Use Your Health Insurance Benefits Wisely

What is this service?
You have a choice about how you use the insurance you have, even if you have no choice of insurance carriers. Smart Health Decisions helps healthcare consumers make the most of the benefits and other services offered by their health insurer.  We do this by familiarizing you with the healthcare services covered by your health insurer, how completely those services are covered, and any special circumstances regarding their coverage (for example, only a certain number of services may be covered, or some services may be covered only during a specific time period).   In addition, we increase your awareness of other often overlooked health promoting and money saving opportunities offered by your health insurer (like discounted health club memberships, drug discounts, and prenatal programs).  It is your responsibility to know the specifics of your health insurance and partner with your providers in choosing care that best serves your needs, fits within your budget, and meets the guidelines of your health insurer. 

Smart Health Decisions does not sell health insurance.

How do consumers benefit from this service?
The consumer looking for help understanding their health insurance can turn to their insurer or their employer if their coverage is work-based.  But, health insurers rank near the bottom in service according to their customers and many employers are providing less support for health benefits issues.  Furthermore, you may not be comfortable discussing your family’s healthcare needs and budget with either your insurer or your employer.  Realistically, the self-interests of your employer and insurer may prevent them from giving unbiased advice that’s best for you.  Our service is designed to help you get better value from your health insurance.  This means you could receive better care, achieve better health outcomes, and/or save more money.  (Harris Interactive, 2007.)

When should healthcare consumers use this service?
To make smart health decisions consumers must know and understand their insurance benefits before they use them.  Ideally, the best time to learn about your insurance coverage is when you sign up or renew it. Also, you should check your insurance benefits whenever you are uncertain about them and especially before receiving major healthcare services.

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