How to Use Your Health Care Benefits When You’re Healthy

As a generally healthy individual, you may see health insurance as a “just-in-case” form of protection in the event you get injured or become sick. While your plan can provide that coverage in your time of need, you should know that your health care benefits likely go much further than helping with emergency room visits and primary care checkups — and you can use them even when you don’t necessarily need them.

Ultimately, your health insurance is important and can be a major resource for keeping you mentally and physically fit. To get the most out of your plan and fully justify your monthly premium, you should know the ways you can use your benefits when you’re healthy.

Health Insurance Basics

Every health care plan comes with basic components that make up how much and what the insurance covers. As you consider how to use your benefits throughout the year, you should understand each part of your plan to know exactly what you can and can’t do.

While different kinds of health insurance exist, the general basics of a health care plan include:

  • Premium: What you pay to maintain your plan, often in the form of monthly payments
  • Deductible: How much you must pay out of pocket before your plan’s coverage applies
  • Copayment or coinsurance: A fixed amount or percentage you must pay for specific services after you meet your deductible — your insurance covers the remaining portion
  • Out-of-pocket maximum: The maximum you’ll have to pay for covered services annually
  • Covered services: The services and treatments your plan covers, such as primary care visits and medication
  • Additional benefits: Any other, non-standard benefits your plan covers, such as wellness programs

Depending on your health insurance, you may need to access specific health providers and hospitals in your plan’s network, or you risk greater out-of-pocket expenses or reduced coverage. Consult your plan’s details to understand where and how you can use it.

5 Ways to Get the Most out of Your Health Insurance

Despite the fact that you might not be under the weather or experiencing an injury, using your plan is still important — accessing different health insurance benefits can help you stay in good health, and you want to make the amount you pay in premiums count.

After taking a look at your plan, you can identify how to maximize its coverage outside of traditional uses like hospital stays, which you may not utilize.

1. Preventive Care Services

Going to the doctor isn’t just for when you’re sick. The best way to stay on top of your health is to prioritize preventive health and wellness services.

Regular health checkups and screenings can keep you consistently informed about your health, allowing you and your doctor to identify potential health concerns, should they arise. At your annual appointment, you can discuss any questions you have about your health, and your physician can give you advice to help keep you on the right track.

These services also include vaccines and immunizations — even adults need vaccines, and you may require specific ones based on your age, health and lifestyle. Keep on top of your immunizations every year by using your health care benefits.

2. Fitness and Health Club Memberships

If your plan includes wellness services, you likely have access to gym or health club memberships for free or at a discounted price. It’s no secret that staying active has many physical and mental benefits, and you can help yourself remain healthy by taking advantage of your plan’s fitness coverage and spending time at the gym.

Aside from standard gym equipment you incorporate into your routine, you may be able to benefit from health club amenities like group exercise classes, tennis and basketball courts, spa services and swimming pools.

3. Mental Health Services

Did you know that 1 in 5 adults in the United States experiences mental health issues? Taking care of your mental health is equally important to your physical health, and your insurance can help you afford mental health services.

For example, your plan may include mental health coverage that fully or partially covers therapy sessions, psychiatry appointments and prescription drugs to help you manage your mental health symptoms. In some cases, health plans will cover mental health services for people with substance use disorder, which can be part of their overall treatment plan.

Even if you don’t experience mental health challenges, you can still benefit from talking to a professional about your life and relationships — and it certainly won’t hurt if your insurance covers it.

4. Health Specialist Consultations

Though your primary care physician can assist you with various health needs, you need to consult health specialists to keep specific aspects of your physical health in check, whether it’s your skin health, heart health or brain health. Most health care plans assist in covering health specialist consultations.

Some specialists you may want to consult include:

  • Dermatologists
  • Obstetricians
  • Gynecologists
  • Cardiologists
  • Neurologists
  • Allergists

While you may not have to visit different specialists for treatment, it can still be highly worthwhile to schedule annual visits based on your health needs and history, especially if you used to have a specific health issue or if health conditions run in your family.

5. Pharmacy Benefits

There’s a high chance your plan comes with some form of prescription drug coverage, which is often vital to supporting your health. Leverage your health plan to save as much as possible on your medication — in some cases, you could save hundreds of dollars by switching to a suitable generic option covered by your insurance.

Some health care plans also include convenient mail-order pharmacy services, allowing you to order refills of prescribed medications and have them delivered to your home. Additionally, you may have access to specialty medication support services, such as therapy programs and financial assistance.

Contact Health for California for Assistance With Your Health Coverage

Are you a California resident? Health for California is here to assist with all your health care needs, whether you need advice about how to best use your plan or you aren’t sure where to begin with health insurance in the first place.

It’s easy to shop for a new plan with us — you can search by coverage category, browse different metal tiers or consider state insurance providers, depending on your unique situation. Plus, you can choose from supplemental dental or vision plans to round out your health care.

Questions about the process or how to find the best plan for your needs and budget? Our experienced team can help. Contact us today to get in touch with a Health for California representative!


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Learn about the Covered California website. Find easy online enrollment. Set up your account, log in, buy insurance and more on the California health marketplace website.