It has been strongly observed that health insurance companies like to keep secrets in order to save money. Peeping through it, when a person undergoes a surgery, weeks later receives a bill for using an out of network anesthesiologist. Sounds ridiculous, doesn’t it? Paying extra for not choosing the one whom you put under from your network. However, insurer sends the heavy bill anyway, hoping the person wouldn’t notice. “Fighting back against this kind of trickery and winning” is a lot easier than one can think, It will help patients wrangle with their health plans, here are those “Top 5 Secrets of Health Insurance Plan”:
1. HAVE A NO SAY? NO PAY”
Your Health Insurance plan shouts out loudly and says it will cost you whenever you purposely choose out of network doctor but while in surgery, the hospital chooses the anesthesiologist. If you get that annoying “out of network” bill, draft a strongly worded letter stating you had no say about the anesthesiologist in network or otherwise and, therefore, won’t pay any additional fees.
“If you don’t have direct control, you are not liable to pay the heavy charges,” this tactic is likely to work every time, but few consumers know about it.
2. Boundaries may get you eligible for more coverage
Depending on your state, you could be eligible for more benefits than your plan is telling you about. Take Delhi, for instance. Health plans operating there must pay for expensive infertility coverage. But one state over, in Chennai, they don’t. Its about state-mandated coverage, though. Its up to you to choose the one.
3. Medical tests may also get covered, unless really needed
Unnecessary tests would put your insurer off to pay. But if you believe you need one, heres how to get it covered: Discuss your symptoms with your doctor in detail and why you think you need the test. Illustrating the same, your plan has to pay for Colonoscopy if you have gastro complaints, health experts say.
4. Letters can do magic
It sounds inconvenient in this digital techsavvy world but the old-fashioned letter is the best way to communicate with your health plan. Telephonic conversations take forever but there’s no record of it, so it’s considered to be “didn’t happen”. Letters almost always get a revert. Some Health Insurance companies will answer email but many won’t. But whom to address these mails? It is recommended to send those to your state insurance commissioner. Nevertheless, it is also mentioned in your plans “Contact us” column with a name of the concerned person followed by his or her designation. Also, keeping records or copies of these letters or mails render you the supremacy of having everything in written when your Health Insurance company promises something to you and then back off.
5. Doctors can be your warriors
If rejection of the coverage is seen in the much needed yet small medication, your Doctor, sometimes can fight for you to win the coverage. You can ask your Doctor to fight for you and lodge a formal complain to state Medicare office or State Board that regulates health insurance plans, as these insurer respects the State Board.