Maximizing Your Health Insurance Benefits: What You Need to Know
0
0
Contents
Introduction
Your health insurance plan is your lifeline when you get sick. It can provide you with access to a wide range of services, including doctor’s visits, hospital stays and prescriptions. However, the details of your plan might be more complicated than you realize. In this article, we’ll explore some common misconceptions about health insurance benefits—and how to make sure you’re getting the most out of them.
How do I know what my insurance covers?
- Check your insurance card.
- Call your insurer and ask about coverage. In most cases, insurers will be able to tell you exactly what is covered and what isn’t by looking at your plan’s details.
- Go online to see if there are any restrictions on specific procedures or medications in your state (it varies by state). There will also be information on what kinds of treatments are covered for specific conditions such as pregnancy or cancer treatment. This can be found on the National Association of Insurance Commissioners website or through other websites like Healthcare Bluebook or HealthPocket that specialize in healthcare cost information.[1]
What is an exclusion?
Exclusions are benefits that your health plan does not cover. For example, some plans do not cover prescription drugs or preventative care. If you want to use an excluded service, you must pay for it yourself or find another way to get it covered by your insurance company.
Exclusions can be confusing and difficult to understand, so it’s important to ask questions if you have any doubts about how they work with your plan.
What is a deductible?
A deductible is the amount you pay before your health insurance starts paying. It can be a flat dollar amount or a percentage of your healthcare expenses. For example, if you have a $5,000 deductible and spend $1,500 on doctor visits and other medical services during the year, then the first $5,000 will come out of pocket before any insurance coverage kicks in.
The size of your annual deductible varies depending on which plan you choose: High-deductible plans generally have lower premiums because they require more out-of-pocket expenses for care but also offer lower monthly payments if something does happen (more about this later).
Can I get a second opinion?
A second opinion is a way to get an outside opinion on your health. You can get one from a doctor or other healthcare professional, such as an occupational therapist or physical therapist. A second opinion doesn’t have to be free, but some insurance policies will pay for it if you ask them to do so.
How do I know if I need one? If you’re not sure whether your current treatment plan is working well enough and want another point of view before making changes, then getting another opinion could be useful–but only if it’s done carefully! It’s important that whoever gives the second opinion understands all aspects of your case (that means no missing information!) and agrees with the first doctor about what treatments are best for you overall; otherwise there may not be any improvement in how well things are going over time…and even worse: there could actually be worse outcomes because both doctors aren’t working together properly towards helping improve conditions over time instead just providing conflicting advice which might confuse people who aren’t familiar with medical terms like “arthritis” versus “osteoarthritis.”
What other benefits does my health plan offer?
Your health plan may offer other benefits, such as prescription drug coverage. You can also choose to enroll in a separate dental or vision plan through the Marketplace.
If you want to learn more about your options for additional coverage, visit the Health Insurance Marketplace website at www.healthcare.gov
Get the most out of your insurance.
When you have health insurance, it’s important to know what your plan covers. While a deductible is the amount of money you pay before your insurance kicks in, an exclusion is something that the insurance doesn’t cover at all. Other benefits include free checkups and prescription drugs for some plans as well as dental care for others. If you want a second opinion about treatment options from another doctor or hospital, ask your employer or agent if they’ll pay for it–they may not be able to refuse this request if it’s made within 60 days of receiving their first bill from the provider or hospital (though some plans do have restrictions on how much can be reimbursed).
To find out what services are covered by your health plan:
- Check with the company directly where you work;
- Contact an independent broker who specializes in employment benefits; and/or
- Visit www[dot]ebscohost[dot]com[slash]consumer[slash]healthinsuranceguide[slash]html
Conclusion
In the end, it’s important to remember that health insurance is designed to protect you from the high costs of medical care. It can be confusing at first, but if you take time to understand your policy and access its benefits, then you can get the most out of this valuable resource.
