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VIEWPOINT: Tips to help make the most of your health plan in 2021

By Dr. Don Stangler

Date:

Last year was a difficult one as the COVID-19 pandemic swept through our country, impacting families and communities nationwide. The health challenges of the pandemic also provided a crucial reminder about the importance of health care. 

For many New York residents and Americans, new health-plan benefits for 2021 began in January. If this is your situation, now is the perfect time to learn how to maximize this year’s health benefits, which may help improve your health and possibly save money. 

Consider the following tips to help you take charge of your health and get the most out of your plan in 2021. 

• Understand health-insurance concepts. Review common health-insurance terms like premium, deductible, and copay. This may help you better understand your plan and how your costs are calculated. Insurance plans differ depending on the providers you see and how much you pay for services. Remember, in-network providers are contracted with your health insurer to provide services at a lower cost, so consider checking whether your current health-care providers are in your network before making an appointment. Out-of-network providers may cost more and lead to higher out-of-pocket costs for you. 

• Schedule preventive services. Be proactive by taking advantage of preventive services that are often covered by your insurance, like an annual physical, mental-health screening, or flu shot. Scheduling these appointments with your primary-care doctor may help prevent health problems before they arise.

• Check your behavioral-health coverage. Some insurers, such as UnitedHealthcare, offer behavioral-health-care programs that can range from treatment for substance use, eating disorders, anxiety, and stress, with a goal of helping to improve your overall well-being. For example, an on-demand emotional support mobile app called Sanvello is available to help you cope with stress, anxiety, and depression.

• Take advantage of telehealth visits. A popular health-care choice, especially during the COVID-19 pandemic, has been telehealth or virtual visits, which enable people to connect 24/7 with a health-care provider via a smartphone, tablet, or personal computer. They may be an easier, more affordable way to talk to a doctor about common health issues. Log in to your health-plan’s member portal to check availability. 

• Explore your options for wellness programs. Many health plans now offer discounts and other incentives for working out, walking, signing up for an online health-coaching program, lowering your cholesterol, or avoiding nicotine. Incentive-based wellness programs are designed to reward people for making healthier choices. Check with your insurer or employer to see what programs are available to you. 

• Review your prescription coverage. Check to see what’s covered under your prescription-drug plan by logging into your health plan’s member portal or by calling the phone number on your ID card. Your plan will show medication costs and coverage and help you locate a network pharmacy. It also helps to ask about generic-medication options. In many cases, generic medications contain the same active ingredients as their brand-name counterparts, and they may save you money. 

Becoming familiar with your new health plan — especially [in the first quarter] of a new year — is one way to help you be proactive when it comes to your health.

Dr. Don Stangler is chief medical officer at UnitedHealthcare of NY (UHC.com)

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