(BPT) - A cancer diagnosis. A mental health crisis. An unexpected complication during pregnancy.
These moments are stressful enough on their own. For many families, they're made even harder by confusing coverage, rising costs and not knowing where to turn for help. Today, people expect more from their health plan, not just help paying medical bills, but clear guidance, real support and tools that make healthcare easier to navigate.
Across the country, health plans are evolving to meet those expectations by focusing on what matters most to consumers: simpler experiences, better access to care and greater affordability.
Taking a broader view of health
Healthcare has traditionally focused on treating illness after it happens. But staying healthy also depends on prevention, mental health support and help with everyday challenges that can affect well-being.
Modern health plans are taking a broader view of health, one that recognizes that physical, behavioral and social needs all play a role in outcomes and costs over time.
One example is expanded access to doula care. Research shows that women who receive support from certified doulas, who provide education, coaching and emotional support during pregnancy, labor and delivery, often experience better outcomes.
Doulas can help expectant parents:
- Communicate more effectively with doctors or midwives
- Manage stress and physical demands during pregnancy and childbirth
- Adjust to the transition into parenthood
Health plans are also helping members address basic needs that support health, such as access to nutritious food, over-the-counter medications and transportation. By helping people stay healthier day to day, plans can reduce avoidable emergency visits and hospital stays.
Making healthcare easier to understand and use
At Anthem Blue Cross and Blue Shield, this shift shows up in how the health plan supports members across different stages of care.
For many people, navigating healthcare feels overwhelming. Understanding benefits, finding the right provider or knowing what something will cost shouldn't feel like guesswork.
Modern health plans are focused on helping members understand their coverage and what affects their costs, so they can make informed decisions and focus on their health — not paperwork.
Behind the scenes, health plans use technology and clinical expertise to help ensure plan dollars are spent on the right care, at the right time. This work helps reduce waste, prevent errors and avoid unnecessary costs, making care more affordable for everyone.
Digital tools are also playing a growing role. With the Sydney Health app, members can find in-network care, see estimated costs before an appointment and manage benefits in one place. Members who use these tools save time and an average of $185, and new AI-powered features are making it even faster and easier to find the right care.
Personalized support for complex needs
When health needs become more complex, having someone to help guide the way can make a real difference.
Care managers, experienced clinical professionals, help members understand their benefits, coordinate care and overcome roadblocks. They work with doctors, specialists and community organizations to help ensure people get the support they need when they need it.
For example, when Lilliana noticed a concerning lump during her pregnancy, she contacted her health plan for help. A care manager helped her understand her coverage, worked with her doctors to coordinate a biopsy and connected her with community resources to support her growing family. That extra guidance helped reduce stress during an already difficult time.
Helping people get and stay on their medications
Getting medications safely and on time is critical to managing health conditions. Health plans support members by making prescriptions easier to manage and helping prevent gaps in care.
Members who use CarelonRx Pharmacy with Auto Refill are 92–94% more likely to stay on track with their medications, supporting better health and fewer interruptions in care.
Removing barriers to care
Health challenges don't always start in a doctor's office. Transportation issues, access to food or other everyday obstacles can make it harder to get the care people need.
Health plans work to identify and remove these barriers by connecting members to local resources that can help, so challenges outside the health system don't stand in the way of care.
Health plans built for today's needs
A modern health plan should make healthcare easier to understand, easier to afford and easier to use. At Anthem Blue Cross and Blue Shield, that means helping people avoid surprise bills, find lower-cost care options and get support when they need it, so they can focus more on their health and less on navigating the system.
As healthcare continues to change, plans that focus on simplicity, affordability and personal support can play an important role in helping individuals and families stay healthy, and feel more confident navigating their care.
Learn more
To learn more about how Anthem Blue Cross and Blue Shield supports members in navigating care and managing costs, visit anthem.com/affordabilityinmissouri.
