Affordable Care Act, healthcare, Obamacare — March 3, 2016 at 11:44 am

Good for you: You’ve got health insurance! So now how do you use it?


Getting covered is only the beginning of Obamacare’s benefits. Here are some tips for using your health insurance.

As of March 1, every health insurance plan purchased and paid for during Affordable Care Act (ACA) open enrollment went into effect.

More than 12.7 million Americans chose a plan through the Health Insurance Marketplace during the third marketplace open enrollment period. Those consumers now have peace of mind knowing they’re protected in the event of an unexpected illness or injury — and access to ongoing care, which is essential to staying healthy, especially if you have a chronic condition such as asthma or diabetes.

But consumers may still have some questions about how to use their coverage and what it can mean for their family. To help consumers understand their new coverage, our friends at Enroll America offer 7 things every newly-insured American should know about their new health coverage.

1. Learn the terminology. Health insurance has its own set of jargon, and you should make sure you know it, too. For instance, a “co-pay,” is the amount you pay for a covered service when you receive the care. A “deductible,” on the other hand, is the amount you have to pay before your health insurance begins to cover your costs. You can find a helpful glossary of health insurance terms HERE.

2. Your plan covers at least 10 essential benefits that you can use. Every plan purchased through the Health Insurance Marketplace must cover these ten services, such as emergency room visits, prescriptions and maternity care. You can view a full list of the essential benefits HERE.

3. Make sure you pay your monthly premium. A “premium” is a set amount you pay every month for your insurance. You’ll need to pay your premium every month to keep using your plan and taking advantage of the lower out-of-pocket costs for any health care services you receive. If you don’t pay, you will risk being dropped from your coverage and having to pay out-of-pocket for your health care, which will likely be much more expensive than the cost of your premium.

4. Preventive care is free! Every plan through the Health Insurance Marketplace must cover the full cost of preventive care services, such as mammograms, vaccines, screenings and more. You can view a full list of covered preventive care HERE.

5. Make sure your doctors and hospitals are covered by your insurance plan. This is also called being “in-network,” and it will ensure your doctors and hospitals will accept your health insurance and you won’t get surprised by a larger-than-expected bill. The easiest way to make sure your providers are in-network is to call them and ask. You can also use that opportunity to find a primary care physician and schedule your first checkup!

6. If you experience an income change during the year, report it to the Health Insurance Marketplace right away. Financial help is available to lower your monthly premium, and you should make sure you’re receiving the proper amount. You may find that your premiums change depending on how much money you’re making, and it may even become more affordable! To make sure you’re paying the proper amount, be sure to update your income information with or your state exchange any time it changes.

7. Have questions? There are experts in your community that will help you – for free. There are trained experts in your community that will meet with you for free and answer your questions. To see who’s in your area and schedule an appointment, you can use the Get Covered Connector.

Health insurance is especially important to have in the event of an emergency, but it’s also there to help you stay healthy and manage any health conditions you may have. So be sure to see your doctor at least once a year or as often as recommended based on your health status. Preventing and managing health issues is a lot healthier — and less expensive — than ignoring them.

If you didn’t get coverage during the third open enrollment period, you may still be eligible for coverage this year. If you experience a qualifying life event — such as having a child, losing job-based coverage, or getting married — visit to see if you qualify for a special enrollment period.

One more thing: Medicaid coverage is available to low-income Michiganders through the Healthy Michigan plan and enrollment is open year-round. Visit the Healthy Michigan website to learn more.

[Image credit: Vic, via Flickr.]