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Many insured Americans have no idea what they are paying for or getting from their Health insurance. It is a common mistake assuming a medical card or insurance guarantees coverage for all services. You should read the fine print, benefit packages or do research on what coverage you really have.

Since I see this every day, I decided to share a few things which will hopefully help you save money and time on your next doctor’s visit.

1. Check with your primary doctor to see if a referral is needed when you need to see a specialist (this could be a dermatologist, eye doctor, or radiologists).  Without a referral, you may not be given medical treatment by a doctor since they will not get paid by your insurance without said referral.

2. Do you have a copay? yes, how much? Copays were listed on your card but with so many changes and so many companies not sending out new cards, your copay may have increased or decreased without your knowledge. If you overpay your specialist, your copay may be held until your next visit without your knowledge.

3. What types of benefits do you have? An example: you go to the eye doctor with your United Healthcare card which is your medical card….do you have a separate Vision Plan?  Normally, Vision  Plans are separate from your medical card and covers exams, glasses and contact lenses whereas using your medical card for an eye exam may NOT cover your routine eye exams unless stated in your benefits.

– check with your HR representative if you have a Vision Plan or check in your benefits package or online.

4. Check what services are covered under your medical card before you head to your doctor’s appointment. You do not want to get a surprise bill because the medical visit or treatments were not covered under your medical plan.

These are only a few things you should check beforehand, you should familiarize yourselves with your benefits as soon as you get your new cards or benefit package and save yourself the headaches of scrambling to find the answers when you need to see a doctor or specialist.

Also, don’t take it out on the receptionist or patient coordinator when he or she tells you they do not know if you need a referral, have a copay or if your exams are fully covered.  They do not know what individual plan you have and you should be prepared and educated on what you are paying for.

Hopefully, this information was useful since many of us tend to wait until we need to use our insurance coverages before doing our research.

Life is good,

Eve

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