Friday, June 12, 2015

Get Smarter About Health Insurance

Everyone keeps secrets.  Even your health insurance company.  Ever have a bill from a procedure or hospital stay and you know for a fact that some of the charges were for services not  rendered or supplies not provided?  Ridiculous, right?  Or, you are asked to pay extra for an out of network anesthesiologist, even though you did not choose the anesthesiologist.  Is it your responsibility to pay?  Is your insurer hoping you wouldn’t notice?

How do you fight back and win against this kind of trickery?  Well it may easier than you think.  But before I begin, you should always consult an expert or your attorney if you feel you’ve been wronged.  And especially if things are not going in your direction. So here are a few secrets that may keep money in your pocket.

Don’t Pay Without a Say

Already mentioned, if the hospital chooses an out of network anesthesiologist and wants to pass the bill to you, fight back.  Draft a strongly worded letter stating you had no say on who the hospital chose for an anesthesiologist.  The hospital should have used someone from in the network and politely say you are not liable for that decision and won’t pay.

This is a great tactic that few know about and even fewer use.  But, give it a try.

More Coverage

You might be eligible for more coverage than your plan is telling you about. Here is where a little research on the internet can go a long way.  Some states require more benefits in some areas.  It is up to you to get the scoop and make sure you get the benefits.

Check out Families USA, a consumer group that keeps up on state rules.  You can also reach out to your state’s insurance commissioner.

Talk Up Your Symptoms

If your insurer does not think a procedure is necessary, like a colonoscopy, but you believe you need one, talk it up!  Review your symptoms in detail with your doctor and have specific reasons why you need the test.  Note that few states, only about 21, require insurers to cover colonoscopies for general screening.

Letters Can be Your Best Friend

Old fashioned and a little bit inconvenient, letters give you a great record, especially if you have to go to court.  And, the insurance companies know it.  While not all communication can be done by snail mail, you can at least follow up with your understanding of the conversation.

Winning with Advocates

Bottom line.  Insurers know that advocates know the laws, especially the nuances a regular customer might not know.  And, this makes them nervous.

There are organizations, such as Patient Advocate, that may offer assistance. Again, the internet is your friend.

It is your life and money.  Take control and spend it wisely.

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