The selection of the best health insurance plan is very important in order to receive the maximum amount of coverage. Use your medical history and projected usage of healthcare services to choose a plan that will provide sufficient coverage for services you anticipate using. Patients with pre-existing conditions should focus on a high level of prescription drugs. The young and healthy population may opt for cheaper health insurance premiums at the cost of higher out of pocket expenses. For the families expecting to have children, they should opt for insurance plans that will cater for the maternity and those with minimal charges on newborns. Try to estimate the possible amount of healthcare that you are going to require for the next year and then go for the plan which provides for it. 

Utilize In-Network Providers

It is essential to seek medical treatment from the doctors, specialists, or hospitals that are included in your health insurance plan’s network to ensure the lowest possible out of pocket expenses. You have to pay more of your own money in the form of copayments, deductibles and higher coinsurance for out of network costs. Find out the doctors such as primary care physicians, medical specialists, hospitals, pharmacies, labs, and urgent care clinics that are under your plan. Have a primary care physician in the plan to manage referrals if a client needs to see a specialist. Check a provider’s network status before each medical appointment or a planned procedure. That way, it increases the chances of receiving the largest percentage of one’s cost from the health plan.

Contribute to a Health Saving Account

HSAs are available to anyone who is enrolled in a qualified high deductible health plan (HDHP). HSAs come with a tax break tri-fecta to pay for today’s healthcare expenses and save for tomorrow. Donations are tax-exempt, money invested in an HSA does not attract taxes, and the money withdrawn for medical purposes is also free from taxes. Many HSAs permit investing of contributions for better appreciation possibilities. You must contribute the annual contribution maximum allowed by the IRS each year in order to maximize the tax advantages and savings for an HSA. Regular and planned contributions from every paycheck make saving easier.  

Use Preventive Services

Currently, almost every health plan has to include a list of a wide range of preventive services as free of charge for the patients. This includes yearly check ups, annual physicals, pap smears, mammograms, colonoscopies, vaccinations, and many other services. Utilize this offering to the fullest extent by following nationally endorsed preventive health care practices for your age and sex. Make sure to attend regular health checkups to increase your chances of catching diseases in their early stages. Anti-venin and flu shots also play an important role in avoiding diseases and costly consequences. A lot of money is saved and health is optimized when zero-cost preventive services are applied.

Utilize Telehealth Options   

At present, most health plans include telehealth services, including options such as video-conferencing, which have no or very low copayment requirements. Telehealth offers an opportunity to receive medical assistance online without visiting a doctor’s office and paying its corresponding fees. It is suitable for minor acute illnesses, medication administration, mental health services, or postoperative care. While it is still important to have care continuity, the doctor-patient relationship is still important for overall care management so continue to use traditional office visits but use telehealth for added assistance. In case of illness or if one requires care, one should first consult with available telehealth services that are allowed under the insurance coverage.

Appeal Insurance Claim Denials

Sometimes, health plans reject filed insurance claims for necessary and appropriate services that lead to surprise billing. Do not pay denied claims right away. First, some documented appeals that should contain letters from your doctor explaining why the care was needed. Appeal letters should be written, emphasizing the benefits offered under your plan that should enable the patient to be offered the denied services. However, consumers do not give up easily and are frequently able to overturn initially denied claims with some persistence. If the above appeals do not work, you can try contacting the department of insurance in your state for more help. Do not pay for your claims appeal case until the case is fully disposed off.

Negotiate Medical Bills & Create Payment Plans

If you find that you are stuck with a large amount of out of pocket expenses in your health plan, negotiate the costs with the providers. Clearly explain your ability to pay to force hospitals and facilities to lower prices or come up with long-term payment plans with little to no interest. Avoid chronic disease management and other crucial healthcare services due to insufficient funds, but do talk with billing clerks to explore payment plans if needed. Most of the providers have discounts, or grants or charge reasonably affordable fees to avoid putting the patient into insolvency. Payment options are also provided interest free for a time span of 1 to 5 years to make the care accessible.  

Review Plan Offerings Annually

There are major differences in the health plan and pricing from one year to another; therefore, it is essential to review all the available options before renewal during the open enrollment period. Examine benefit options such as premiums, deductibles, copayment schedules, and coinsurance levels; list of covered and noncovered services; and preferred provider organizations and point-of-service plans of several available choices in both the employer group plans and newly established public health insurance marketplaces. Change the switch plans or insurance companies completely if another one is more suitable for current healthcare needs at a lower estimated yearly cost. It is not appropriate to stick with the existing coverage without checking the annual changes and new plans that might offer more cost-saving options and better plan management.  

Conclusion

Choosing suitable health plans, avoiding out-of-network treatments, ensuring maximum utilization of benefits such as annual checkups, telehealth, appealing against denials, negotiating on cost, and reconsidering options of insurance annually enables consumers to make the best out of their insurance policies while managing costs. Self-administration of health insurance assists in providing cost effective health care throughout the life of an individual.