Station InitiativesWellness Wednesday


How to maximize your health insurance benefits

Posted at 3:57 PM, Jul 13, 2023

Most Americans give their insurance high ratings, but they often avoid using it and express frustration understanding what is and is not covered.

That's according to a survey from KFF, a health care think tank. And a good reminder from the Utah-Based insurer SelectHealth to use the benefits available to you.

“It's there for you when you get sick. It's there for you if you have an accident. But people tend to forget about other types of things that can take advantage of in their health plan,” said Heidi Castaneda with SelectHealth.

Castaneda manages thousands of health insurance plans, hoping people use them before they get sick or injured. But many of us let distractions keep us from basic self-care.

She said, “When you're really busy, and it's overwhelming, then you do tend to avoid things like that.”

July marks the halfway point in the year. Have you seen your primary care physician for the basics?

“Immunizations, wellness checks, you know, if you if you're due for your colonoscopy, a lot of those things are covered, at little to no cost from a member perspective. So really, your primary care can help quarterback all of that care for you,” said Castaneda.

Your provider can also help you understand your own prescriptions. You should feel comfortable asking them about new, better, or less expensive options. You can learn about some of those options with other tools online and over the phone.

“We do not mind phone calls for people who are trying to plan ahead and want to understand their benefits. We'll take as much time as needed to walk through it with you and answer all the questions you have at any of those stages,” said Castaneda.

That phone call or online research is also a time to ask big picture questions – what would my plan pay for to hep me be healthier and happier in general?

“That's one thing I would say a lot of people just don't realize they have. They know they got the medical, but they don't know they could get additional dollars for healthy behaviors. So, if you're going to walk 7000 steps for more than 21 days in a year, you can be reimbursed, you know, for those kinds of things all the way up to $580 a year for your family. So you could do that. You could also join a gym and we can we can cover your gym payment through a reimbursement program...” said Castaneda.

And if a half-year check in shows you aren’t offered what you need, now you know.

“So that is really the biggest thing. Make sure that you're aware of the coverage. And most people don't read every fine detail. But if there's things that are a particular need for you and your health status, make sure you're getting those things covered. Make the best use of your premium dollars that are being paid towards your health plan.”

In recent surveys Americans were most confused about their deductibles and how they can use health savings accounts. Those are good places to start with questions for your insurer. For example, some plans let you use your health savings account to pay for over the counter allergy medicine or even for high protection sunscreen.