Published on September 27, 2022

Seven Health Insurance Tips That Can Save You Money

health insurance policy booklet and stethescope

Health insurance is something you don’t think about unless you’re shopping for it or get a bill in the mail.

Fortunately, there are a few ways to help you save money on your health care expenses by knowing how your health insurance plan works.

“Get to know your health insurance policy. By making use of free preventive services and understanding your network, you can reduce your health care costs and even experience better health,” said Jordan Anderson, Vice President of Sales and Account Management at Avera Health Plans.

Here are Anderson's seven tips to make the most of your coverage:

1. Understand which providers are in your network. If you visit a certain facility or provider, will your health insurance cover it? It’s a question you should ask before seeking non-emergency medical attention. Out-of-network care can lead to higher out-of-pocket costs since your insurance plan only covers certain providers and facilities.

2. Know when to use acute, urgent or emergency care. An ER visit will cost you more than going to Urgent Care. According to the Health Care Cost Institute, on average, an emergency room visit costs $1,389, while urgent care averages only $155. Go to your regular clinic when minor injuries or illnesses occur during office hours. After hours, think about whether or not it can wait until the next morning. Urgent Care can handle issues that require immediate attention such as minor cuts and burns, sprains and broken bones, or respiratory issues. Critical issues such as chest pain, stroke symptoms, head injuries, trouble breathing or dangerously high fever warrant a trip to the emergency room.

3. Read your summary of benefits and coverage (SBC). You pay a health insurance premium every month—so what are you getting for it? Your SBC can tell you. This document outlines the benefits and coverage of your health insurance plan. Contact your health insurance company if you have questions about what kinds of services are covered.

4. Make use of preventive services. Many health insurance plans are required to cover certain services, even if you haven’t reached your deductible for the year. Certain tests and shots can save your life and might not cost you a dime. Contact your health insurance company if you have questions about what preventive services are covered for you.

5. Check to see what kind of online access and resources your plan provides. You should learn if your health plan has an online portal that allows you to pay your bills, read your SBC or find important information on benefits, like what is covered for pharmacy. Our mobile app allows you to view claims, make a payment and search providers. Download the app now.

6. Check the cost of your prescriptions. Can you get a generic instead of a brand-name drug? An Association for Accessible Medicines study found that the average patient co-pay for a generic prescription is just over $5.50. You will likely face a higher co-pay for brand medications, so talk to your medical care provider about which option is best for you. With Avera Health Plans you can also search online to see what tier your prescription falls within.

7. Check on coverage for out-of-area dependents. Do you or your dependents live outside your network area? For example, do you have a college student on your plan? Your insurance plan may offer out-of-area coverage that will give you and your dependents continuous in-network benefit coverage for certain services, even if you’re outside your in-network area.

Learn more about member resources and benefits with Avera Health Plans.

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