5 health benefit myths — busted
There are lots of things many of us think we “know for sure” about our health insurance. As we take on each myth one by one, you might become aware of value you never knew your health insurance had. It’s part of how we’re helping make quality care more affordable.
Myth 1: I have health insurance, so I don’t need to worry about what my medical procedures actually cost
Myth 2: Health insurance is like car insurance — if I use it too much, the cost will go up
Myth 3: Health insurance is for when you’re sick, not for keeping you healthy
Myth 4: Health insurance doesn’t cover mental health services
Myth 5: Health insurance only covers services from a medical doctor
Myth 1: I have health insurance, so I don't need to worry about what my medical procedures actually cost
Once we have insurance, most of us figure we’re covered, and we rarely think about what medical procedures cost. But there are cost differences that can impact you — big ones and small ones. Here are a few tips that may help keep your costs lower.
The truth: Your medical costs can vary, even with insurance.
Even with insurance, medical costs still matter. Here's why.
Let’s say your allergies flare up and you need a doctor visit. Instead of paying this: Office Visit, Allergy & Asthma Specialist: $252. You might pay something more like this: Copay: $50. That is, if you see a network doctor. Why? It’s all about what network providers agree to with your insurance company.
When you have health insurance, your insurance company works with providers in a particular network (like providers affiliated with your local hospital, for example). They agree on what will be paid for certain procedures. So when you choose their services, your cost will likely be lower. Depending on your plan, that might either be a copay or their discounted rate. Providers who aren’t in your health plan network could charge more, which means their services could cost you more or may not be covered at all.
What about major surgeries?
Let’s say you’re having a major procedure, like shoulder surgery. Because larger procedures have larger costs, it’s even more important to know in advance what providers in your network charge — because different providers may charge different amounts for the same health care service. If you’re a UnitedHealthcare member, sign in to your account and choose “Find Care & Costs,” or reach out to us in advance of your surgery at member.uhc.com/help to help find care and estimate your costs.
3 ways to shrink your health care costs
- Choose network providers.
- When you’re getting a major procedure, like surgery, compare the costs that different providers near you charge. UnitedHealthcare members can choose “Find Care” in the UnitedHealthcare app or under the “Find Care & Costs” tab on the member website to see what the different providers near you charge.
- When you need immediate care, consider your care options. For instance, if it’s after hours for your primary care provider and you have a health issue that’s urgent but not life-threatening, think twice before you spend hours waiting in the emergency room or possibly end up with an unexpected bill. Alternatives like urgent care could save you up to $2,300. Or for lab work, imaging or outpatient surgery, look into freestanding clinics vs. the hospital. If you’re a UnitedHealthcare member, take a look at your money-saving options for care.
Myth 2: Health insurance is like car insurance — if I use it too much, the cost will go up
When most of us think of insurance costs, we think about car insurance. Fender bender? Yikes — your next car insurance bill will most likely go up. But what about if you get sick? Will your health insurance claim make your health premiums go up too? Actually, no. Health insurance works differently. In group health plans, your premium won’t go up, even if you use your health insurance a lot. Let's take a look.
The truth: Using insurance to help stay healthy may actually lower health costs over time.
What shapes your health insurance premiums?
In group health plans, health insurance premiums aren’t set for individual people. They’re based on all the people who live around where you live and are right around the same age as you are. No matter how much you use your insurance for the plan year, it won’t affect your premiums in a group health plan. In fact, the preventive care included in your coverage is designed to help you stay healthy by managing and maintaining your health, and it’s generally covered at 100 percent by most health plans. It can help reduce your risk of developing health issues that would need diagnostic care, which could have additional costs, depending on your plan coverage.1 So consider using your health insurance and getting your checkups to help stay healthier!
Myth 3: Health insurance is for when you're sick, not for keeping you healthy
When you break a leg or need to go to the hospital — that’s when most of us think about health insurance and are glad we have it. Yet there’s so much more you could be getting out of your coverage. Let’s take a look at the many benefits health insurance offers to help you get and stay healthier.
The truth: Your insurance has at least 5 important things you can use to help stay your healthiest. Which means if you’re not using them, you’re not getting the most value out of your health plan.
Your health coverage: The more you use it, the better your health may get
When you take advantage of your health care benefits when you’re well — things like annual exams and routine preventive screenings — it may help catch health issues early when they may be easiest to treat. And, depending on your plan, it may be 100% covered, meaning you’d have no cost. Just be sure to use a network provider.
What is routine preventive care? It includes things like:
- Your annual physical exam
- Immunizations
- Well-baby and well-child care
- Mammography, colonoscopy, sigmoidoscopy
- Cervical screening
Get a preventive care checklist to prepare for your next annual wellness exam. If you’re a UnitedHealthcare member, sign in to your account or call the number on your health plan ID card to find a provider.
5 health insurance benefits to use to help keep you healthier
Many insurers offer a range of benefits to help keep members well. UnitedHealthcare offers these benefits for most members:
- Annual physical — $0 copay or coinsurance when you use a network provider
- Preventive screenings — $0 copay or coinsurance when you use a network provider for covered tests like mammograms, cervical and colorectal screenings, and blood pressure screenings
- Flu shots and other vaccines — $0 copay or coinsurance for covered services when you visit a network provider
- Well-baby/well-child exams — $0 copay or coinsurance for covered services when you visit a network provider
- Plus rewards that put the health in health care — Your UnitedHealthcare plan may include rewards programs like UHC Rewards and UnitedHealth Personal Rewards®, where you can get tailored goals and incentives to reward you for doing things like eating healthier or becoming more active. Learn more about UnitedHealthcare rewards programs.
Myth 4: Health insurance doesn't cover mental health services
Mental health is just as important as physical health, and many health insurance plans include coverage for mental health, behavioral health and substance use.
The truth: Most plans cover treatment for mental health care.
Mental health matters
In the United States, mental illness ranks among the most common health issues.2 1 in 5 adults experience mental illness every year. And 1 in 6 kids do, too.3
Beyond affecting our emotional and social well-being, mental health disorders can impact our physical health, raising our risk for illnesses like heart disease, stroke and diabetes.2
The good news is that many health insurance policies include coverage for mental health care. Coverage often includes behavioral health treatment, like psychotherapy and counseling, inpatient services, meaning if you need to be hospitalized or to stay in a treatment facility, and treatment for substance abuse.
What about virtual mental health care visits? Lots of people say they’re more comfortable with virtual visits for mental health care. If that’s you, ask your insurance provider if they offer virtual mental health care options.
Important mental health resources
- These phone and text resources are available to everyone throughout the United States for help in a crisis.
- In any emergency, call 911
- Suicide & Crisis Lifeline: 988 or 988lifeline.org/chat
- Substance Use Helpline: 1-855-780-5955
- National Domestic Violence Hotline: 1-800-799-7233 or 1-800-787-3224 (TTY)
- Crisis Text Line: Text “Home” to 741741
You’re not alone, and help is available. So get help when you need it — and take care of yourself.
When your mind needs us, we’re here for you
UnitedHealthcare supports members’ mental health with online, app-based and in-person resources and care.
Myth 5: Health insurance only covers services from a medical doctor
Quick. Name 10 things your health insurance covers. You’ll probably name physicals, vaccines, surgeries, and then … you might trail off. Well, that’s why you need to explore the truth behind this common myth.
The truth: Your health plan covers a range of services — beyond things from your doctor or hospital — that may surprise you.
7 surprising services your health plan may cover
While different health insurance policies are structured differently and none cover everything, some of the possibilities may surprise you. See if your plan covers these 7 services — and see how much more value you could be getting out of your health insurance.
- Chiropractic care. With many insurance policies, you can see a network chiropractor for the cost of your copay.
- Tobacco cessation. Many health insurers help cover medications to help you quit smoking, like nicotine nasal spray, nicotine inhaler, bupropion and varenicline, as well as may include counseling. Eligible UnitedHealthcare members have access to Quit For Life® — coaching and support to help quit tobacco.
- Weight loss. Most health insurers provide obesity screening and counseling. Eligible UnitedHealthcare members have access to Real Appeal® — online coaching help for building healthy habits that support weight loss in areas like nutrition, fitness, sleep and stress.
- Naturopathy. Naturopathy may or may not be covered — depending on where you live. Many insurers will cover a licensed naturopath (naturopath practitioners use natural remedies like herbs, exercise and nutrition to help your body heal itself).
- Substance use. Most insurance companies cover substance abuse care under their mental health services. So if you or a loved one needs support or guidance on treatment options, call them now and get started toward recovery. UnitedHealthcare members can find confidential substance use help, treatment and resources here.
- Massage therapy. This one’s a maybe. The best way to get massage covered is to prove you need it by getting a doctor’s prescription. But some insurers only cover massage therapy by physical therapists. However, Medicare doesn’t cover massage therapy at all. Your best bet is to ask your doctor and your insurance company.
- Acupuncture. Most health insurance plans do cover acupuncture, but some of them will only cover it for certain conditions — things like lower back pain, migraines and nausea. It’s important to ask your insurance company — and make sure your acupuncturist accepts insurance, because some don’t.
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