Every health insurance plan is different, so it’s important to check your insurance plan to see what services it covers. You would look up your mental health benefits the same way you find your physical health benefits. Many insurance cards today have a number you can call on the back of your insurance card. Most insurers now have “patient portals” that allow you to get information about your plan benefits online. You can look online to find out which providers are in your network or find directories of participating plan doctors and health care facilities.
Your “Summary of Benefits” will provide detailed written information about your plan’s costs and benefits, including preventive services that are now offered to you at no cost. If you aren’t sure about how to use your benefits, you can call the phone number on your insurance card and ask that a person explain them to you.
When insurance plans refer to primary care, they are usually referring to your main doctor or other community care clinic, for which your main doctor, physician’s assistant, or nurse practitioner may work. He or she takes care of your general health and may refer you to specialists for help with specific illnesses.
A specialist is a medical provider with extra training in a specific type of medical condition. For example, a cardiologist is trained in heart health, while a psychologist is trained to evaluate and treat mental and emotional issues. Make sure you understand the process for seeing a specialist under your plan. Sometimes you can only see specialists after you see your main doctor.
Also, if you need to use a hospital, keep in mind that even though your doctor or specialist may see you in the hospital, he or she doesn’t work for that hospital. That means that you might get one bill from the hospital and another from the doctor. And, sometimes, the hospital doesn’t accept the same insurance as the doctor. This can be confusing even for people who pay close attention to their benefits. So, it’s always best to ask questions upfront.
Many health insurance plans offer extra programs at little or no cost, such as programs to help you quit smoking, weight loss groups, or support groups for anxiety or depression. You can sign up for these on your health insurance plan’s website, by calling the insurance company, or by asking your doctor for information.
If you have major life changes, such as losing a job, getting a better-paying job, or having a baby, these events can change the amount you need to pay for health insurance. Keep your insurance company up to date about big life changes so you don’t pay more than you should.