June 27, 2024

The world of health care is confusing and complicated. The good news? It doesn’t have to be. Understanding your benefits is the first step to being a good health care consumer. You need to know what is covered and how it is covered under the plan your employer provides.

Why does it matter?

Being a better health care consumer has numerous benefits. But the most important is that it keeps you from overpaying. Medical providers make a lot of mistakes on billing — 80% of medical bills have an error.

Understanding how your benefits work, and how to read and pay bills is the foundation of saving money on medical care. Things to know include:

  • Knowing when you have a copay
  • Knowing what % of coverage is your responsibility
  • How to read your bill
  • Understanding your Explanation of Benefits and paying based on this document instead of the bill from a provider.

Pro-tip: Always pay attention to your carrier and what providers are in network. This will allow you to find the best available care for the best price. You can usually find in-network providers via your carrier’s website. Here are examples of Anthem and UnitedHealthcare’s tools.

How can I lower my out-of-pocket expenses?

This is a great question to start becoming a better health care consumer. The first step — take advantage of tax-advantaged accounts available to you.

There are a number of pre-tax accounts that you can deduct money into for use on eligible medical expenses:

  • Health Savings Account
  • Flexible Spending Account
  • Limited Flexible Spending Account
  • Dependent Care Flexible Spending Account
  • Health Reimbursement Account

Remember, your benefits plan may not offer each of these accounts, or any of them for that matter. Every employer offers different benefits. However, make sure to ask your HR person or manager about the options available to you. Sometimes plans will even contribute money into these accounts for you!

What about pharmacy costs?

The cost of prescriptions can sometimes feel out of control. So, this is another fantastic question! There are programs to help you get prescriptions at a lower cost. Become a better health care consumer by understanding what options you qualify for.

Here are some of the most common programs:

Pro Tip: If you do not qualify for the programs above, or live in an area they do not serve, check your insurance card! Reach out to the number on the back of your pharmacy ID Card. Your contact could help you identify ways to save.

Wellness Reimbursement

You can actually make money as a health care consumer. Employers, and insurance carriers themselves, will pay you money as you complete annual checkups and other preventative care.

This money can be used for a variety of wellness expenses. Think gym memberships, workout clothes, step trackers and more. Reach out to your HR person or contact your carrier to understand all the wellness incentives that are available to you.

 

I’ll be the first to admit — even these tips can be overwhelming. There is a lot to know about your benefits and health care. But your HR team is there to help you navigate any challenges you may face. And if your company has a strong broker partner, there may be additional resources to support you as well.

Becoming a better health care consumer takes a bit of time and learning. But it is worth it in the end when you get the care you need, at a price you can afford. If you have any questions, don’t hesitate to reach out.

 

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