Personalized Health Care Options Through Your Health Plan

When it comes to health care, it can sometimes feel like you’re on your own. However, some health plans offer tools to guide members through important care decisions, which can help to avoid costly or time-consuming mistakes.

To maximize your coverage and make informed decisions for your health, it’s important to understand the resources available through your health plan. Here are a few ways your health plan might offer personalized health care support.

Help with selecting the right health plan

Your onboarding experience is the first indicator as to whether you’ll have access to personalized support. For example, eligible Harvard Pilgrim Health Care and Tufts Health Plan members have access to personalized plan selection support through a partnership with MyHealthMath. This decision support tool helps simplify the process of selecting a plan by providing an estimate tailored to a member’s health needs and budget.

Additionally, new members can receive one-on-one call center support for questions about benefits and coverage when they enroll. After enrollment, a digital guided welcome program is available to walk the member through how to access plan information (and coverage details) online.

Tools to calculate costs of many medical procedures

When planning for future health expenses, your health insurer can help. Cost estimator tools such as Harvard Pilgrim’s Estimate My Cost and Tufts Health Plan’s Treatment Cost Estimator help members compare and choose care options for everything from primary care visits to lab and radiology services to outpatient procedures and inpatient procedures, like surgery.

The Reduce My Costs program also helps members find quality, lower-cost providers for certain health services. Not only does this help limit out-of-pocket costs, but also rewards members for choosing a lower-cost provider.

One-on-one health coaching, reimbursement and more

To reach your health goals, it can be helpful to have a guide on your side. Both Harvard Pilgrim and Tufts Health Plan offer health coaching, connecting members with a dedicated health coach who can help them create and maintain a plan personalized to their individual lifestyle.

If physical fitness is a goal, Harvard Pilgrim and Tufts Health Plan offer some reimbursements to members for eligible gym memberships and fitness class subscriptions, including virtual options. The Living Well program also live streams virtual fitness classes, guided mindfulness sessions and health webinars from experts to keep members engaged in every aspect of their well-being.

Health care planning and personalized support

For serious or complicated health issues, like cancer, diabetes or recovery from a stroke or neurological condition, dedicated care management can make a big difference. Nurse care managers help members manage treatment of their existing conditions, guiding them through the complex health care system by planning, implementing, coordinating, monitoring and evaluating the health care options and services available.

Through Tufts Health Plan, you can you can connect with a registered nurse at any time to discuss minor health issues you’re experiencing. Harvard Pilgrim even provides 24/7 emotional support for those in need of behavioral health and/or substance use treatment. In addition, access to behavioral health apps can be a great benefit, such as Sanvello—an app to help members better understand and track their mental health, while providing personalized progress check-ins along the way.

There’s no one-size-fits-all health plan. Everyone has different health goals, needs and lifestyles, so personalization in your health plan is key. That way, you can be sure that your health insurance is working specifically for you. Get in touch with your plan’s representative to learn more about customizable benefits your plan has to offer.

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