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Health Insurance Coverage and Benefits: How to Maximize Them

couple researching health insurance coverage and benefits

Decoding your health insurance coverage and benefits can be difficult, especially as a new applicant. Due to the many ins and outs of health insurance, it can take forever to navigate alone. That’s why you need an experience healthcare advocate to help you to navigate through the healthcare system.

Here at My Healthcare Direct, we want to help you from experiencing confusion by providing you with valuable information. Let’s dive into our 8 key tips for maximizing your health insurance coverage and benefits.

agent explaining health insurance coverage and benefits

8 Tips For Maximizing Your Health Insurance Coverage and Benefits

To navigate your health insurance coverage and benefits with ease, follow these simple tools:

Learn About Your Plan Online

Before connecting with your insurance agent, It is best to read about your chosen plan to learn the basics (i.e., doctor’s network, limitations, disqualifying factors, etc.). Research gives you an overall sense of what questions to ask your agent.

For example, if your plan does not cover dental or vision, it helps to know if it’s something you can’t do without.

Speak With Your Insurance Agent

When seeking information about your policy, it is best to speak to a licensed professional because they are most equipped to advise you regarding your personal needs and budget. Otherwise, you run the risk of receiving misinformation that could put you at a disadvantage.

More so, agents with experience will give you accurate advice about doctors in your network or any secondary insurance.

Read The Fine Print

When reviewing your policy, it’s necessary to read the fine print because there may be certain excluding or disqualifying factors you were previously unaware of.

For example, it may help you to know whether you’re eligible for certain types of care, such as corrective cosmetic surgeries, organ transplants, or glasses/contact lenses.

Stay Within Your Network

In-network doctors are groups of doctors your insurance has agreed to pay at a specified rate. Although you may need to see a doctor outside of your network, staying in the network prevents additional out-of-
pocket costs and the need for referrals.

If you are experiencing difficulty finding a specialist, your agent or insurance provider can give you a list based on location.

Ask Questions About Coverage & Benefits

When meeting with your agent, it’s good to be prepared with a list of questions. For instance, you may want to ask about copays, deductibles, premiums, or coverage periods.

Learning about the basics of your plan helps you narrow down your most pressing concerns. Writing down details of the conversation during your meeting prevents you from forgetting any vital issues.

Take Advantage Of Discounts & Programs

If prescription discounts are available, don’t be shy to take advantage of them. If you lack a specific form of coverage, such as dental, there are dental and medical discount plans separate from your health insurance.

Although these discounts are not guaranteed and vary significantly depending on the provider, they may be a good option given your circumstances.

Factors Affecting Your Premiums

Your premiums will change based on age, location, tobacco use, plan category, and whether the plan covers dependents. Specifically, your age can make your premiums up to three times higher for older people, and insurers may charge up to 50% more for tobacco users.

With your agent, being informed about these factors will help you select the most appropriate plan. 

Determine If You Need Supplemental/Short-term Insurance

When consulting your agent, they can help determine whether you need a supplemental policy. If you are enrolled in original Medicare, supplements (Medigap) exist to make your coverage more affordable while also covering certain hospital bills. 

Short-term insurance benefits those lacking access to other types of insurance, providing temporary coverage for preventative care, doctor visits, and urgent/emergency care. Like any policy, it is crucial to do your due diligence by asking questions and researching.

Realize Your Health Insurance Coverage and Benefits Potential

Decoding your health insurance coverage and benefits can be easy. By choosing My Healthcare Direct, we can provide simple, reliable, and direct answers to complicated questions and provide you with the best health insurance plan for your needs and budget. Learn more about us by visiting our About Us page.

Our experienced and licensed professionals will help you navigate your policy and eliminate your stress surrounding health insurance. Contact us to speak with an agent today!