Health insurance can help you get access to many services to help you maintain your health. There are important details to know about your health insurance and how to use it.
USING INSURANCE EFFECTIVELY
HEALTH INSURANCE CARDS
Once you enroll in health insurance, you will get a card in the mail with your insurance information on it.
Your insurance cards are important to keep with you. If you do not get an insurance card in the mail, contact your insurance company or talk to your enrollment assister.
If you are enrolled in Medicaid you will get an insurance card or two depending on the state you live in. You may receive one card which is specifically for Medicaid and one that is from an insurance provider. The green card pictured here is an example of the card for Michigan expanded Medicaid. Visit an enrollment assister to see what yours will look like.
GETTING TO KNOW YOUR HEALTH INSURANCE
Once you enroll in health insurance or Medicaid, you should get a Summary of Benefits and Coverage that will will help you better understand what services are covered by your health plan.
If you do not receive a Summary of Benefits and Coverage, you can ask your insurance company or Medicaid office for a copy in your preferred language at any time.
Remember that you will need to re-enroll in health insurance once a year. Your insurance company should send you reminders in the mail when it is time to re-enroll. Depending on the cost and your previous experience, you might want to re-enroll in your current plan, or look for a new one. Your enrollment assister can help you make that decision.
Sometimes your health insurance will deny your medical claim, which is a bill filed by your doctor to your health insurance company after you visit your doctor. This can be very frustrating, but if you feel that the insurance company’s denial is wrong, you can challenge these denials. Talk to your enrollment assister about steps to take if you want to challenge a medical claim denial.
PRIMARY CARE HAS MANY MORE BENEFITS THAN THE EMERGENCY ROOM
There are many differences between seeking care from a primary care physician or using your local Emergency Department.
| Primary Care | Emergency Department |
|---|---|
| You should see your primary care doctor when you are sick and when you are well. | You should only go to the emergency department for a life- threatening situation. |
| If you have an appointment at your primary care doctor’s office, you may have a shorter wait. | You may have to wait a long time if you go to the emergency room. |
| Going to your primary care doctor is a lot cheaper than going to the emergency room. | Going to the emergency room can be very expensive. |
| You will likely see the same doctor each time you go to the primary care doctor’s office. | You will see whatever doctor is working when you go to the emergency room and they may not know you or what is best for you. |
| Your primary care doctor will help you manage any chronic conditions like diabetes or asthma. They can help prevent diseases and keep you healthy. | In an emergency room, doctors will mainly treat the problem you came in with, such as a severe sickness or injury. |
FINDING AND KEEPING A DOCTOR
There are many important decisions
to consider when selecting your doctor.
Before seeing a new doctor, make sure that the doctor is “in-network”. This means that your insurance will pay for all or most of your visit. If you are looking for a new doctor, you can:
- Call your insurance company or Medicaid office to find out what doctors you can see
- Call and ask the doctor’s office if your doctor is covered under your plan
- Ask your friends and family if they know of any good doctors close by
- Ask an enrollment assister
Depending on your health needs, you may need to see a specialist. A specialist is an expert in a certain area of health care such as an expert on the heart or an expert on the brain. For most health insurance plans, you will need to get a referral from your primary care doctor before you can see a specialist. Your health insurance company might need to approve some services before you can see a specialist.
If you have any questions or problems with seeing a specialist, contact your health insurance company or Medicaid office, or talk to an enrollment assister.
You deserve to have a doctor that you trust, speaks your language, and who you feel comfortable around. If you do not think your doctor is a good fit, you can find a new one by asking your enrollment assister. Think about whether or not the doctor you visited is right for you.
- Did you trust your doctor, and feel they cared about your health?
- Did you feel that the doctor listened to you and that your needs were addressed?
- Did you feel like the doctor respected you and treated you fairly?
- Did they provide any assistance you asked for, like an interpreter or translation?