Open Enrollment: How to Get the Most Out of Your Benefits

October 15, 2018

Your health care plan is about much more than simply going to the doctor and getting medication when you get sick. Medicare and most commercial plans offer a number of benefits that can help you stay healthy and save money.

Not every plan offers all of these benefits, so you should contact the number on the back of your health care ID card or visit your plan’s website before you schedule an appointment.

Preventive services

Did you know there are a number of services that you can get that will keep you and your entire family healthier – and they’re at no cost to you? Under the Affordable Care Act, health care companies cover what are called preventive services. They’re called preventive services because they can help prevent illness and disease.

All in all, there are 15 covered services for children and adults, and they include:

Blood pressure screening
Cholesterol screening
Type 2 diabetes screening (for adults with high blood pressure)
Age-appropriate immunizations for hepatitis A & B; HPV; measles, mumps, and rubella; and many others
Tobacco use screenings and cessations interventions for tobacco users

You should always check coverage with your plan. You’ll still have to see a doctor that is in your network to get these services, but it’s well worth your time.

No-cost wellness services

Many plans offer free programs to help members achieve important health goals, such as losing weight, becoming more active, cooking and eating healthier, or reducing stress. For example, your plan might offer you a weight loss program that allows you to log your weight and get easy-to-use tips, recipes, exercise videos, and words of encouragement.

These health and wellness programs are designed to be fun and easy to use, even for those who may be new to healthy habits.

Mental health care

We all know how important your mental health is, and the affect it has on your body and your family. Many insurance plans, including Medicare Part B, provide coverage for members to see a specialist, such as a psychiatrist or someone who specializes in substance abuse.

And FYI, a depression screening with your primary care doctor is considered a preventive screening. See them first and get recommendations for next steps.

Special screenings for moms-to-be

You and your health plan both win when you have a happy, healthy baby. That’s why plans are required to cover special preventive services for women who are either currently pregnant or trying to get there. Besides health screenings for conditions like anemia and gestational diabetes, you should be covered for lactation support and breast pumps.

Nurse Line

It’s 3 am and your six-year-old just woke you up with a cough and a temperature of 99 degrees. Maybe it’s nothing, but you’d sleep better if you could get some advice. Call the nurse advice line. It’s a great way to avoid an expensive trip to the emergency room, and you can get help right when you need it.

Your health plan’s nurse advice line is available 24/7. Call them anytime to talk to a licensed, registered nurse to find out more about common health issues. You can also call the AltaMed nurse advice line at (866) 266-5092.

If you’re experiencing a true medical emergency, call 9-1-1 or go to your nearest emergency room.

Save on your medication

If you have prescription coverage, you can save even more with generic drugs. In most cases, they are totally identical to the “name brand,” at a fraction of the cost. Be sure to ask your doctor or pharmacist about them.

Many health care plans also offer mail order services. In some cases, you could pay less for your prescriptions. Even if you don’t, you’re still saving several trips to the pharmacy.