how to use your health insurance 101

ENROLL-Virginia!

Who is ENROLL-Virginia!?

I have Insurance……. Now What?

Using Your Insurance

Why have health insurance?

• Ensure financial security• Obtain preventive services for FREE and stay healthy

• Annual physical, check-ups• screenings • prevention counseling• contraception.

• A medical home• Manage health conditions, chronic diseases

Understanding Your Health Coverage• Network

• In-Network • Out-of-Network

• Deductible• Copay• Coinsurance• Premium• Out-of-Pocket Maximum

• Worst-case scenario• Chronic diseases (diabetes, cancer, etc.)

• Provider

Co-Pay and Co-Insurance

$ Co-Insurance

$

Monthly Premium

$ Co-Pay

Consumer Patient

Explanation of Benefits (EOB)

• This is NOT A BILL• After you doctor visit, you may receive an EOB from your insurer• An EOB is an overview of the total charges for your visit and how

much you and your health plan will have to pay.

• If you need help understanding your EOB, you can call ENROLL-Virginia! at 1-888- OR visit our website at www.enroll-Virginia.com

Where to Go for Care?

• Dial 911 if you have an life-threatening situation• Primary Care Doctor• Specialist

Preparing for Your Visit

• Make sure to schedule an appointment in advance• Arrive early to fill out registration forms• Bring your insurance card and ID• Pay your copay

At your Doctor Visit

• Be honest with your doctor about:• Your lifestyle, family & medical history• Medications (request a refill if needed)

• Ask Questions!• What is my main problem?• What do I need to do?• Why is it important for me to do this?• How do I see a specialist?

• Not satisfied? Change your provider!

Next Steps After your Appointment

• Schedule a follow-up appointment if needed• Fill prescription if needed• Call your doctor’s office:

• If you experience any side effects or other problems with your medicines• If your symptoms get worse• To get results of any tests you’ve had• To explain your test results

Do You Need Help Paying For…

• Prescriptions• Needymeds.org

• Copays