Top 3 Health Insurance Mistakes That Will Bankrupt You...And
How To Avoid Them
Think your health insurance is all the protection you need
from outrageous medical expenses?
Think again. According to a Harvard study, 46.2% of all
bankruptcies are caused by medical bills and illnesses – and more
than three-quarters of them are filed by people who
have insurance.
“Most of the medically bankrupt were average Americans
who happened to get sick,” says Dr. David Himmelstein,
leading author of the study. “Too often, private health
insurance is an umbrella that melts in the rain."
Some of the medical bills that can send you into bankruptcy
are actually preventable. The trick to getting the maximum
benefit out of your health insurance and steer clear of debt
is to avoid these three big mistakes:
1. Not following the rules
Just because your insurance covers a specific treatment
doesn’t guarantee they’ll pay for
it.
Insurers operate behind a complex system of deductibles,
referrals and pre-authorizations –rules you
HAVE to follow correctly or the company won’t shell
out for your medical expenses.
Too often people go ahead with expensive treatments without
consulting their policies first. Or they assume that their
hospital or doctor’s staff will worry about all the
details for them.
Problem is, you are entirely responsible for
jumping through all the administrative hurdles before you
get your treatment.
Something simple like forgetting to get a pre-authorization
from your insurer before your treatment could cause them
to go from paying the full price to zero.
If you forget the rules, you can forget getting the full
reimbursement allowed for your treatments. And you can
expect your company to collect the outstanding balance.
Read your explanation of benefits carefully. If you don’t
understand what the rules for referrals, limitations, pre-authorizations
and other restrictions are for your plan, ask your plan’s
administrator for help.
2. Out-of-network treatments
Some insurance plans will only give you maximum coverage
if you use their approved network of healthcare providers.
The big mistake that can cost thousands is choosing a
hospital or doctor that’s not in your network, expecting
that some or all of the bill will be paid for. Your insurer
might only cover a small portion of the bill, or refuse
to give you a dime.
It’s just not safe to assume that your treatments
will be covered. Going out-of-network is a quick way to
rack up major bills, so make sure you keep your care in
the plan as much as you can. If you have to seek outside
treatment, don’t be surprised by the additional expenses.
3. Bad billing
Medical billing is not fool proof. Mistakes show up all
the time. Your mistake? Not putting your bills and explanations
of benefits under the microscope.
Sometimes the slightest typo could turn a $5.46 charge
into a $5,460 one. Other times a close look can reveal
charges for treatment you didn’t receive, or for
regular supplies that should have been included in the
room charge.
It can be difficult to decipher the bizarre language of
medical billing, but it’s worth the effort to uncover
the mistakes and overcharges.
- Ask your doctor to give you an estimate of the expected
costs before you are treated.
- When you’re in the hospital, you (or a friend)
should keep a log that records all the tests performed
and treatments and medications given.
- You will get both a bill from the hospital and an explanation
of benefits from your insurer. Compare them both to the
log you kept while hospitalized, and your doctor’s
previous cost estimate.
- If you see something out of place, demand an itemized
bill and your medical records from the hospital. Compare
the two to make sure you actually got all the treatments
you’re being billed for.
To stay healthy and stay out of debt, you need
to take charge of your health insurance. Read your policy
carefully. Don’t make assumptions about your coverage
without taking to your plan’s administrator. And pay
attention to your bills. |
