When you get an annual physical or pick up your prescriptions, you see a provider either face-to-face or virtually. What you don’t always see is the network of people working together behind the scenes to ensure you have access to the care you need. This can include doctors, nurses, medical device makers and other providers. But it almost always includes your health insurer, the company that provides you with health insurance.
What is a Health Insurer?
Each month, you pay a fixed cost, called a “premium,” to your health insurer, and in return, they provide you with health insurance. Health insurance helps cover the cost of your medical care and prescriptions. It can be beneficial in many ways. For example, it helps cover the cost of medical emergencies like a broken bone. Your plan also often covers many preventive services for free or at a low cost. This includes things like annual check-ups with your primary care provider.
Besides helping cover and reduce the cost of your healthcare, there are many other things your health insurer does to take care of you.
Working with Providers
Health insurers work directly with doctors, pharmacists, and other providers daily. To ensure members can access the care they need when they need it, they create a list of doctors and specialists who have the right credentials. This list helps you know which providers are covered by your health insurance plan. It also ensures all members have access to quality healthcare.
Arkansas Blue Cross and Blue Shield works with many local providers. We do this so that our members have convenient options for their care. We also make finding a doctor near you easy through our online provider directory.
Whole Person Health Programs
When we think of our health, we may first think of our physical body. But both our physical and mental health affect our overall well-being. That’s why insurers provide access to a variety of services in support of both. At Arkansas Blue Cross, we call this a whole-person approach. Some of these services often include:
- Preventive Care: Preventive services help you stay healthy and spot health issues early Most health plans cover yearly check-ups, screenings, and vaccines at no cost to members. It’s important to find a primary care provider and prioritize regular health check-ins, but you may also be able to visit your local pharmacist for some preventive services! Recent changes in Arkansas law expanded the services offered by pharmacists to include things like flu and strep throat testing.
- Diagnostics and Treatment: Diagnostics refers to the tests you may need, like an X-ray, to help figure out the cause of a health problem. Insurers can help you find an in-network provider to help with these tests and a treatment plan.
- Mental and Behavioral Health Support: Research shows that mental and behavioral health can also affect your physical health. Insurers support members with a variety of behavioral health This can include access to resources like mental health counseling and substance abuse treatment programs.
- Prescription Medications: Your insurer will create a list of medications that they cover through your plan. This is called a “formulary.” Your insurer often works with your provider to determine which drugs are safe and have minimal side effects for patients. They also help determine whether a generic option will work in place of a brand name medication. These drugs have the same active ingredients and are often much cheaper for members.
Member Education and Support
Whether you just received a new diagnosis or want more information on a health-related topic, insurers help you understand your healthcare options. They share information and help educate on topics that can feel hard to understand, helping you feel more confident as you make decisions about your health.
They can also help direct you to additional resources like support groups for specific conditions. For example, Arkansas Blue Cross has a diabetes support program. Our case managers can help direct you to the right resources and determine eligibility for available programs. By offering extra support, insurers help remove potential barriers and ensure members are empowered with information while navigating their care.
Taking Good Care of Our Members and Communities
Health insurers are always working on your behalf. At Arkansas Blue Cross and Blue Shield, we work with providers daily to maintain your access to quality care. Our members page offers more details about our health benefits and programs to help you take good care of yourself and your loved ones. We’re committed to providing the education, tools and support to help you manage your health and wellness so that you can live your best life your whole life long.
For more information on how health insurance helps you and your family, visit Understanding Health Insurance.