Proper usage of your health insurance

 

          What exactly is a health insurance and how to most successfully benefit from it? Well, those are the questions we are trying to answer in this article! The fact is that, still, many people don’t know anything about it, and most surely- suffer great financial losses because of it!  

          You see, simplest definition of health insurance would be that it represents one kind of insurance that is made to help protect you from high medical care costs. If we talking about the U.S. we already know that most of the people in the United States get a health insurance policy through their employers who usually helps pay for that insurance. People are offered with a health plan that they must choose! What are those plans? Well, it’s easy- these plans are nothing more that simple contracts with some health care providers and medical facilities to provide care for members at reduced costs. Beside this type of contract- it is important to know that you can also purchase health insurance on your own which is, in most cases, much more expensive then  employer-based insurance. Although all this sounds a bit complicate- it is far more best option because, everyone who not have health insurance-must pay medical bills directly which is definitely the most expensive solution!

We are aware of the fact that there are several different health insurance packages and they all come with different price! What are these factors that affect this insurance price so much? Well, first factor is definitely a prolonged life in modern countries! How come? Well, because of advances in medicine and medical technology - people in developed countries are living longer and therefore- it is logical to assume that there is a larger group of older people requiring more medical care than a young healthier population. This is one of the main factors which are causing an increase in the price of health insurance.

There are also several other factors such as:

·        insufficient exercise

·        excessive alcohol use

·         Smoking

·        street drugs

·        unhealthy food choices

·         a shortage of doctors in impoverished or rural areas

·        obesity,

·        the modern sedentary lifestyle  

That’s why- it is logical to assume that insurance price could be lowered easily- if people were doing exactly opposite of the above! The benefits would be doubled! That healthy lifestyle would definitely protect us from several diseases and all insurance companies would lower their bills! 

We have already mentioned that the insurance is offered through managed care plans which are being signed by certain doctors and hospitals. Therefore- they are also called – health providers!  Doctor, hospital and you form a plan's network and like you- they have also agreed to follow the plan's rules. That’s why- it is logical to assume that you insurance company will only pay bills to the providers who are members of the network! Therefore- they will not pay for you to go to a provider who is not in its network. There is one more important thing to know- your doctor, who is a member of your network, may easily sent you to someone outside the plan's network! This may be done in several reasons and logically- you will must cover all the bills! That’s why-before you go anywhere- you must ask the insurance company if it will approve the use of the out-of-network hospital.  

Like we have already pointed out -your health insurance policy is an agreement between you and your insurance company. When you sign it- you will get the lists of medical benefits such as tests, drugs and treatment services you will get for free or which bills your insurance company will pay a part! That’s why- all these services are called "covered services."

Of course, you must be careful because it is extremely easy to sometimes use something that isn't on this list, such as deferent medications and similar…In this case-you have to pay for any uncovered medical care that you receive. People are also interested to find out more about the term “medical necessity”! Although many think so-the fact is that medical necessity is not the same as a medical benefit. A medical necessity is simply anything that your doctor considers to be necessary, while -medical benefit is something that your insurance plan has agreed to cover. That’s why- sometimes these necessities aren’t covered with your medical insurance!

 

 

Here are some simple but useful tips about how to get the best out of your insurance! They are easy to apply and cause big money saving!

Just keep one thing in mind all the time- there are already described ways to save money on insurance, but skipping coverage isn't one of them. Medical bills are something that can cause bankruptcy over a night!

Like we already know- there are many different types of health benefit plans, but you must choose only that one which offers you best deal! Read about it, check out the plan, or plans, ask all the questions and then- choose what’s best for you! 

Remember- cheapest isn't always the best! Ask about cover preventive care, well-baby care, vision or dental care! You must think about your family also!   

Not every health insurance company offers services of same quality! You see, the fact is that not all health plans, doctors, hospitals and other providers give the highest quality care. Try asking about some examples and try finding out how you can measure quality.  Internet search is also a good option! People on all kinds of forums can provide you useful information!

You see, it is important to know that every family change such as marriage, divorce, child birth or adoption, or the death of a spouse is a sign for you to change your health benefits. How come? Well, the fact is that you and your family may be eligible for a special enrollment period under provisions of the Health Insurance Portability and Accountability Act (HIPAA). You don’t want to miss this because you can save a lots of money!

Are there any more life events that can affect your health benefits! Well, the fact is that there are! One legal act known as Consolidated Omnibus Budget Reconciliation Act (COBRA)-you and your family can purchase extended health coverage under your employer's plan in situations such as: losing your job, change employers, get divorced…and similar! You see, this coverage isn't something that lasts for too long! In most cases it ranges from 18 to 36 months depending on your situation. That’s why- you have to be sure about all these conditions and that you are fallowing the plan of your health providers! Best thing to do definitely is to get the copy of Health Benefits Under the Consolidated Omnibus Budget Reconciliation Act.

HIPAA generally limits pre-existing condition exclusions to a maximum of 12 months (18 months for late enrollees). HIPAA also requires this maximum period to be reduced by the length of time you had prior creditable coverage. You should receive a certificate documenting your prior creditable coverage from your old plan when coverage ends. To find out more, read Questions & Answers: Recent Changes in Health Care Law.

Well, there is even a procedure you can do just before you go in retirement! Well, you should definitely find out more about the possible health benefits which could be extended to you and your spouse during your retirement years. Although it might look easy- believe- it never is! That’s why- you just make sure there is no conflicting information among these sources about the benefits you will receive. Sometimes, nothing can be done and you definitely must lose your retirement health insurance! In this case- the best thing to do is to go on private insurance!

There is one useful information you should definitely know! You see, the fact is that ordinarily medical expenses are not tax deductible until they exceed 7.5 percent of your income. So, this could be really expensive! However, if you're self-employee- you can get a tax break without meeting the threshold. We don’t even want to point out how useful this could be!

 

Remember one thing , the lowest premium isn't always the cheapest plan. How come? Well, the most important thing is the fact what your insurance covers! It is much more important then, what you pay up front. On the other hand- remember that even a good coverage can have big loopholes! That’s why- you must first inform yourself about everything, possible benefits,

policies for doctor visits, benefits for mental health, prescription drugs, dental care…