Purchasing the right health insurance plan doesn’t have to be complex. You just need to think about your priorities and follow 3 EASY STEPS. Check out this video as Lauren examines her health insurance options. You can apply these same concepts to confidently make the decisions that are right for you!
I hope this post helps you Spin Your Healthcare Your Way!
Check out how more information on how to choose insurance in our new book,Easy Healthcare: Choose Your Health Insurance.
I 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!
My friend Sally is super friendly, smart and has a great job. Sally recently explained to me that she is very annoyed with her doctor’s office. Why?
She was at her doctor’s office last week and she was trying to figure out whether one of the healthcare services she wanted was going to be “paid for” entirely by insurance.
She kept asking the doctor’s billing people, “Is that covered?” Although the billing people said “yes,” she later got a big bill from her doctor. How could this be?
Healthcare has a lot of specific language that you need to understand. If you ask the wrong question, you might not get the answer you were looking for.
“Covered” services: are healthcare services that your health insurance “covers” under your health plan. So you might think, “If it’s covered, I won’t have any out-of-pocket costs.” Think again!
Most insurance plans have co-pays and deductibles. If you haven’t met your deductible for the year, you will likely have to pay for the whole service even though it’s a “covered” service. Until you meet your deductible, you will have to pay for the services yourself.
Likewise, most insurance plans have co-pays for certain services. For example, the cost of your doctor’s visit may “covered” but you may have to pay between $5-20/visit because that is your co-pay for the service.
Again, if you only ask, “Is this service covered?” You are not likely to get the answer you are looking for.
Asking the right question can help you get the answer you are looking for.
Let us know what you are annoyed with your doctor about. Leave us a comment below and let us know what is on your mind.
For more information about your health insurance, see HealthSpin’s Easy Healthcare: Choosing Your Health Insurance.
Helping you “Spin Your Healthcare Your Way!