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Making the most of your health care benefits

Jan./Feb. 2010 California Country magazine

Tips for making cost-effective use of your health insurance benefits while holding down out-of-pocket costs.



It's important to get medical care when you need it most. To save on costs, you may be tempted to avoid a doctor's visit in hopes of getting better on your own. Keep in mind that delaying care often results in more intense future treatment and an even greater financial, health and emotional cost. For instance, what you think is a nagging cough could quickly turn into a nasty case of pneumonia requiring hospitalization.

Here are some tips on making cost-effective use of your health insurance benefits while holding down out-of-pocket costs:

  • Review your plan selections. If you are in good health and only see the doctor for well-care, consider switching to an HSA-compatible insurance plan. These plans offer affordable monthly premiums, high deductibles and a tax-free way to invest and save. Funds accrue year after year and may be used for qualified medical expenses. Overall, take a careful look at your plan design to make sure it fits your needs.
  • Use your preventive care benefits. Services like blood pressure and cholesterol checks, mammograms, Pap smears, PSA tests, diabetes and cancer screenings, and physicals can keep you from developing a preventable condition—or keep previously undetected conditions from getting worse.
  • Consider medical professionals within your health plan's network. Using out-of-network providers typically results in higher copayments—or sometimes no coverage at all.
  • Use a mail-order pharmacy program. Many health plans offer both cost savings and convenience through mail-order delivery of maintenance medications. Some plans provide up to 90 days of mail-order meds for the same copayment as a 60-day supply from your local pharmacy.
  • Go generic and save. Generic drugs often are a lower-cost alternative to their brand-name counterparts—and they work the same way, according to the Food and Drug Administration.
  • Take advantage of health coaching, health education, wellness benefits and other free tools and resources offered by your health plan. Health plans want to help their members be healthy. That's why many offer free health coaching programs, health education materials and wellness benefits.

Every health plan is different. It's a good idea to check with your plan's customer service department to determine how the plan will cover specific services and products.

Sam Cole is a regional vice president for Health Net of California Inc. For more information, visit www.healthnet.com.


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