Many people make one or more mistakes when they use their Health Insurance or Medicare – and as a result, they end up paying part or all of the bill out-of-pocket. And there’s nothing more annoying than paying for insurance and still having to pay out-of-pocket. So be sure to do these 2 things before you get care…
- Always be sure your provider is in network. If your doctor refers you to a specialist, be sure the specialist is in network. If you’re getting lab work, be sure the lab is in network. It is not the providers responsibility to inform you whether or not they’re in network – so ask up front to be sure.
- Every medical treatment has a billing code. For example, the removal of a skin tag may have several different billing codes depending on WHY it was removed. 1 billing code might be covered by your insurance while another billing code is not. So always check with the provider before getting a procedure done to be sure it will be covered.. Your provider should know since they perform and bill the procedure every day. If the procedure is not covered, maybe they can do another procedure that is. And if not, at least you’re know up front and you can decide if you’re willing to pay out-of-pocket.
Author: neil steinman
Neil Steinman is the principal of Orange County Health & Life Insurance in Orange County, CA – and has been serving the needs of California residents for nearly 20 years.