A deeper look at your health insurance could reveal some benefits you might not know about. These may include products or services that could save money and time, and improve your care.
Health insurance benefits are ever-evolving. For example, many insurers introduced new benefits during the COVID-19 pandemic and have kept them in place for your convenience. It is a good idea to check your plan documents at each renewal to make sure you get the most from your plan.
Free or discounted telehealth
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It’s not always convenient to visit a doctor’s office. You may even prefer not to visit to reduce the risk of further illness to yourself and others, or you may not feel well enough to make the journey.
Telehealth brings doctors to you via video chat, messaging service, or other electronic means. Since 2019, these services have become a regular way to speak with healthcare professionals.
According to the Centers for Disease Control and Prevention (CDC), in 2019, 43% of health centers could offer telehealth services. However, in 2020, 95% were using telehealth options. The COVID-19 pandemic was responsible for the large rise in telehealth services, but even with pandemic restrictions relaxed, telehealth appointments rose from 0.1% in 2019 to around 5% at the end of 2021.
This effect was also seen in mental health services, with many more options for contacting a therapist online or by phone following the pandemic. For example, a 2023 study examined data from just under 13,000 mental health treatment facilities. In April 2019, 39.4% offered telehealth services, but by September 2022, this rose to 88.1%.
It stands to reason that health insurers would align their services to include coverage for telehealth services. Some initial consultations may be cost-free, and many insurance plans offer a 24/7 nurse support line. This can be helpful when you need out-of-hours medical advice or are unsure whether you need to see a doctor.
Consider checking your plan documents for more information on the telehealth services available.
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Health insurance plans that include prescription drug coverage typically offer a discount for ordering your medications via mail. This can be especially helpful if you have a chronic condition requiring regular medication or difficulty getting to a pharmacy.
Checking your plan documentation or contacting your insurer can help you confirm your coverage.
Inpatient care
If you need to stay in the hospital overnight or longer, health insurance can help you manage the unexpected costs associated with inpatient care.
Insurance plans will often cover:
a single standard room with a private bathroom
diagnostic tests, like blood work, x-rays, and scans
medications you need during your stay
doctors’ fees
any medically necessary surgical procedures
You may have to pay copayment or coinsurance for some items or services, but your plan documents will fully explain your out-of-pocket costs. A copayment is a fixed amount you will pay toward your care, while coinsurance is a percentage of a cost.
Care coordination
Care coordination can make a big difference if you have a chronic or end-stage health condition. Typically, a case manager is assigned to you who can answer your questions, help you set goals, and work with your healthcare team to meet your needs.
They can also recommend healthcare professionals, organize care, and follow up on aftercare.
Health management programs
Many health plans offer management programs for chronic conditions such as high blood pressure, asthma, diabetes, and heart disease.
These programs differ from one insurance plan to another, but they can help you understand how to manage or treat your condition. This often includes a mix of online learning, outreach programs, and even wellness seminars built around your condition.
Be sure to ask your insurer whether they have any management programs to help you with your condition.
Preventive services
Often, a select number of free preventive services are available with an insurance plan. These may include:
flu shots
immunizations
health screenings
diet consultations
fall prevention for older adults
These services are typically offered within your insurer’s network of doctor’s offices, hospitals, and clinics, and you will not usually have to pay out-of-pocket costs like copayments or deductibles.
If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.
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Some insurance plans offer reimbursement for gym membership fees up to a specified amount. Others may offer local fitness classes or groups.
Sometimes, company insurance plans work with gyms and fitness facilities. Employers may be incentivized to offer perks like gym memberships because they’ll get better discounts on the insurance they provide their employees.
In a 2016 study of people with heart disease, those who were able to get 30 minutes of moderately vigorous exercise for 30 minutes per day, 5 days per week, cut their annual healthcare costs by more than $2,500.
Summary
Health insurance has many benefits, but some may not be immediately clear. When you receive your plan documents, take the time to read through your benefits carefully so you can get the most from your plan.
If you need medical care, knowing your out-of-pocket expenses will also help you avoid any unexpected costs. Information on any applicable deductible, coinsurance, or copayment will also be available in your plan documents.
You may find your insurance plan offers free preventive services, discounted gym memberships, and free online consultations, which can help keep you active, healthy, and enjoying life.
Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.
