Co-Pays, Deductibles, and Essential Services – Oh My!!


Are you new to the health insurance system?

Did you recently change plans and are a little apprehensive about using your coverage?

Does the phrase “essential services” mean anything to you?

If you answered yes to the first two questions and are a little fuzzy on the third one, this post is for you! Don’t be embarrassed to admit that the health insurance is a bit confusing.  You are not alone! Think of it as learning a new language and remember the more you use it, the more familiar you will become with it!

On the Department of Health & Human Services (HHS) site, learn about the benefits to health insurance:

Thanks to the Affordable Care Act, health insurance companies and group health plans are required to provide you with an easy-to-understand summary about a health plan’s benefits and coverage…. The Summary of Benefits and Coverage is designed to help you better understand and evaluate your health insurance options.

Also on this site, you can learn about co-pays and deductibles! If your insurance provider offers education on the ins and out of using your insurance coverage, try to attend their workshop or read their materials. These are usually effective ways to help you get the most out of your health benefits.

Now let’s get started using your health insurance plan. Here are some helpful actions you can take:

  • Find a doctor who accepts your plan.
  • Figure out which health screenings, immunizations or essential services you are in need of. To do this, search the complete list provided on the website of HHS’s Office of Women’s Health.
  • Make the appointment! Ask if you will need to fast or not eat prior to the visit.
  • Inquire about your co-pay or deductible.
  • Write down your questions for your provider before showing up to the waiting room at the doctor’s office. The newness and nervousness may cause you to forget.
  • If this is a provider you’ve never seen before, be sure you take any prescriptions with you that you currently take.
  • Remember to take your new insurance cards!
  • Don’t be a “no show.” Visiting the doctor for the first time in a long time can be scary, but it is a vital step to take on the road to good health. Set the alarm on your cell phone to help remind you!
  • Arrive early, first visits generally require the completion of paperwork.
  • Remember you are your best advocate. If you are confused by something that came up during your visit or in the statement you received in the mail following the visit, contact your provider or insurance provider.

If you haven’t signed up yet, click this link to see if you qualify to enroll during a Special Enrollment Period.

And remember insurance coverage is not a privilege, it is a right! Take care of yourself. The world needs you!!