My Health Insurance Doesn’t Cover Anything?

Health Care CostsThis is the question I got this week from a 22-year-old woman who just started her first job after college:  like most young adults, she doesn’t go to the doctor very often, but recently went to the dermatologist who prescribed some medications for her acne.  The prescriptions weren’t paid for by her insurance and were very expensive.  She wondered why she should continue to pay for her employer’s health insurance if nothing was going to be covered.

We talked about her policy, and, of course, there was a deductible.  Since she hadn’t gotten any healthcare services this year, she had not yet met her deductible.  The medication was “covered” by insurance, but the cost of the medication went toward her deductible.  So, she had to pay for the prescriptions out of her own pocket.

When she chose her health insurance plan, she picked the cheapest policy.  She didn’t realize that one of the reasons why it was cheaper was because it was a “high deductible” insurance plan.  It’s likely that most of her healthcare services this year won’t be paid for by the insurance company because of the high deductible.  For our 22 year old, this might be a wise choice.  She pays less per month and she is unlikely to need many healthcare services since she is young and healthy.

Even if you did not select a “high deductible” plan, many people are frustrated at the start of the year by the fact that a lot of healthcare services are not paid for by insurance due to the deductible.  

What can you do?  First, when you select an insurance plan, know what your deductible is.  If your employer has a Health Savings Account (HSA) which allows you to put pre-tax dollars away to pay for healthcare services, it’s wise to put in at least enough to cover the deductible.

You might also want to consider choosing a lower deductible plan the next time you can change your plan.  You need to consider the increase cost of the insurance vs. the lower deductible.

Planning ahead is the best solution so you do not have surprises like our 22 year old.  At least now, she understands her insurance plan and knows what to expect.

Tell us how you choose your deductible?  We’d love to hear from you!

For more information about your health insurance, see HealthSpin’s Easy Healthcare: Choosing Your Health Insurance.

We hope we’re helping you “Spin Your Healthcare Your Way!

 

So You’re Signing Up For ObamaCare…What Is Covered?

What is covered under Obamacare? It used to be that insurance companies only covered the services that were most profitable for them. Now, with Obamacare, basic services like preventative care must be covered. This is true for Medicare as well.

P.S.–Please remember that ObamaCare has added an extra enrollment period that from March 15 – April 30, 2015Spin your healthcare your way and check out our Easy Healthcare eBook Guides.

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HealthSpin’s Easy Healthcare: Choose Your Health Insurance gives you the practical steps you can take to choose the right insurance plan for you and your family.

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How to Get a Preventive Doctor’s Visit Paid for by Insurance

Elderly woman and senior practitioner during medical check-upI recently had my regular annual check-up with my doctor.  I really didn’t have much wrong, but I wanted to talk to her about a few issues I was having.  The nurse quickly told me that if I had to talk to the doctor about a specific “problem,” the office could not do my annual check-up at the same time since my insurance plan would only pay for the annual visit as “preventive” if I didn’t talk to the doctor about any specific issues.  

That seems silly, doesn’t it?  But the nurse is right!

This isn’t the doctor’s rule but rather an insurance rule.  Your insurance will normally cover a “preventive” visit once a year.  This “preventive” visit is to check your blood pressure, weight, and other general indicators of how healthy you are.  If you’re a woman, you may get your annual pap smear and mammogram.  If you are a man, you may get your prostate checked along with a colonoscopy.  These “preventive” visits are different than an appointment you make to see the doctor for a specific problem.  If you have a problem, the doctor will bill your insurance as a regular visit.  If you have a co-pay, you will have to pay out-of-pocket for a portion of the visit.  The amount that you pay will depend on your insurance plan.

It’s important to understand this because the doctor can’t just mark down the visit as “preventive” if it’s not.  Many patients call the doctor’s office after the visit to say they want the billing for the visit or service changed to “preventive” so the insurance company will pay for the entire visit or service.  The doctor can’t do this.  If they do change the billing, they are committing “fraud” and can get in trouble.

The best way to handle how you are charged is to call your insurance company beforehand and ask what preventive services are fully paid for by the insurance company.  You can ask your doctor; however, there are a lot of different insurance plans and the doctor’s office might not have the right answer for your plan.

Tell us how you  make sure you know what’s covered for you and your family under preventive services. We’d love to hear from you!

For more information about your health insurance, see HealthSpin’s Easy Healthcare: Choosing Your Health Insurance.

We hope we’re helping you “Spin Your Healthcare Your Way!