Trying to fully understand your health insurance policy can be confusing. Most of us know the basics, such as premiums, deductibles, in-network providers and co-pays. But journey past the basics to try to grasp exactly what a plan offers and what it doesn’t offer, things get confusing.
Since medical insurance is a topline expense in many monthly budgets, it is important to make the most of a policy. It is well worth the time to research and fully comprehend all the perks, benefits and options so that our plans work to our advantage.
Know the Perks
Most of us are aware of any preventive screenings such as mammograms or eye exams that our policies offer. But in addition to preventive care, some medical insurance plans will offer discounts for gym memberships, yoga classes, meditation training, exercise equipment and visits to a chiropractor.
Certain plans will cover the cost of programs designed to get and keep us healthy. These could include areas such as nutrition and healthy eating as well as classes to help people stop smoking. These added policy benefits are often overlooked. While you are gathering information on your coverage, request a copy of your medical insurance company’s Rights Summary Plan Description. This will provide you with some of the most important details to your plan and what your rights are.
One area of coverage you want to be really up-to-date on is the costs associated with prescription drugs. One money saving tip, regardless of what insurance policy you have, is to consider taking advantage of the generic versions of your medications. But there is another way to save additional dollars that many consumers are not aware of: Where you purchase your medications can significantly affect how much you pay.
Take the time to compare costs between pharmacies, including your local warehouse clubs. By law, in most states, you do not need to have a membership to fill and purchase your prescriptions at the warehouse pharmacy. Simply have the doctor call your prescription into the pharmacy or bring in a prescription slip. When you arrive at the warehouse let them know you are there to pick up a prescription and they will let you in.
Flexible Spending Accounts
In addition to your medical insurance, if your employer offers a Flexible Spending Account (FSA) you may want to take advantage of this. An FSA allows employees to allocate pre-tax money to their account throughout the year. These funds can be used to pay for certain out-of-pocket medical and healthcare expenses. Here again, it pays to dig deep and see what is covered. Professional services such as physical therapy or acupuncture may qualify as an expense. Other possible covered medical items could include things like bandages, blood pressure monitors or blood sugar monitoring supplies.
If You Are Denied a Claim
Here’s one last moneysaving tip when it comes to medical insurance coverage: If your medical claim is denied you can face a significant financial challenge as you may be the responsible party. You can always appeal a denied claim and it is well within your consumer rights to do so.
Appeals are usually reviewed by a specialist in the area of care you are receiving. Any supporting documentation or letters from your doctor as to why this treatment is necessary can be helpful to push a claim through. The Patient Advocate Foundation helps consumers with a wide variety of healthcare and insurance issues.