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Health Insurance Policy: Are You Covered? |
| Date Added: March 12, 2010 10:16:54 AM |
| Author: sunpport89 |
| Category: Education And Reference: Reference |
| Navigating the health insurance maze of rulles can be perplexing and frustrating. There are many types of plans that cover – or do not cover – a whole scope of health services. How can you be sure of what is covered by your health insurance. • Covered services are specified in the package of medical benefits described in your insurance plan. These services can include screening, medications and diverse treatment methods. Your insurance policy also specifies the forms of services that aren't covered by your insurance company. As you have possibly realised, you have to pay 100% for any uncovered medical care and treatment that you get. You may still need to pay for a part of covered treatment or a part of the total cost. • Medical necessity and medical benefit: A medical necessity is not the same as a medical benefit. A medical benefit is set by your medical practitioner. A medical benefit is something that your insurance plan has agreed to cover. In some cases, you doctor may decide that you require medical care and treatment that is not covered by your insurer. This is because insurers base their policies on what is normally beneficial for the majority of people. Insurance companies cannot possibly know all the combinations of treatment methods and services that will be beneficial for each person. So what can be done to avoid unpleasant surprises? Your doctor will try to study your insurance plan so he or she can offer you covered medical care. However, there are so many different insurance policies that it isn't possible for him or her to be aware of specific details of each policy. By getting to grips on your insurance policy, you can help you medical practitioner choose medical care and treatment that is covered in your policy. Consider these tips: • Read your insurance. It is better to be fully aware of what your insurer will pay for before you receive a service, have tested or fill a prescription. Some forms of care may need to be approved by your insurance company before your physician can provide them. This is frequently the case for more costly test, such as CT and MRI scans, operation or visits to specialists. • For some forms of covered care, the number of treatment covered a year is limited. This normally applies to mental health treatment and physical, occupational and speech therapy. • If you still have queries about your coverage, phone your insurer and ask a representative to explain it. • Remember that your insurer, not your medical practitioner, decide on what will be paid for and what will not. Most treatment options your medical practitioner advises will be covered by your insurance policy, but some might not. When you receive medical treatment that is not covered or you get a prescription filled for a drug that is not covered in your insurance, your insurance company will not pay the bill. You can still receive the treatment your physician recommended, but you will need to pay for it yourself. |
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