Are you choosing the right health insurance plan—or just the one with the lowest monthly premium? Health insurance can be confusing, expensive, and frustrating. Between deductibles, copays, coinsurance, provider networks, and unexpected medical bills, it’s easy to feel overwhelmed. But understanding how your coverage works could save you money, protect your access to healthcare, and help you make more confident decisions for yourself and your family. In this episode of Wellness in Every Season, Autumn welcomes Carrie Sorenson, Community Health Educator with the University of Maryland Extension. Through the Smart Choice, Smart Use program, Carrie helps individuals and families understand how to select and use their health insurance. She’s been teaching health insurance literacy since 2017 and believes that better education can help people access the care they need at a price they can afford. Drawing on Autumn’s background in medical billing and coding, they break down complicated insurance terminology, explain common billing mistakes, and share practical strategies for navigating the healthcare system. What You’ll Learn 💰 Understanding health insurance costs: What premiums, deductibles, copays, coinsurance, and out-of-pocket maximums actually mean—and how they affect what you pay. 📊 How to compare insurance plans: Why choosing the lowest monthly premium doesn’t always mean spending less on healthcare. 🏥 In-network vs. out-of-network providers: What to verify before scheduling appointments with doctors, specialists, hospitals, therapists, labs, or imaging centers. 🔍 Avoiding unexpected medical bills: How to recognize possible billing errors, check insurance adjustments, and question charges that don’t look right. ⚖️ Appealing denied insurance claims: When to challenge an insurance company’s decision and when to contact a provider’s billing department instead. 👨👩👧👦 Choosing coverage for your family’s needs: Why your medical history, preferred providers, lifestyle, and access to care should influence your decision. 🩺 Using preventive healthcare benefits: How to explore screenings, annual checkups, and other preventive services included in your coverage. 💳 HSA vs. FSA: How health savings accounts and flexible spending accounts can help you set aside tax-advantaged money for eligible medical expenses. 📅 Planning healthcare expenses: Why understanding your deductible, plan year, and out-of-pocket maximum can help you make more informed decisions about scheduling care. Your Health Insurance Should Work for You One of Carrie’s most helpful explanations is that health insurance costs often follow three phases: Phase 1: I pay. You pay applicable costs toward your deductible. Phase 2: We pay. You and your insurance company share certain costs through coinsurance. Phase 3: They pay. Once you’ve reached your in-network out-of-pocket maximum, your plan generally pays 100% of covered in-network services for the remainder of the plan year. Understanding these phases is a starting point. Individual plans may have copays, covered services, or other benefits that work differently. Carrie also emphasizes that choosing health insurance isn’t just about the numbers. It’s about making sure your plan supports the care you actually need. The goal isn’t simply to find the cheapest insurance. It’s to find coverage that fits your health needs, your budget, and your life. Continue the Conversation 💌 Have you ever received an Explanation of Benefits (EOB) and wondered what all those numbers actually mean? What’s the difference between what your provider billed, what your insurance company negotiated, what insurance paid, and what you truly owe? Carrie continues this conversation in the Wellness in Every Season Companion newsletter, where we explore how to read an Explanation of Benefits and better understand your medical bills. Connect With Carrie Sorenson University of Maryland Extension Carrie is a Community Health Educator who teaches health insurance literacy through the Smart Choice, Smart Use program. University of Maryland Extension: https://extension.umd.edu/home/ Smart Choice, Smart Use — Health Insurance Literacy: https://extension.umd.edu/programs/family-consumer-sciences/health-insurance-literacy/ Explore the program for educational materials, health insurance decision-making resources, and information about available classes. Additional Resources Maryland Health Education and Advocacy Unit Consumer assistance with health insurance disputes and medical billing concerns. IRS Publication 502 — Medical and Dental Expenses Information about eligible medical expenses and related tax rules. IRS Publication 969 — Health Savings Accounts and Other Tax-Favored Health Plans Information about HSAs, FSAs, eligibility requirements, and tax considerations. Health insurance benefits, provider networks, tax rules, and consumer protections vary by plan and circumstance. This episode provides general educational information, not individualized insurance, financial, tax, or legal advice. Confirm coverage and costs directly with your insurer and consult a qualified professional when appropriate. For more wellness tips and exclusive content, join my newsletter! 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