4 Ways HR Can Help You Understand + Use Your Employer-Sponsored Health Insurance

Health insurance can be confusing to understand and sometimes frustrating to navigate. If you get health insurance through your employer, we explain how to work closely with your human resources (HR) team to ensure you know your plan benefits and limitations. 

Working with HR to understand and utilize your employer-sponsored health insurance can help you optimize your diabetes management and health-related finances. Here are some of the top ways they can be helpful as you’re navigating your plan:

#1—You can rely on HR as your health insurance expert

HR can provide education on important health insurance plan features, deadlines, benefits, etc. Your HR rep may have an initial sit-down with you during the employee onboarding process to talk about health insurance plans, offer an annual lunch ‘n learn to all employees who want to know what their coverage options are before the enrollment deadline, or even send routine “health insurance 101” emails company-wide. 

All these outreach methods can help keep your organization informed of any health insurance updates or important must-knows.

#2—HR can help you decide on insurance plans

Seeing health insurance plans laid out in an HR guide or webpage can be dizzying. HR can help you decide on the best health insurance plan for you that is offered by your employer. Your HR rep can help break down everything (deductibles, co-pays, etc.) so you can feel confident in your selected plan to manage your type 2 diabetes. 

Consulting HR can also help you determine how different plans might affect health and financial planning. For example, if one plan has higher co-pays on office visits than another, HR can help you pick out a plan that’s affordable for you. You shouldn’t have to be a health insurance expert!

#3—HR can help advocate for changes in future plan offerings

If all of the plans you evaluate don’t meet your needs, HR can be a health insurance advocate for you. If the group or individual needs are not met with the current plans offered, HR can advocate for the company to adjust the plans offered in upcoming years. Enacted changes may help ensure your needs are better met or costs are reduced, so it’s important to speak up and often with HR!

You may voice a need for change when:

• The affordability of services and medications are high with a high deductible healthcare plan (HDHP)
• Seeing a specialist for your type 2 diabetes includes a higher co-pay
• A continuous glucose monitor (CGM) is only being covered at 20 percent until you meet your high deductible
• The insulin you used last year is no longer covered by your current health insurance plan offerings

And so on!

While your HR rep won’t be able to do anything during the current plan year, requesting better coverage to HR for the next plan year can serve you well. Send a professionally-worded email or request a face-to-face conversation to submit your requests to HR. They can operate as an advocate on your behalf to help facilitate essential changes.

#4—HR can help take care of the busy work

Last, HR might take on the role of health insurance middleman if unexpected problems arise as you’re using your insurance. For example, HR might be willing to gather details on your behalf as an “An insurance claim is a formal request to your insurance provider for reimbursement against losses covered under your insurance policy.” icicprulife.cominsurance claim advocate. 

Don’t rule them out if you have issues getting your type 2 diabetes supplies, services and/or medications covered! They should be there to assist you with submitting necessary paperwork or finding resources to get you the supplies and services you deserve. 

Bonus tip: Employee Assistance Programs can help too!

In addition to working with HR, employee assistance programs (EAP) can help you with other personal or work-related concerns. Your work may offer an EAP that provides access to counselors and services that can help you with your job performance, health, mental and emotional well-being. 

In the United States, 97 percent of companies with over 5,000 employees offer an EAP! Many smaller companies also provide them. Ask your HR team if there is an EAP available to you.

HR should be a part of your diabetes support team

When approaching any health insurance situation at work, remember that you and your HR rep are in it together! You should be able to go to HR with any health insurance-related questions, which may include:

• Why is my co-pay so high on (this medication or service)?
• I used to see this provider earlier in the plan year but now insurance says they aren’t covered. Why is that? What can I do about it?
• Why is the insulin I was using last year no longer covered? Is there a way I can stay on it and still get last year’s cost or do I have to switch meds?
• How do I submit a prior authorization (PA) for a new medication? Can you help me submit this PA?
• Why did our deductibles go up this year? Can you help advocate to change that in future plan years so (this medication or service) is more accessible to me?
• I used to go to (this pharmacy), but now insurance says I have to use (another one). Why is that?

You may have to advocate for yourself at first and initiate these important questions and conversations with HR. At the end of the day, your HR rep should become an advocate for you as they learn more about the unique situations you encounter with health insurance while living with T2D.

Lean on Beyond Type 2 health insurance resources to strengthen your understanding of the health insurance marketplace, get answers to FAQs and learn more about how you can optimize your health insurance plan to thrive with diabetes.

Editor’s note: Information in this resource is derived from a health insurance guide originally created by JDRF, an active partner of Beyond Type 1 at the time of publication. It has been edited to suit the needs of the type 2 diabetes community.