Newly insured should study policies

So, you’re covered. Now what? By the time the federal enrollment period for health insurance closed on March 31, more than 12,800 Alaskans had become newly insured by one of many new policies. But getting insured is only the first step!

Learning to navigate your new health insurance policy may seem daunting, but it will bring you huge financial and health benefits. Now is the time to familiarize yourself with your plan, learn important insurance terms and take some simple steps toward better health.

Every plan varies and offers something a little different when it comes to coverage, deductibles, copays and benefits. Take the time to learn your own plan and be sure to review your insurance policy annually for any changes, or to make sure it is still meeting your needs.

These new health insurance policies arrive with stacks of paperwork, and the language is often hard to decipher. Here are five basic insurance terms that are important to know:

· Benefits — The health care items or services covered under your health insurance plan. Covered benefits and excluded services are outlined in your policy’s coverage documents.

· Copay — The fixed dollar amount you are expected to pay for a covered health care service, or per prescription. The amount varies from policy to policy.

· Coinsurance — Your share of the costs of a covered health care service, calculated as a percent of the allowed amount for the service. You pay coinsurance plus any deductibles you owe. For example, if the health insurance or plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your coinsurance payment of 20 percent would be $20. The health insurance or plan pays the rest of the allowed amount.

· Deductible — The specified amount of money you owe for health care services before your plan begins to pay. For example, if your deductible is $1,000, your plan won’t pay anything until you’ve met your $1,000 deductible for covered health care services that are subject to the deductible. The deductible may not apply to all services.

• In-network — In-network providers have agreed to offer medical services at a discounted cost to insurance plan members, saving you money.

Now that you understand your coverage, here are three simple steps toward better health.

· Medical care is important, but the best thing you can do for yourself is to live a healthy lifestyle. Eating a balanced diet, making good lifestyle choices and getting regular exercise will increase your chances of long-term health.

· Don’t wait until you’re sick to find a doctor. Take advantage of the annual check-ups and preventive care offered by most policies to stay healthy and avoid some of the more costly interventions down the road. Find an in-network doctor and establish a relationship with them early. For help finding these providers in Alaska, check your plan’s list of providers or contact the Alaska Primary Care Association.

· Keep a medical history. Keeping all your health information in one place will help you take charge of your health as well as help your physician provide better care. Maintain a list of surgeries, conditions, medications and family history, and keep track of all documents or medical records. A simple file folder is an effective way to keep everything organized.

Open enrollment has closed, but some Alaskans may still qualify for a special enrollment period, Medicaid or Denali Kid Care. Visit healthcare.gov or a Community Health Center nearest you to find out if you qualify, or contact Alaska 211 at 211. To speak with the Alaska Medicaid office, call (907) 269-6529. The next open enrollment period is projected to be Nov. 15 to Feb. 15, 2015.

Cherise Fowler is the outreach and enrollment coordinator for Alaska Primary Care Association. She provides training and technical assistance in implementing the Affordable Care Act for Alaska.