Understanding Health Insurance

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Health insurance is a necessity for everyone who wishes to maintain or improve their health. Whether you use your health insurance for regular checkups, chronic and debilitating illnesses, or unexpected emergencies, you will find that carrying an insurance policy can result in a significant cost savings for you and your family. Those who carry health insurance often have a difficult time understanding what is covered under their policy and where they can go to obtain the services that they require. Without this necessary information, it is likely that many health insurance holders do not receive the maximum benefit that their insurance provides.

We all need health insurance to receive financial assistance for the maintenance and restoration of our health but we don’t all receive all of the assistance that we are eligible to receive. Most of us are aware that our health insurance will cover at least a percentage of certain treatments such as office visits, hospital stays and surgeries and prescription drugs that fall under their list of covered drugs but many of us don’t know what is offered beyond these basic services. Not all plans cover the same treatments so the only way to fully understand what is covered in your plan is to read your policy carefully.

Some examples of inclusions that are not well known include speech classes, hearing aids, gym memberships and a variety of other features. The only way to know for sure if these items are covered is to review your policy carefully or contact your provider. You may find a variety of services or treatments that are covered under your plan that could amount to a significant financial savings.

Knowing what is covered under your health insurance plan is very important but it is equally important to understand what is not covered under your insurance plan. You should review your plan carefully to ensure that the services that you choose will be covered by your health insuranc plan. Sometimes treatments that are deemed medically necessary by your doctor will not be covered by your plan. In this case it may be necessary to bear the burden of this expense in order to maintain or restore your health. If your claim is denied because your provider does not consider the treatment necessary, then you have the right to file an appeal.

You should carefully review the provider’s policy to ensure that you fully understand the appeal process before filing your appeal. Your claim may still be denied even if you follow proper procedure but the possibility that you will lose your appeal as a result of improper filing is greatly reduced. You should review your insurance plan carefully before undergoing preventative treatment to determine whether or not the treatment will be covered. In an emergency you may not have the opportunity to review your policy before authorizing treatment but you will have the opportunity to appeal if the treatment is not covered.

Knowing which doctors you can visit can also be confusing. Some health insurance policies allow you to visit any doctor you choose while others limit you to the participating doctors in their plan. Also, whether or not you can see a specialist is often difficult to determine. Usually, the receptionist at the doctor’s office will be able to tell you whether or not they accept your health insurance policy before you schedule your appointment. You can also call your customer service representative to inquire as to whether a specific doctor will be covered.

Health insurance can literally be a life saver but understanding your policy can be a nightmare. In most cases carefully reading your policy to determine the covered treatments as well as the exclusions and limitations may help you understand your policy better. If after reading through your policy you still have general or specific questions you should contact the customer service representative for your policy. They will be able to provide you with answers that will enhance your understanding of your policy. Knowing what is covered and what is not covered are the most common misunderstandings involving health insurance.

It is also important understand your provider’s appeal process in case you ever incur claims that are denied. In all cases your health may necessitate treatment that is not covered and you will have to make the difficult decision of whether or not to authorize the treatment.


Source by Anthony Shelton



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