The Next Step – Making
the Most of Your Coverage
CMS BLOG
April 18, 2016
By: Cara V. James, Ph.D., Director of the Office of Minority
Health at the Centers for Medicare and Medicaid Services
Millions of Americans are gaining health coverage every year.
Between 2013 and 2014, African Americans and Latinos saw the largest declines
in uninsured rates[1]. During the 2016 open enrollment period,
over 2.2 million individuals of color selected plans through the Marketplace[2]. Getting coverage is a big accomplishment,
but it is just the first step. Regardless of your race or ethnicity, taking
advantage of your coverage so you and your family stay healthy is an equally
important step.
You may be getting coverage for the first time, or you may have
coverage but do not use it very often. Regardless of how long you have had
health coverage or where your coverage comes from (e.g., your employer, the
Marketplace, or other sources of coverage), you may have a lot of questions on
how you and your family can best use it to get the care you need. In 2014, the
Centers for Medicare & Medicaid Services (CMS) launched, From Coverage to Care (C2C) to help
individuals do just that – move from getting coverage to receiving the care
they need. C2C is an ongoing initiative designed to help individuals achieve
better health and navigate their way through the health care system.
C2C includes a number of resources such as the Roadmap to Better Care and a Healthier You and
the newly released 5 Ways to Make the Most of Your Health Coverage,
is designed to help you figure out what you can do to put your health first for
a long and healthy life. One of the first ways is to confirm your coverage.
Make sure your enrollment is complete and that you have paid your premium if
you have one. This way you can use your health coverage when you need it.
The next step is to know is where to go for answers if you have
questions about your enrollment and coverage. If you have questions about your
enrollment status or premium, contact your health plan. Your health plan will
also be able to tell you what services are covered and what your costs are
likely to be. The Roadmap can help explain key health insurance terms, like
“coinsurance”,” and “deductible”. The Roadmap also provides information on
establishing and maintaining a healthy lifestyle, finding a provider, and
helping patients engage in their health care. The Roadmap is available for
download in eight languages, a tribal version, and in video format on the C2C website.
It’s important to remember that health insurance isn’t just for
when you are sick. You can use your coverage to get recommended health
screenings and preventive services which can help you stay healthy. You can
find out which screenings may be right for you by visiting, MyHealthfinder.gov. Seeing your healthcare
provider also provides an opportunity to ask questions about what you can do to
stay healthy. When choosing a provider and making an appointment, it is
important to pick someone who is in your network, if your plan has one. If the
provider you select is out-of-network, the visit may end up costing more. If
illness does take you to the doctor’s office, be sure to fill any prescriptions
that the doctor may prescribe. Some drugs cost more than others, so if you are
concerned about potential costs, ask in advance how much the prescription is
and if there are more affordable options.
Insurance can be confusing, but there is help. Check out all of
the From Coverage to Care resources and find out
what you need to do to make the most of your coverage so you can live a long
and healthy life.
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[1] Office of the Assistant Secretary for
Planning and Evaluation (2015). ASPE Data Point: Health Insurance Coverage and
the Affordable Care Act. Retrieved from: https://aspe.hhs.gov/pdf-report/health-insurance-coverage-and-affordable-care-act-september-2015
[2] Office of the Assistant Secretary for
Planning and Evaluation (2016). ASPE Issue Brief: Health Insurance Marketplaces
2016 Open Enrollment Period: Final Enrollment Report. Retrieved from: https://aspe.hhs.gov/sites/default/files/pdf/187866/Finalenrollment2016.pdf
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