How to Make the Most of Your Health Plan
After understanding all the basics of your plan, consider what changed from last year to the new year. This can be as simple as knowing the difference in your monthly premium or which doctors are in network. A new year means a new health plan. Manny Licata, vice president for Group and Individual Operations at BlueCross BlueShield of South Carolina, provides some tips for how to make the most of your plan.
Know your plan
The first thing to do in the new year is to understand all the basics of your plan. BlueCross offers a variety of plans. Knowing which plan you have and what is covered or included is important.
- What is your copay? It’s the fixed amount for a covered service you pay to the provider before receiving the service.
- What is your deductible for the year? It’s the amount you pay toward costs of covered health care services each year before your health insurance begins to pay its part.
- What is your coinsurance? It’s the percentage you pay when you and your health insurance split the bill for a health care service.
- What doctors are in network? You can find the physician list or provider directory in My Health Toolkit®.
Know what changed
After understanding all the basics of your plan, consider what changed from last year to the new year. This can be as simple as knowing the difference in your monthly premium or which doctors are in network.
Know your pharmacy plan
Another area to consider is what drugs you have access to with your plan. This can be particularly important if you take a medication regularly. It will help ensure that you know the cost of your medicine before you pick it up at the pharmacy.
Discuss any changes with your doctor. You should have this conversation with your doctor before refilling the prescription in the new year.
Know what is free
There are a few things that are free with some BlueCross plans. One of the most common of these is a flu shot. Your health plan may have others, such as a yearly physical. You can find details for what is included in your plan in My Health Toolkit. Explore plan perks.
Know your tools
There are tools to help you manage your plan. With most BlueCross plans you will have access to several tools that can help you manage your health and your plan all year. Log in to My Health Toolkit and get to know what is there.
- You’ll find a physician list, so you know you are visiting an in-network doctor.
- Blue CareOnDemand℠ Powered by MDLIVE® allows you to talk with a doctor anywhere for a low, fixed copay through your phone, tablet or computer.
- You have access to your digital ID card(s) so you don’t have to worry if you left your insurance card at home.
- You can also view and manage your claims.
My Health Toolkit also has a mobile app so that you can access your information from anywhere. The app also has answers to many of our frequently asked questions.
Know where to go
If you have any questions or need help navigating your health plan, find help at the South Carolina BLUE℠ Retail Centers. There are locations across the state in Columbia, Mount Pleasant, Myrtle Beach and Greenville. The stores also have other resources available.
Know your rewards
Members who purchased a BlueEssentialsSM individual health insurance policy are eligible for the Blue Rewards℠ program. A member can receive up to $150 by getting a flu shot, a yearly physical and registering for Blue CareOnDemand. Reward dollars can be used for covered medical expenses. Pharmacy is excluded. That means a family of four could potentially get $600 in rewards to use on health care for the year. Review your plan materials for more details.
Stay in the know
Follow BlueCross across all social media channels to get health tips, helpful information and nutritious recipe ideas. You can find us on Facebook, Twitter and Instagram. You can also catch more helpful information here on our blog.
MDLIVE is an independent company that provides a telehealth platform on behalf of BlueCross. MDLIVE and the MDLIVE logo are registered trademarks of MDLIVE, Inc.
Dec. 27, 2019
(Updated January 2024)
Know the Lingo
The lingo used in health care insurance can be confusing. Get to know the language used with these helpful videos:
What are benefits?
This term refers to everything covered by your health insurance.
What is deductible?
The amount you pay toward costs of covered health care services each year before your health insurance begins to pay its part.
What is coinsurance?
This is the percentage you pay when you and your health insurance split the bill for a health care service.
What is a network?
These are the doctors, hospitals and other providers and facilities that work with your health plan.
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