Your Community Health Options plan offers access to the benefits that help you reduce out-of-pocket costs while ensuring you and your family can meet your health needs. Learn how you can save here.
Some people become so overwhelmed with their health insurance that they often don’t take advantage of the benefits they pay for. Of course, insurance is there for emergencies, but did you know you can use it to lower your out-of-pocket healthcare costs, often for everyday services?
You’d be surprised at how many benefits go unused. And if you’re in an employer-sponsored plan, you’re leaving money on the table. According to the U.S. Bureau of Labor Statistics, health benefits can amount to up to 10% of your total compensation.
Don’t let your plan go to waste: Be sure to know your benefits by reading through your Member guide and Summary of Benefits found within your Member portal at healthoptions.org. Even if you checked at the beginning of the year, it’s never a bad idea to look again so you don’t miss out on health and wellness benefits.
Importantly, Community Health Options plans offer access to benefits that help you reduce out-of-pocket costs while helping you meet your health needs. Here are some ways you can save:
Need an office visit? Find a local in-network urgent care here. If you don’t have an urgent care near you, a primary care walk-in clinic is usually less expensive than an ER visit.
Read your Schedule of Benefits and Summary of Benefits and Coverage in your Member Portal for more information. Still have questions? Call our Maine-based Member Services team at (855) 624-6463 between 8 a.m. and 6 p.m., Monday to Friday.
*Not available on catastrophic plans
Health insurance metals help people understand the amount of cost sharing that goes on between the plan holder and the insurance company in any given plan. (Need a refresher on how these costs work? Check out our health insurance lingo blog post here!)
Remember that the exact amount of cost sharing can vary from plan to plan. And at each metal level, you’ll pay a different percentage of total yearly costs of your care, while your insurance company will pay the rest. Total costs include premiums, deductibles, and out-of-pocket costs like copayments and coinsurance.
As a rule, the less the insurance company pays in cost sharing, the lower the cost of the plan. So, Bronze plans typically have the lowest monthly premium costs and highest costs when you need care. Monthly premium costs generally increase according to metal levels. Silver, Gold, and Platinum cost more each month in premium payments but will have lowers costs when you need care. While your monthly premium price is often the top consideration when purchasing health insurance, it’s important to consider the deductible and cost sharing as well, since these two factors can impact the total amount of out-of-pocket healthcare costs you might incur in a plan year. The total cost of care is what really matters.
When choosing a plan, you’ll want to think about how much you (and your dependents) are likely to use your insurance coverage. Consider things like how often you see a doctor, what medications you take, and whether you foresee scheduling any elective surgery during the year to come. If you think you’ll use your healthcare plan frequently or have prescription medications you take regularly, you might want to consider a higher metal level that offers lower deductibles and makes your costs easier to predict (like a Gold or Platinum plan). If you don’t expect needing many healthcare services, a lower-premium/higher cost share plan might be a better fit.
One thing that’s important to know is that ALL Community Health Options’ plans in ALL metal categories offer $0 cost share preventive care, including yearly wellness checks. Many plans also offer an array of low-to-no-cost benefits that help offset many healthcare expenses (like wellness visits, prescription benefits, and vaccines), even for people with chronic conditions. All non-HSA plans offer Amwell® urgent care telehealth visits with $0 cost sharing. So, whether you choose Bronze, Silver, Gold or Platinum, you can find a plan that meets your budget and your needs while giving you peace of mind and helping to keep you and your family healthy.
