotional issues. Make sure you understand the process for seeing a specialist under your plan. Sometimes you can only see specialists after you see your main doctor.
Many health insurance plans offer extra programs at little or no cost, such as programs to help you quit smoking, weight loss groups, or support groups for anxiety or depression. You can sign up for these on your health insurance plan’s website, by calling the insurance company, or by asking your doctor for information.
If you have major life changes, such as losing a job, getting a better-paying job, or having a baby, these events can change the amount you need to pay for health insurance. Keep your insurance company up to date about big life changes so you don’t pay more than you should.
Find a Health Care Provider
Providers can be doctors, specialists, therapists, hospitals, clinics—any person or place that provides you with health care. If you don’t already have a health care provider, or if your current provider is not part of your new insurance plan, how do you find one?
- Ask people you trust. Ask your friends and family about who their doctors are.
- Check your plan's provider network. Your insurance company should have a list of providers they work with. Sometimes this information is available on the insurance company’s website or you can contact the insurance company’s member services office and describe the kind of provider you want.
- A good fit matters. Contact your plan if you are assigned a provider and you want to change. You can request another provider without even seeing the one assigned to you, or even after you’ve seen the provider many times. It’s your health, your body, and your right to see a provider who makes you feel comfortable.
- Find a match. Think about what you want and need from a provider. You may want to look for providers who are close to your home or work, and whose office hours are convenient for you. Ask if the provider, or someone in their office, speaks your language, and find out what hospital the provider works with.