Health Insurance Tips | Choosing The Right Health Insurance Plan
Health Insurance Tips | Choosing The Right Health Insurance Plan
Health insurance is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured. Health insurance can reimburse the insured for expenses incurred from illness or injury, or pay the care provider directly.
Your health insurance can help you keep your healthcare costs manageable. But many families may not be maximizing the benefits their insurance provides—and could be paying significantly more than they need to for healthcare as a result. Here’s how to ensure you get the most out of your insurance policy.
With the steep costs of availing hospitalization, treatments, and medication, it only makes sense to protect yourself in every possible way by buying health insurance that offers comprehensive coverage. But to ensure that you get value for the money you spend and choose the perfect policy, it is important to understand some critical insurance terms and conditions.
This is the first element to consider. Each health insurance policy has a waiting period, which is a defined period of time, immediately after purchasing a policy, when you can’t make a claim.
For instance, if your health insurance policy has a waiting period of 60 days and you buy the policy on January 30, 2018, you will be able to make a claim only after March 29, 2018.
Room rent provisions
In case you have to be hospitalised, your insurance company will cover costs of your hospital room. But, this is covered only up to a certain extent.
It is very important to check what the extent of per day coverage is because you will have to bear any extra costs. What’s more, the other charges are also levied as per your room type and will be deducted accordingly by the insurance company.
So, if your room rent coverage is very low, your out of pocket expenses will be much higher towards the room as well as other medical charges.
Check if the network is wide enough
It is important to look at the list of hospitals and clinics where your health insurance policy covers cashless treatment. The wider the network of cashless hospitals, the more useful you’ll find your health policy to be.
Besides, the cashless facility means that you won’t have to negotiate claims processes. The insurer will settle the bill directly with the health service provider.
Don’t forget pre- and post-treatment expenses
If you’re scheduled to have a surgery you will have to have consultations with a doctor beforehand, undergo tests and maybe even be hospitalised a day prior. Similarly, after the surgery, you’ll have to stay hospitalised for a few days for post-operative care, which will also include follow-ups with doctors, tests, and medicines.
So, it’s imperative that your health policy covers these expenses in addition to those of the medical procedure.
Watch out for the deductible
A deductible or sub-limit is the amount that you have to first pay towards any health costs. Only when the total crosses this amount will your health policy kick in.
The higher the deductible, the more you will have to take on before the policy comes into play. So, evaluate the pros and cons of a higher deductible, its feasibility given your income and expenses and then decide if the policy works for you.
At the end of the day, a health insurance policy is a legal document binding you and your insurer. So it’s only prudent to scrape beyond the surface to see whether your premiums are justified and if your policy is going to deliver on the promises it’s making.
Choose the right plan for your family. Before you simply stick with the same insurance plan each year, make sure that you look at what kinds of medical and dental needs your family currently has. If you have orthodontal work on the horizon, or someone in your family was just diagnosed with a chronic illness, make sure you choose the plan that covers those best.
Make sure you understand your plan.
Keep those benefits documents you get when you sign up for your insurance plan handy. They can provide great info on what you’ll pay for different types of services, and what the rules of your insurance plan are—like whether you need to choose an in-network primary care physician or if you need referrals to see a specialist. Following the rules will help you ensure that you get quality care at a significant savings.
Ask an advocate to work for you.
“If you receive a large bill for services—following an ER visit or surgery, for example—and you don’t understand how to read it, hire a medical billing advocate to assist you,” suggests Ruth Linden, founder of Tree of Life Advocates in San Francisco. “She or he will not charge you if everything is in order.
On the other hand, if errors or a questionable charge is found, the typical billing advocate may charge you one-third to one-half of the amount they save you. Your cost savings could run into thousands of dollars.” This can be especially important if you’re dealing with a complex medical issue that requires significant—and expensive—care. Some insurance companies have even begun offering their own advocates, such as UnitedHealthcare’s Advocate4Me program, which provides a single point of contact with an expert who can help you understand your coverage and find the help you need.
Stick with in-network providers.
“The lowest charges are for doctors and hospitals who participate in your insurance network,” says Adria Goldman Gross of MedWise Insurance Advocacy in Monroe, New York. “Check to make sure that the doctors who are treating your children are on your insurance plan. It’s also best to be confident that the doctors are affiliated with hospitals that are covered on your insurance policy.”
Make the most of it when you max out your deductible.
Once you’ve met your deductible in most plans, you’ll pay significantly less out of pocket for any healthcare you use above and beyond that. So if you’ve already met your deductible for the year, that’s the time to schedule appointments to get your skin screened, your eyes checked, and any other services you need at a decreased cost.
Get your prescriptions via mail order.
For medications you use long-term, you’ll reduce hassle and cost if you order pills on a subscription service through your insurer. “Utilizing 90-day supplies and mail order can decrease dispensing fees,” says Diana Graalum, clinical pharmacy manager at MedSavvy.
Max out any discounts, programs and benefits.
Insurance companies sometimes offer health and wellness programs, including discounts on fitness classes, programs dedicated to help with specific medical conditions, apps to help you track medications and health records, or other perks. Make sure you check your insurance company’s website regularly for new benefits.