Lots of Californians got new health insurance plans in January, so now is the time to get to know your benefits to make the most of your policy.
Many plans offer free preventive services, mental health support and access to wellness apps, options which often go underused because you might not realize they are available.
Amy Jordan, vice president of consumer experience for UnitedHealthcare, said your health plan’s digital app can do much more than list your benefits and help you find an in-network provider. The apps are now highly personalized and can help you compare costs and treatment options.
“The best step is to download an app or log on to the website so they kind of understand what’s there,” Jordan recommended. “Reach out to your Member Services team so that when the time comes that you need care, you’re actually able to understand exactly where to go and how to navigate.”
Jordan added you need to understand how your plan is structured in terms of your premium, co-pays and deductibles, coinsurance and out-of-pocket maximum, all terms defined on the website JustPlainClear.com.
People who have chosen a bronze plan on CoveredCA should be aware that although they may have low monthly premiums, the insurance policy may not pay anything until the deductible has been met. Some deductibles are as high as $10,000, making the bronze plans expensive to use.
Joy Dockter, senior health attorney at the Western Center on Law and Poverty, said you can really limit costs by making sure the specialist you want to see is in your plan’s network.
“Check with your doctor,” Dockter advised. “Be sure all appropriate pre-authorizations have been received, and if the doctor is unsure, call the insurance plan. Also ask for the good-faith estimate at hospitals. Read it; understand what it said.”
Dockter noted hospital care may be a better choice than a surgery center for low-income patients because only hospitals are required to offer financial assistance programs or charity care.
UnitedHealthcare contributes to our fund for reporting on health care.
