Understanding your health benefits (even if you don't know much about them)

When you hear “health benefits” (or “health insurance,” “benefit plan,” “employee health plan”), it can feel like an alphabet soup: deductible, copay, premium, in-network, out-of-pocket maximum… How do you make sense of it? And how do you use what you have so it works for you? ‍

Good news: you don’t need to become a health-plan expert overnight. But understanding the basics can help you make better decisions, avoid surprises, and make the most of what’s available. That’s what we’ll cover here — in plain language. And because your employer offers you a Rezilient Health benefit, you already have a powerful tool to make accessing care easier, more affordable, and a lot less stressful.

‍What are “health benefits”?

At the simplest level: a health benefit is a service, support, or coverage available through a health plan (often provided by your employer, union, or via an individual plan) that helps you when you need healthcare. This could include: 

• Coverage of doctor visits, hospital stays, surgeries
• Preventive services (vaccines, screenings)
• Prescription drug coverage
• Mental health services
• Extra “help” services, like navigation or support

The rules vary widely depending on the plan. When you’re choosing a health plan, often during open enrollment, you might see multiple options with different monthly costs (premiums) and deductibles. It can be hard to know which one is actually “better.”

Here’s how to think about it:

• Premium: This is what you (or your employer) pays every month to have insurance, even if you don’t use it.
• Deductible: This is what you pay out of pocket before your insurance starts covering certain services.
• Copay and coinsurance: These are the smaller payments you make when you get care (like $30 office visit or 20% of a procedure cost).

A high-deductible plan usually has a lower monthly premium, meaning you’ll pay much less each month. But if you do need care, you’ll pay more out of pocket before your insurance starts paying. 

A low-deductible plan typically costs more each month, but your insurance starts helping with costs sooner, which can be helpful if you expect to need frequent care or have ongoing health conditions. 

When choosing what’s best for you, think about: 

• Your health needs: If you’re generally healthy and don’t visit the doctor often, a high-deductible plan might save you money over the year.
• Your savings cushion: If paying a large bill upfront would be tough, a lower deductible plan might give you peace of mind. 
• What’s included beyond the basics: Some employers offer added benefits (like Rezilient Health!) that cover primary and urgent care with no copays or out-of-pocket costs, which means even a high-deductible plan may still give you easy, affordable access to care.

Because every plan is different, taking a little time to understand your specific coverage can make a big difference. According to the U.S. Department of Labor, learning about your rights and responsibilities under your group health plan is a key step.

‍Why does understanding your benefits matter?

Here are some of the big reasons: 

• Better decision-making: If you know what your plan covers, and how much you’ll pay, you’re in a better position to choose when and where to get care, ask good questions, and avoid surprise costs.
• Make the most of what you’ve got: Coverage only helps if you actually take advantage of it. If you don’t understand that a service is covered (or what you’ll pay), you might skip something important.
• Avoid wasted money / resources: Some plans have choices (e.g., virtual care vs in-office), and using the right option can save you time and money. Education can help you spot those.
• Better health outcomes: When people engage with their plans and benefits, preventive care gets used, conditions get caught earlier, and overall wellness improves. 
• Peace of mind: When you know what you have, you’re less stressed about “what happens if…” scenarios. 

‍Good questions to ask about your plan

If you’re new to this, here are some basic questions you can ask (or look up in your plan documents): 

• What services are covered (doctor visits, specialist visits, labs, imaging, prescription drugs, mental health)?
• What is the in-network vs out-of-network rule? Are there extra costs if I go outside the network?
• What is my deductible (if any)? What do I have to pay before the plan kicks in?
• What are my copays / coinsurance for common services (primary care, specialist, ER, urgent care)?
• What is my out-of-pocket maximum for the year?
• Does the plan cover preventive services at 100% (no cost to me)?
• Are there additional benefits (wellness programs, telemedicine, navigation support)?
• When is the open enrollment period (when can I change plans or options)?
• What happens if I have a life change (e.g., get married, have a child, lose a job) – how do my benefits adjust? – The U.S. DOL notes that life and work changes require benefits decisions.

‍How Rezilient Health fits in

Here’s where things get easier. Rezilient Health is an added benefit on top of your existing care. If your employer offers Rezilient Health, it means you have access to high-quality, convenient healthcare services at no cost to you.

That includes:

• Primary care for regular checkups, lab reviews, and preventive care
• Urgent care for things like colds, sinus infections, or minor injuries
• Virtual care (telehealth) for same-day appointments from anywhere in the United States
• CloudClinic visits for in-person exams where our medics use advanced technology to connect you with your provider in real time
• Care coordination for referrals and specialist options

With Rezilient, there are no copays or out-of-pocket costs for these visits. Whether you meet your provider virtually or at a CloudClinic, all services performed through Rezilient are fully covered by your employer’s plan. You can think of Rezilient as an extension of your health benefits, one that’s easy to use and designed around your life.

Rezilient isn’t here to replace your existing primary care doctors or specialists, if you already have established relationships – we’re here to support and connect your care. For example, we can: 

• Handle urgent or same-day needs when your regular doctor isn’t available
• Coordinate referrals or follow-ups with your existing providers
• Share visit notes and test results to keep your full healthcare picture connected

Rezilient can also act as your primary care provider, managing checkups, preventive screenings, and ongoing health needs. Either way, we’re part of your broader healthcare ecosystem. 

‍Key takeaway

Your health benefits are one of the tools you have to protect your health, your finances, and your peace of mind. They’re only as useful as how well you understand them. Education makes a difference: knowing what you have, knowing how to use it, and knowing where to go for help.

And with Rezilient Health as part of your support system, you have extra guidance and a partner to help you navigate, understand, and optimize your coverage, at no out-of-pocket cost to you.