What does exercise and health insurance have in common? Both are good for you. But if you injure a knee on a daily jog and go to the ER, you could get a surprise medical bill if the hospital or the ER doctor who treated you isn’t in your network. A real health insurance hassle!
Anyone who has a pulse knows that benefits can be complicated to understand and use. Here are 8 useful tips to help you avoid health insurance hassles:
- Do you understand insurance terms like copay, coinsurance, in-network and out-of-network? Not sure? Here is a handy health insurance glossary.
- It’s in your best interest to read the benefit plan information you received during the open enrollment season.
- Benefit plan details can change from year to year. Your doctor or hospital might be in-network one year and out-of-network later. Your insurance company’s website can provide valuable information on your current plan benefits and the status of your doctor, local hospitals and other healthcare providers.
- Insurers often revise their prescription drug list—called a drug formulary—which lists the medications the benefit plan covers and the copay levels. Generic medications typically cost less than brand-name drugs; this is why these meds reside on different levels on the drug formulary. The drug formulary can also be found on your insurance company’s website.
- Many employers offer high deductible health plans, which are less expensive for employees to pay for each month. But high deductible health plans have higher out-of-pocket expenses for doctor visits, hospitalization and drugs. Be sure you understand what the plan will pay for before you enroll.
- Ask the HR department for help if you have questions on plan options and what they mean.
- Many insured’s have encountered a health insurance claims issue. You may have access to special “advocates” often provided by the insurance broker who designs benefit plans for the employer. Advocates like BenefitsVIP can work on your behalf to solve a health insurance claims issue and other insurance problems. If you’re unsure if you have access to benefit advocates, check you plan documents or ask HR.
- Finally, carry your insurance card with you at all times. You’ll never know when you’ll need it.