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Health Insurance Secrets | Financial Planning Tips

Health Insurance Secrets

Health insurance coverage is a coveted benefit. Those without coverage can run up huge medical bills for minor procedures, often ruining credit scores and emptying bank accounts. Even those with health insurance tend to pay quite a bit more than they might expect. It is always necessary to understand how your policy works, and always necessary to figure out ways to reduce your overall payments. If you take the time to understand your rights as a consumer, you will receive the coverage for which you have paid. Two of the best ways to demonstrate this knowledge are to understand your insurer’s “out-of-network” policies and your rights as a patient.

Co-pays and deductibles are a standard part of health insurance such as an individual health insurance. Most of these payments are relatively low, but there are situations in which most patients will have to pay higher fees. If you visit a doctor that is classified as “out-of-network”, your coverage amount will tend to be lower. This is done to encourage patients to visit specific doctors with whom the insurance agency has a pre-existing relationship, and also to make sure that overall health costs are kept at a reasonable level.

If you are not able to choose your doctor, though, you may be able to avoid these costs. Out-of-network fees tend to be waived if you are in an emergency, especially if that situation involves a hospital. Hospitals often send patients to their own internal specialists, many of whom may not be in your insurance network. Patients forced into this sort of treatment can generally avoid out-of-network fees by informing the insurance company of this fact. Your lack of choice in the matter will generally negate the provisions necessary for the additional insurance billing.

Insurance companies are businesses, and most keep a weather eye on the bottom line. If the company is billed for an expensive procedure, many will initially respond by turning down the request. The company may refuse to make an initial payment to your doctor, claiming that more information is needed from the consumer. In these cases, the company will often ask you for more information on your medical history or will seek out various types of paperwork meant to prove that you are not covered. Such actions are outside of the scope of your insurance contract, though, and you are not required to send in any information. In most cases, the lack of response will require the insurance company to honor its reimbursement agreement. You may wish to inform your physician if you encounter such a situation, as it may take several months for the insurance companies to disburse funds in such circumstances.

Saving money on your insurance is largely a matter of making the company live up to its own contract. If you are willing to examine the document and play by the rules, you might find that your total medical bills will drop. You have to consider your rights as a consumer when dealing with insurance companies, and simply abiding by your insurance agreement is the best way to reduce your costs.

This article is courtesy of The McKiernan Insurance Agency, a San Diego Insurance Broker.

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