Guide to Using Your Health Care & Insurance

Take an Active, Empowered Role in Your Health Care

Clinician patient consult

As a college student, this may be your first experience making a doctor’s appointment, using your health insurance, or visiting a doctor other than a pediatrician you know well. It’s common to feel confused or overwhelmed at any point in the process.

We are deeply committed to helping you learn to use your healthcare in a way that feels collaborative and empowering both at UNH and beyond.

The World Health Organization defines empowerment as “a process through which people gain greater control over decisions and actions affecting their health.”

At Health & Wellness, we want you as a patient to feel confident about taking an active role in your care.
 

 

What does it mean to be an active participant?

As a patient, active participation means you:

  • Feel empowered to ask questions and advocate for yourself at your appointments.
  • Feel heard and respected.
  • Understand the information presented to you.
  • Have the information and resources you need to make decisions about your care and how to manage health conditions.
  • Are asked for your opinion and are included in the decision-making process.
  • Know how to access your health insurance benefits and pay for care.

 

How can I advocate for myself?

Ask questions!

This may be the most important part of self-advocacy. If there is something you don’t understand—during the registration process, your appointment, getting your prescriptions, following up with referrals, anything!--please ask for clarification. You may also want to write down any questions you have ahead of time so you don’t forget to ask them in the moment.

Common questions:
  1. What are all my treatment options?
  2. Why is this test/treatment/procedure necessary?
  3. What are the risks or side effects of that test/treatment/procedure?
  4. How much will it cost? Are there less expensive options? (Keeping in mind that you may need to ask your insurance for more information.)
  5. What does that word mean?
  6. I still don’t fully understand. Could you clarify/tell me more?
  7. What do I do if I miss a dose of the medication you’re prescribing?
  8. Are there activities, foods, substances (i.e., alcohol, smoking) I should avoid with my diagnosis or medication?
     

Get your healthcare providers’ names (and write them down if you need to).

And don’t be afraid to ask again if you’ve forgotten! This will help if you need to follow up, provide feedback, or ask a question after your appointment.

If you felt comfortable with your provider, you may be able to ask for them by name for a future appointment. Or, on the flip side, if you feel that the provider is not a good match for you, you may be able to request a different one next time. Keep in mind that providers have different specialties, so this may not always be possible, depending on the type of care you need.
 

Be as specific and detailed as you can.

It can be intimidating to talk to a stranger about your body or personal challenges. Or maybe you are worried that certain symptoms aren’t important. Trust us when we say, our staff has heard it all and want to provide a compassionate space for you to share your concerns. The more specific you can be about what you are experiencing, the better we will be able to help.
 

If you do not receive the response you were hoping for, let us know.

With so much health information (and often misinformation) online these days, many of our patients attempt to do research on their symptoms before they get to their appointment. It’s natural and helpful to educate yourself about your health concerns, but there is no substitute for a well-trained, highly experienced healthcare provider. We are happy to talk through your research, but we may have to correct misconceptions if they arise.
 

Ultimately, communication is key.

We would rather be able to address your concerns in the moment than find out later that you were dissatisfied with your visit. Please feel free to let us know things like:

  1. Your preferred name or nickname.
  2. Your pronouns.
  3. If you are feeling rushed or need more time.
  4. If you are confused or have more questions.
  5. If you are feeling uncomfortable (with questions asked, certain procedures, etc.)
  6. If you don’t understand certain terms or instructions.

 

What can I expect when making and attending an appointment?

Safety

We strive to provide a safe, empowering space for you to share your concerns. Just as we ask you to share and ask questions, we want to ensure you feel comfortable in doing so. We offer trauma-informed care, staff chaperones, the ability to invite trusted friends or family to your appointment, translator services, and telehealth appointments for those uncomfortable with or unable to attend in-person visits.

If you do not feel comfortable using our online appointment system, you can call or come into our office and our registration staff can help you understand how to make an appointment and what to expect at your appointment.
 

Collaboration

Your healthcare should involve shared and informed decision-making. To help you make decisions, we offer:


Convenience

We provide medical and psychiatric care, plus radiology, laboratory and prescription and non-prescription medication services right in our centrally located main building. We also have our Living Well education/counseling services, biofeedback, and light therapy located upstairs. Find our hours and locations here.
 

Human-powered care

We acknowledge that we are human, which means we may not always get it 100% right. That being said, we are committed to learning and growing as a staff and as an organization. If you have feedback for us, please let us know either at your appointment or via our feedback form. QR codes to this feedback form are also available in each patient room.  

 

What is my Patient Portal (MyHealth&Wellness) and how do I use it?

MyHealth&Wellness is our secure, online portal for your personal health management. You can use it to:

  • Make an appointment
  • Securely message with Health & Wellness staff
  • Read notes from your provider
  • Get test results
  • Manage, upload, and access health forms
  • Access and update health history and immunization records
  • View your financial account summary
  • Upload and update your insurance card(s)

If you haven’t been to your health portal yet, get familiar with it here.

 

More Resources

 

Paying for Care at Health & Wellness

Students can be seen at Health & Wellness regardless of what insurance they have.

The UNH health fee combined with your insurance or benefits plan ensures that your out-of-pocket costs at Health & Wellness stay as low as possible. This fee ensures that students have access to medical appointments and wellness counseling and coaching without a copay, among other benefits. Health insurance is not billed for services covered by the health fee.

It is your responsibility to know your health insurance coverage. You are responsible for charges that are not covered by your health fee and insurance. Refer to your Explanations of Benefits (see glossary) to keep track of what is and is not covered by your insurance company, and to make sure your claims are processed correctly.

This price list can give you an idea of the cost of certain procedures, visits, and medications at Health & Wellness.

 

    Using Your Insurance or Health Benefits Plan

    Visit our “Student Health Insurance” page to learn about health insurance, UNH health insurance requirement, and log into the Wellfleet Insurance portal if you use the UNH Student Health Benefits Plan.

    Every health insurance plan is different, so it’s important to know what your specific plan covers. Here are our top tips for using your benefits:

    1. Read your plan’s summary of benefits, which insurance companies are required to provide in easy-to-understand language.
    2. Schedule your annual physical each year. This is a good way for you and your doctor(s) to get to know each other, to keep up with your own health status, and to find out what kind of health care you may need in the future. Annual physicals are considered preventive care, which is completely covered by health insurance plans (i.e., no co-pay or additional billing for these visits). Keep in mind, however, that you may be charged for an annual physical if you bring up a health concern (for example: frequent headaches, heavy periods, allergies, etc. Note: STI/HIV testing is covered once per year as a screening benefit, but is not typically covered more than once per year).
    3. When in doubt, contact your insurance provider. If you aren’t sure if a certain procedure, medication, or visit is covered by your plan, call the number on the back of your insurance card or login to your online health insurance portal and look for help regarding benefits information.

     

    Understanding Insurance Terms

    Explanation of Benefits (EOB)
    When you bill a visit, procedure, or medication through your insurance company, the company will provide an EOB that details how they processed your claim. The EOB would also include a reason if the claim was denied, which provides you with an opportunity to resolve the issue prior to being billed for services. If something in the EOB does not look right or you have questions, you may need to contact your insurance provider and/or your health care office.

    In-Network vs. Out-of-Network
    Health insurance companies negotiate discounts with certain providers or health care facilities, which are then considered ‘in-network’. If you go to a provider or facility that is ‘in-network’ with your insurance company, it will almost always cost less than going to one that is ‘out-of-network’.

    Some health plans will only pay for services when the member uses in-network providers, while other health plans will pay at least some of the claim even if the member uses an out-of-network provider.

    Deductible vs. Premium
    When choosing and a health plan, it’s important to look beyond the monthly payment (your premium) and consider the deductible. This will help you calculate the total cost of your insurance and care, rather than just the up-front costs.

    The deductible is how much you have to spend before your insurance starts covering services (not including free preventive services). So, for example, if you have a low monthly payment but your deductible is $8,000, that means you have to pay $8,000 of your own money before insurance will start helping you with your health care costs. If you anticipate needing a lot of health care when choosing your plan, you may want to pick a higher monthly premium with a lower deductible. On the flip side, if you don’t think you’ll be using your insurance much in the year ahead, you might opt for a lower monthly payment and a higher deductible.

    Copayments vs. Coinsurance
    Another factor in calculating the total cost of insurance is copay/coinsurance. Both are payments you make to your insurance company each time you use services (not including free preventive services). 

    Usually, you pay 100% of the cost of your care until you meet your deductible, after which you pay a copayment (aka “co-pay”) or co-insurance.

    A copay is a fixed amount (such as $20 or $40) that you would pay for a specific service covered by insurance. Coinsurance is paid as a percentage of the cost of a service (for example, you pay 20% of your care and your insurance company pays 80%).

    Referral vs. Pre-Authorization
    A referral is issued by a primary care physician (PCP) for the patient to see a specialist. With certain insurance plans (usually HMO plans), you as the patient are required to get a referral to a specialist or other provider outside of your PCP.  If a referral is missing, you will likely be responsible for the total cost of care.

    Prior authorization is issued by an insurance company to for care at a designated provider. This usually applies to Out-of-Network care; however, it may also apply to certain medical procedures. 

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