Health Insurance Secrets…Revealed!

July 5, 2018 Health and Wellness

Health insurance is pretty much a necessity – helping you deal with all manner of unforeseen health complications. Insurance companies, in a bid to lure customers, come out with a slew of attractive offers. But there are a number of health insurance ‘secrets’ that most consumers are not privy to. Unfortunately, not knowing about something doesn’t mean that it can’t affect you. Which is why it’s important that you know about these health insurance secrets, that can have a significant impact on your coverage.

There Is Never a 100 Percent Coverage

When your insurance agent tells you that “everything is covered”, a little healthy skepticism and scrutiny of the actual plan would be a good idea. There’s an “out-of-pocket limit” number which means that you will be expected to pay a small percentage of your medical bill. Only after you pay your share, will your insurance company bear 100% of your remaining expenses. Your plan might be really expensive, but it has its own exclusions and co pays. So be aware of them beforehand.

Recommended Read: Additional Benefits Available with Health Insurance Plans

A Hospital May Be in Network but Not the Doctors It Calls

This is one of the tricky health insurance secrets, you might never know. Your hospital and your doctor could be approved to being in-network. And the specialists, labs and tests come under out-of-network. These are common knowledge. But there might arise a case, when your in-network hospital, calls doctors from a hospital, outside of your insurance company’s network. In such scenarios, your insurance company might refuse to pay for it. So, be sure to question your agent about this issue as well.

Be Well Aware of What Is Not Covered

One of the health insurance secrets, you may not be aware of, is the list of pre-approved services. Everybody knows that out of network treatments, over the counter drugs and elective surgeries are not covered. But there are times when certain procedures, treatments and hospital stays are also not included in the coverage and you will be asked to bear these expenses. So, be sure to know in detail, the coverage extent of your plan.

Expensive Claims Could Be Denied

Sometimes even when your insurance company is inclined to pay for your expenses, you will be denied the payment if your claim is expensive. This is one of the health insurance secrets that your insurance company will definitely not want you to know. Thus, you will end up paying those expensive bills. If you find yourself in such a situation, do demand an explanation for the specific reasons why your claim was denied.

Recommended Read: What Health Insurance Plans Must Cover: The Essential Benefits

Always Check Your Medical Bills

This is one of the major concerns stalling American healthcare and one of the best kept health insurance secrets. According to a recent survey by the Medical Billing Advocates of America, up to 80 percent of all medical bills have errors. The errors are in the form of Bill coding mistakes and billing errors. The former is when the hospital sends the wrong code, or the insurance company wrongly reacts to a correct code. The latter is when the same item is charged multiple times, wrong cost is recorded or when duplicate bills are sent. In such cases, the company refuses the claim outright. Thus, it is important that you carefully and patiently check all the bills. If you notice any mistake, immediately ask your agent for an explanation.

Being aware of these secrets will go a long way towards helping you make more informed decisions when it comes to insurance. It’s always good to keep your insurance agent on his/her toes – questioning them about the minutest details, and unraveling the secrets of their trade!