Health insurance companies use a bit of gamesmanship when they select which customers they are going to cover, and which they are going to deny. Their purpose is to keep their costs as low as possible, while increasing their profits. Savvy consumers can play this game, too. The more you know about how health insurance works, the less hassle you will have to deal with. You might even end up saving yourself some money in the process.
Does your health insurance come with a network? If so, then you can save yourself some money by making sure that the doctors and specialists that you see are included in the network. There are two ways that that you can do this.
You can ask your insurance company for a list of doctors that are officially considered to be a part of their network. Or, you can call the office of each doctor or specialist before you schedule an appointment, and specifically ask if they are a part of the network that is connected to your health insurance plan.
If a doctor is out of network, then you can usually expect to end up paying for the entire cost of the visit yourself. Choosing one that is in network can save you quite a bit of money. Some insurers will cover the cost of seeing an out of network specialist if there isn’t an in network specialist that is local.
Insurers might cover the cost of emergency care that you received from a hospital that wasn’t in the network. Or, in some cases, you can talk your insurance company into giving you written permission to use an out of network provider (that they will still cover the costs of). If you are going to attempt to do this, I would suggest planning ahead, because this could take a lot of time.
Most health insurance companies do not provide coverage for mental health therapy. You might save yourself some hassle if you contact your insurance agent and talk with her about exactly what will be covered. Do this before you make that first therapy appointment. It’s better to know ahead of time what out of pocket costs to expect tham to be hit with a bill that you did not see coming later on.
Those of you who, like me, are using alternative medicine (such as acupuncture or massage therapy), should know that not all health insurance plans will cover this form of treatment. This is another good thing to have a conversation with your insurance agent about before you schedule treatment.
Personally, I have found that my acupuncturist will give me a discount if I don’t make her attempt to file a claim through an insurance company in order for her to get paid. See if your acupuncturist or massage therapist offers the same type of discount.
The generic form of prescription drugs are usually just as good as the brand name version of the same drug. Ask your doctor if there is a generic version of whatever medication he is prescribing, and tell him you want that instead of the brand name. If there is a medical reason why that would not be a good idea for you to do, your doctor should be able to point that out. I’ve been using the generic, over the counter version of the medication I use for my allergies for years, instead of the prescription, brand name, version of it. This has saved me quite a bit of money!
Image by Iwona Erskine-Kellie on Flickr