Discover the importance of health insurance, how to use it, and how it can support your health.
Health insurance is a contract between you and an insurance company that helps you pay medical bills in exchange for a monthly cost. Without health insurance, medical bills can be very expensive.
A major benefit of health insurance is that preventive care is often offered at no extra cost. This includes annual physical exams, vaccinations, and cancer screenings. Preventive care can help you avoid serious – and potentially costly – medical issues in the future.
In short, health insurance helps you avoid having to pay potentially high medical bills on your own, while also giving you access to preventive care that can help you stay healthy.
Not all health insurance plans are the same. What your health insurance covers depends on your policy, deductible, copays, and other factors. To find a plan that fits your needs, you'll need to know a few key parts and terms.
- Provider network: Choosing an in-network doctor will significantly lower your out-of-pocket costs because they work with your insurance to keep costs lower. In-network doctors will change based on your plan.
- Deductible: Your deductible is the amount of money you owe for services covered by your plan before your insurance pays the remaining costs.
- Out-of-pocket maximum: The most you will spend in a year for care is called your out-of-pocket maximum. Once you hit this amount, your insurance pays the rest.
- Copays and coinsurance: A copay is the upfront cost you pay when seeing a doctor. Coinsurance is the percentage of the cost you’ll pay for care covered by your insurance until your deductible is met.
Understanding how to use your plan can save you money and time. Let's take a look at how you'll use your insurance on a regular basis to get the care you need.
Having health insurance means you have a premium, which is a monthly fee to use your plan. If you get insurance from an employer, this is typically automatically paid from your paycheck.
One of the best ways to make the most of your health insurance is to see in-network doctors. They work with your insurance to have discounted costs, while out-of-network doctors don't. To find in-network doctors, log in to the member portal or use the search for your area.
When you enroll in a health insurance plan, you’ll get a member ID card with details about your coverage. Carry this card in your wallet so it's always available at doctor’s appointments or the pharmacy. Your card also includes customer service numbers if you have questions about your insurance or medication costs.
After getting care, your doctor will submit a bill to your insurance company. This is called a claim. Based on your plan, your insurance will then determine how much it will pay and what you owe. You'll receive an explanation of benefits that explains those costs. You’ll also get a bill for your portion.
Get reliable answers to your insurance questions, such as how to get prior authorization and submitting a claim.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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