Get the most out of your health insurance with these tips.
Health insurance is a large portion of many people’s monthly bills. Even with employer-sponsored plans, the cost can be significant. Get the most for your dollar by maximizing the payback.
File Every Claim
Just because your insurance isn’t going to cut you a check or pay for your service doesn’t mean you shouldn’t file a claim in most cases. Claims that eat away at your annual deductible and annual out-of-pocket get you closer to making your insurance pay for your medical bills. Always weigh this against the cash price for the service. If paying directly is going to give you a significant discount, you may want to skip the insurance claim.
If you have a service done somewhere that you direct pay but it might be covered by your insurance, file a claim directly with your health plan. Most plans allow you to file claims on their websites. They may require some additional paperwork or information from your provider. Insurance companies like to reject these claims hoping you will give up, most will eventually relent and pay if you call them.
Know Your Coverage
The fine print of your policy frequently includes lots of services and perks most people don’t know about. Some have included dental and vision coverage. More policies cover additional services like chiropractic care than did a few years ago. Gym memberships might be covered or heavily discounted. Don’t forget to look at whatever perks program your insurance has. These provide discounts for various healthy things, including discounts at local or national gyms.
Smoking cessation programs may be covered or completely free. Insurance companies consider this to their benefit since it will improve your health so many will pay the entire cost. Diet and weight loss counseling may be covered. For people with some chronic conditions, newer health insurance laws mandate this coverage. Sleep studies should be covered if ordered by a doctor, take-home sleep study kits may be covered at a higher rate so they cost you less.
Holistic treatments like acupuncture may be covered under your insurance as more providers focus on wellness services. Some will also cover herbal supplements, massage therapy, and other services not considered parts of Western medicine.
Hot tubs and swim spas might be covered by some health insurance plans. These require a doctor’s prescription and certain conditions like arthritis.
100% Covered Services
Telehealth services may be covered at a 100% rate by your health insurance. You will have to use whatever telehealth service they offer, but it will cost you nothing, and no surprise bill. Minor ailments that genuinely don’t need an in-person visit should be done through telehealth.
Labwork through national laboratory chains like Quest or LabCorp is covered at a 100% rate by many insurance programs. This requires you to have a doctor’s order for the test and to go to one of their collection facilities to have the labs drawn. As insurance plans have added deductibles for labwork and diagnostics, opting for one of these outside labs will save you significant money.
Nurse advice lines and condition counseling services are 100% free services many insurance companies have added. These services are direct through your insurer’s service rather than through a local provider but they cost you nothing to use. You can ask questions or get advice without an office call.
Plan Your Plan Year
Know how much of your deductible you have used so far in the year and how close you are to satisfying your out-of-pocket maximum. Towards the end of the year, as you satisfy your deductible, more services will be fully covered. If you had put something off, now would be the time to have it done while your coverage will cover more of the cost.
If you are close to your out-of-pocket maximum for the year, this is the ticket to “free” health care. With your out-of-pocket for the year satisfied, most plans cover everything at 100% for the rest of the year. Check your plan’s fine print and plan accordingly.
This can be an opportunity at the end of the year to stock up on expensive prescriptions. Fill as much as you are allowed by your insurance while you have 100% pharmacy coverage. Did you put off an expensive diagnostic due to cost? Now would be the time to find out what is up with that achy knee while the scan is covered at 100%.
The same would be true for elective surgeries you may have put off. Be warned that towards the end of the year, you won’t be the only person scrambling to use those end-of-the-year benefits, so appointments may be a bit harder to schedule.
Don’t Forget Your HSA Or FSA
If you signed up for one of these health-related savings accounts, or have one funded as part of your insurance coverage check your balance and what your year-end rollover amount is. If you have money available that you can’t roll over you will lose it if you don’t spend it. Submit any health-related expenses you incurred during the year that you have not already submitted.
Review the plan’s list of what items can be reimbursed. If you buy routine items from Amazon or have accounts with Target or Walmart, all of your past purchases are there. You can go through those for things that may qualify for reimbursement and print out a receipt you can use to submit a claim. All those random bottles of pain relievers and shoe insoles add up and will help recoup some of that money in your account.
If you need to buy things to recoup some of the money in your account, start by stocking your home supplies and first aid kit. Bandages, bottles of over-the-counter meds you use throughout the year, or a spare pair of shoe insoles are potential items for reimbursement. A bulk box of band-aids never expires.
If you still have funds left you could buy over-the-counter qualifying supplies and donate them to a local shelter or charity. Helping someone in need is a better use of the money rather than going towards buying an insurance exec another yacht.