Some people become so overwhelmed with health insurance that they don’t take full advantage of the benefits they pay for. Of course, you have insurance for emergencies, but did you know you can use it to lower out-of-pocket healthcare costs for everyday services?

You’d be surprised at how many benefits go unused. According to the U.S. Bureau of Labor Statistics, health benefits can amount to about 7% of your total compensation. That means if you don’t use your plan, you’re leaving money on the table.

In this guide, you’ll find tips to get the best value from your plan and reduce medical expenses.

General tips to save on healthcare costs

• Choose generics: Whenever possible, opt for generic drugs instead of brand-name meds. They are just as effective and cost much less.
• Take advantage of preventive care: Many preventive services are available at no cost to you and can help your doctor find health issues before they become serious. Some plans, like self-funded plans offered by employers, do not have to offer free preventive coverage, so check your plan documents for specific details.
• Consider a Health Savings Account: If you are in a high deductible plan, you could save money with a Health Savings Account, often called an HSA. You can set money aside for qualified medical expenses in an HSA, and you won’t pay taxes on contributions to the account or interest you may earn in the account. Talk to your bank, broker or financial adviser.
• Use in-network providers: Your health plan has a network of doctors and other clinicians, hospitals, pharmacies and other service providers. To save money, choose from these providers who have agreed to give you services at negotiated rates to lower costs.

Learn about the Community Health Options network here.

Tips for Community Health Options Members

• Use urgent care for non-emergencies: When you’re hurt or sick, sometimes you need care right away. Of course, head to the emergency room or call 911 if your condition is serious. To save money, you can visit a network of urgent care centers across New England. Find one near you here.

Most Members can also get urgent care telehealth for $0 out-of-pocket without having to leave their homes though Amwell® (or $0 after meeting the deductible on an HSA plan).

• Reduce lab and X-ray costs: If your doctor prescribes an X-ray or blood work, you can save money at certain locations instead of going to the hospital. Almost all non-HSA plans offer X-rays at specified locations with a $75 copay, while labs have a $25 copay at specified locations. HSA Members pay a copay or coinsurance after they’ve met their deductible. You can contact the Member Services number on the back of your ID card for help finding a location near you.
• Save on prescriptions: Most common generic medications will cost just $5 for a 30-day supply. And if you use mail order through Express Scripts, you can get a 90-day supply of most maintenance medications for the price of two 30-day supplies. Additionally, at in-network pharmacies that accept GoodRx, through Price Assure  you’ll automatically pay our generic price or the GoodRx price—whichever is lower. Note: HSA plans have a deductible before copay or coinsurance for prescriptions, while HSA Plus plans provide access to specific medications before the deductible (noted with HSA+ on the drug formulary).
• Get help with chronic illness care: If you have asthma, coronary heart disease, chronic obstructive pulmonary disease, diabetes or high blood pressure, our Chronic Illness Support Program (CISP) saves you money on routine care at in-network providers on non-HSA plans. Through Express Scripts, you pay $0 for mail-order preferred generics and save 50% on copays for preferred brand maintenance medications. You’ll find CISP-eligible maintenance medications in the formulary on our website. If you work for a company with more than 50 employees, you may have access to an HSA Plus plan that offers a CISP plan with slightly different benefits.
• Use preferred providers on tiered plans: If you are on a tiered plan, you’ll find preferred tier providers who meet or exceed our quality, price and efficiency standards. These providers offer high-quality care at a lower copay or coinsurance, with a lower deductible and out-of-pocket maximum. Click on “Doctors and Hospitals” in your Member portal to search preferred providers throughout Maine and New England, including Centers of Excellence in Massachusetts.
• Review your benefits regularly: Be sure to know your benefits by reading your Member Guide and Summary of Benefits. Even if you checked at the beginning of the year, it’s never a bad idea to look again so you don’t miss out on health and wellness benefits. You can find both in your Member portal.

Have a question about Community Health Options or your benefits? Call our Maine-based Member Services team at (855) 624-6463 from 8 a.m. to 6 p.m., Monday through Friday.

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