Health Insurance Plan: Are You Covered?

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Health Insurance Plan: Are You Covered?
Date Added: March 18, 2010 04:03:05 AM
Author: sunpport89
Category: Shopping: Tools
Share \| Navigating the health insurance maze can be perplexing and frustrating. There are many types of plans that cover – or don't cover – a large selection of health services. How can you be sure of what is covered by your health insurance. • Covered services are featured in the package of medical benefits described in your insurance policy. These services can include testing, medications and various treatments. Your policy also lists the types of services that aren't covered by your insurer. As you have possibly realized, you have to pay 100% for any uncovered medical care that you get. You might still need to pay for a part of covered medical care or a part of the total cost. • Medical necessity and medical benefit: A medical benefit and a medical necessity are different issues. A medical benefit is determined by your physician. A medical benefit is something that your insurance policy has agreed to cover. So what should you do to stay away unnecessary surprises? Your doctor will try to be familiar with your insurance coverage so he or she can offer you covered care. However, there are so many different policies that it isn't possible for him or her to be fully aware of specific details of each plan. By taking a grip on your insurance plan, you can help you doctor opt for medical treatment that is covered in your policy. Below are several tips: • Read through your insurance. It is better to be aware of what your insurance company will pay for before you get a service, have examined or fill a prescription. Some types of medical care may need to be approved by your insurance company before your physician can provide them. This is usually the case for more pricy screening, such as CT and MRI scans, surgery or appointments with specialists. • For some types of covered medical treatment, the number of treatment covered per year is limited. This usually includes mental health treatment and physical, occupational and speech therapy. • If you still have queries about your insurance plan, contact your insurer and ask a representative to explain it. • Remember that your insurer, not your doctor, make decisions about what will be paid for and what will not. Most treatment options your doctor recommends will be paid by your insurance, but some may not. When you get medical care and treatment that is not covered or you have a prescription filled for a drug that is not covered in your policy, your insurance company will not pay the bill. You can still get the medical care your physician recommended, but you will need to pay for it yourself.


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Health Insurance Plan: Are You Covered?

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