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Get the most out of your insurance
If you’re one of the 8 million Americans who signed up for coverage during the Health Insurance Marketplace’s initial open enrollment period, you may be wondering how to get the most out of your new health plan. So, let’s take it step by step.
The first step is to understand how your plan works. Find out from your insurer: What’s your share of the cost for a doctor or hospital visit? Will your share be higher if you use an out-of-network provider? What will you pay for prescription drugs?
When you first got coverage, your insurance company should have sent you a membership package, including a proof-of-insurance card. The card will answer some of those basic questions about cost as well as tell you how to contact your insurer.
Next, choose a doctor with whom you can have an ongoing relationship. Look at your insurance company’s website or handbook to find which providers near you accept your health plan. At the same time, ask friends and family for suggestions.
Narrow your choices by calling the doctor offices you think might work for you and asking the staff a few questions: Is the provider accepting new patients? Is the office open at hours convenient for you? Which hospitals does the provider use?
If you like what you hear, make an appointment. Be prepared to provide your name, address, date of birth, Social Security number, and information about your insurance. Also, have your insurance card with you when you call.
You may need to wait a few weeks for a regular checkup. Be sure to bring to your first visit your insurance card, a photo ID (such as a driver license), any forms you were mailed and asked to complete, and a list of your prescriptions.
It’s important to show up early for your appointment. Check in at the front desk. The office staff will make a copy of your insurance card and ID in order to bill your insurer. If you owe a copayment, the staff will collect it when you arrive or leave.
Don’t be shy. Ask if you don’t understand something your doctor says. Before you leave, you should know the answers to these questions:
•How is your health? If you have a medical condition, what is it? What will happen if you don’t take care of it?
•What should you do to get healthier?
•If you take medicine, do you know how much to take and when to take it?
•What are you supposed to do next? (For example, do you need blood work or additional testing?) Where do you go to get it done? When do you need to see your doctor again?
•What should you do if you have questions once you get home?
If, after the first couple of visits with the doctor you’ve selected, you’re not satisfied with your choice, it’s all right to keep looking. Try someone else. You may prefer another doctor in the same office or clinic or another doctor at another office or clinic.
Once you’ve settled on a provider, keep going. You should still see your primary care doctor regularly, even if you see a specialist for a particular illness. Your primary care physician can help answer questions about your health, change any medications that are making you feel sick, and figure out when your next visit should be.
Don’t let a convenient excuse stand in the way of making that next appointment.
You’re not sure what you’re supposed to do next? That should never hold you back. Talk to your doctor about what you need to do, or have someone you trust come with you to your next doctor visit and help you understand.
You’re too busy? We’re all managing families, jobs, and other things, but you can’t do those things if you’re not in good health. It may be possible to schedule a follow-up visit after hours or on weekends. Check with your physician’s office.
You’re scared? Don’t put off seeing your doctor or getting a medical test because you worry about hearing bad news. Regular doctor visits and health-care screenings let you detect problems early, when they’re most treatable.
Visit healthcare.gov or call 1-800-318-2596 if you have other questions about your new insurance coverage. Nothing is more important than getting healthy -- and staying healthy.
Bob Moos is the public affairs specialist with the Centers for Medicare and Medicaid Services, Region 6.
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