Outside of Your Coverage?

One of the most significant selling points of any insurance is that it brings peace of mind. Knowing that your well being and costs are being taken care of should anything happen to you or your family helps provide a sense of comfortable peace. But it would be foolish to assume that your Insurance will Cover Everything that could go wrong. That’s why you want to know exactly what is included in your home insurance and what your deductible is with your car insurance. There is the same train of thought with your health insurance. There are basics of your health coverage that you can always expect. Most of that includes preventative care such as doctor’s visits and hospitalization. However, not all care is covered.

 

There may be times that your doctor recommends a Specialist for surgery or some other care-related need. If they recommend someone outside of your coverage, you can find yourself in a tricky situation. One of our first recommendations is to ask your doctor if they can recommend anyone that is within your coverage. If they do not know anyone, then you can ask your insurance company to do the leg work. Ask them for a specialist that is within your insurance coverage. You can even ask them to cast a broader net to surrounding areas if you feel like you are not finding the specialist that is right for you. If you find someone within your coverage, great! Meet with them and make sure that you feel entirely comfortable with them and ensure that they feel confident in your treatment.  It can also be in your best interest to at least see the first recommended specialist. They can serve as a second opinion.

If you do end up paying out of pocket, try to negotiate the best price possible before the surgery. Go over every possible expense and work with the hospital to ensure that any discounts that are available are applied. Also, please do not ignore the hospital’s collection department. It may seem like they are just like every other collection agency out there. However, they are trying to help you! They can help set you up on a payment plan as well as lower the cost of the final amount that you owe the hospital. It is in your best interest to become one of their favorite clients.

We hope that these ideas help you if you should ever find yourself needing care outside of your coverage. If you ever need to readdress your health care insurance needs, please always feel free to call us.