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eVitality June 2009
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Getting the Most From
Your Health Insurance

Photo of doctorIn an uncertain economy, it’s even more important to make sure you get all the coverage you’re entitled to from your health insurance.

These strategies can help.

  • Use the emergency room (ER) for true emergencies. When you have a life-threatening emergency, such as a heart attack or stroke, it’s clear the ER is the place to be. But going there for the flu or an earache wastes your money and the ER doctors’ expertise.

    Keep in mind that many insurance carriers require you to call them within a certain time period after an ER visit, or you may have to pay a higher percentage of the charges. Check your plan booklet to familiarize yourself with the requirements.

  • See if you can get your good health habits subsidized. Many insurers offer discounts on good health behaviors, such as gym memberships, weight-loss groups, and smoking-cessation programs. Check your insurer’s “wellness” benefits on its Web site, or call the customer service center to learn what your policy covers.
  • Appeal any denied claims. If your insurance company denies a health care claim, you have the right to challenge the decision and seek to appeal it. Ask for your doctor’s support.
  • Avoid hospitalization. More than half of all health care costs are for hospitalizations. Learn if there are alternatives to surgery in a hospital, including medication or outpatient or same-day surgery.
  • If you have a flexible spending account (FSA), plan carefully to make sure you use it all. If you find you have money left in your FSA at the end of the year, use it to pay for over-the-counter medicines, a refill on your maintenance medications, or contacts and eyeglasses.
  • Take advantage of free preventive care. Any opportunity to manage disease early is better for your health and your pocketbook. Check your plan booklet for free physical exams or recommended health screenings, such as Pap tests, prostate exams, or mammography services.
  • Avoid defensive medicine. If your doctor suggests you have an expensive test, such as an MRI or CT scan, ask why you need the test, if it’s really necessary, and what your options are.
Any opportunity to manage disease early is better for your health and your pocketbook.

Most importantly, take care of your health by making health-promoting lifestyle decisions, maintaining a healthy weight, exercising regularly, avoiding tobacco, and eating a healthy diet. The healthier you are, the less you’ll spend on health care.

For more information, visit the Association for Health Research and Quality at www.ahrq.gov/consumer/insuranceqa.

© StayWell Custom Communications. Information is the opinion of the sourced authors and organizations. Personal decisions regarding health, diet, and exercise should be made only after consultation with the reader's own medical advisers. This material may not be reproduced for redistribution without written permission from StayWell Custom Communications.


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