Why Isn’t My Insurance Covering Anything?

Pharmacist Showing Product To ClientI often receive questions from people who say they went to the doctor but their visit wasn’t paid for by their insurance, or their prescriptions weren’t covered. These people want to know why they are paying for health insurance if it isn’t going to cover anything.

In most cases, the answer is that they haven’t yet met their deductible. Many plans cover doctor’s visits and prescriptions, but only after the patient has paid first. If your plan has a deductible, it means that you will pay out-of-pocket for expenses up to that amount, and then insurance will kick in.

So let’s say, for example, that you have a $250 deductible with your insurance plan. You may have to pay out-of-pocket for doctor’s visits or copays until your total expenses reach $250. To be clear, that doesn’t mean $250 per instance. You may pay $60 for a prescription in January, $30 for another in February, and so on. All of those expenses get totaled—in this example you are up to $90. Once you have paid a total of $250, your insurance will kick in and cover your expenses for the rest of the year.

These costs usually reset at the beginning of the year. Hello, January. Early in the year, you may be paying out-of-pocket, but as the year goes on and you meet your deductible, your insurance may start paying on your behalf.

As you budget for the year, you may want to keep these expenses in mind. In fact, you may want to set aside some extra money each month toward the end of the year to cover your out-of-pocket costs at the beginning of the next year. You may also consider opening a flexible spending account (FSA) or health savings account (HSA) in the future to help cover your out-of-pocket costs.

What is the Deadline for Enrolling in Obamacare?

mom with kid at doctorHopefully by now you have health insurance in place for 2016. If not and you’re enrolling in Obamacare, sign up as soon as you can.

It is currently too late to enroll in health insurance and have it be effective January 1st. Makes sense, since we are already a few days into January.

You can, however, still sign up to have health insurance for the remainder of the year. The deadline and absolute latest you can sign up for Obamacare is January 31st. And if you wait until that later part of January, your health insurance won’t actually be effective until March 1st, so keep that in mind. If you enroll in Obamacare by January 15th, your coverage will begin as early as February 1st.

So if Obamacare is your choice, enroll now. The sooner the better.

Curious about what Obamacare will cover? Watch this short video.

Want to know even more about Obamacare? Check out my book Easy Healthcare: Obamacare, available as either a paperback book or an ebook.

 

 

One Question Could Save You from Unexpected Medical Bills

Mother and baby in home officeYou’re scheduling an appointment with a doctor. It could be a well visit or one to discuss a particular concern. You’ve agreed upon a time and asked whether the doctor accepts your insurance. You’re all set, right?

Maybe not. Many doctor’s offices will accept your insurance even though they don’t participate in your insurance plan. The doctor may not have signed a contract with your insurance company agreeing on a total charge for the visit. This means your insurance may not cover the visit as you are expecting. It may cover a smaller than normal amount and you’ll be stuck with bills to pay the difference.

You can avoid a situation like this by asking a different question. When you call to schedule your appointment ask if the doctor “participates” in your insurance plan.

It is also important to recognize that some doctor’s offices are very large and have a number of doctors in the facility. If you have a specific doctor that you want to see, make sure your particular doctor and the office as a whole participate in your insurance plan. For instance, if you have Medicare or Medicaid some doctors in your practice may accept those, while others in your practice do not.

Avoid unexpected medical bills by ensuring that your doctor and the doctor’s office participate in your insurance. All it takes is the right question: “Do you participate in my insurance plan?”

Would you like to make empowered healthcare choices? Get started with the free MyHealthSpin Toolkit. Filled with free ebooks, workbooks, and videos, you will be able to spin your healthcare your way. GET YOUR TOOLKIT NOW