While health insurance plans are cost effective for most consumers, many people do not know what their plans specifically cover and require. As a result, most consumers are not getting everything they can out of their health insurance policies. One way to remedy this problem is to read through the policy and take advantage of the programs and benefits offered when they are needed. Be familiar with any requirements of disclosure and notification to receive policy coverage. Consumers should ask for itemized billing and verify the coding when there is a question.
Prescriptions
Most healthcare plans will cover at least a portion of prescription medications. There may be a co-pay involved, depending on the type of plan. The policy may require the insured person to go to a specific pharmacy or merchant to be eligible for the reduced rate. When consumers have been on the same medication for quite some time without a less expensive generic substitute, they should ask the pharmacist if a generic label is available.
Surgical Procedures
Before having surgery, check with the insurance company to find out exactly what is covered under the policy and what co-payments will be charged. Make sure that the hospital where the procedure will take place is on the eligibility list and that the doctor has privileges to operate there. Get an estimate from the physician or surgeon on how long the recovery process should take and whether outpatient procedures are an option. Find out whether the services of a home care agency professional are covered and make any preliminary arrangements if necessary. Look into post-surgical therapy and see what providers are eligible under the policy plan. Ask the physicians or surgeons writing the prescriptions to request generic drugs when possible.
Home Healthcare
If the health or safety of a loved one is in question, it may be time to change their living arrangements. Some insurance policies include at home healthcare as an option, especially for senior care. An assisted living facility may not be the only type of elderly care covered, although consumers may not think to ask for alternatives. Having in home healthcare services ensures independence, peace of mind and home safety.
Nurse Line
Many insurers offer a free nurse hotline that clients can call before seeking professional medical care. This will help the consumer determine whether a visit to the doctor is necessary. If not, the patient will save a co-payment and valuable time. There may be a simple home remedy to fix the problem.
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