Save if You Have Insurance

Know health insurance terms and plans.

This allows you to make wise choices. Read “Questions and Answers About Health Insurance - A Consumer Guide” from www.ahrq.gov/consumer/insuranceqa and www.healthdecisions.org.

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If you can get health insurance through work, do it.

Saving Money in the Hospital

More often than not, it will cost you less than if you buy it on your own. If you can choose from more than one plan, compare the options. The best deal may not be the cheapest plan. It is the one that gives the best price for the benefits you need and are most likely to use. If you need help to understand the options, ask your employer. Get facts from the insurance company's Web site and/or customer service representative, too.

Raise your deductible.

Your deductible is the amount you must pay before your health insurance kicks in. Like car insurance, monthly premiums cost less if you pay a higher deductible. Healthy adults can usually save money with this option.

Check into a Consumer Driven Health Plan.

This gives you greater control over how you use your health care benefits. You pay a high deductible. You pay for your health care costs from a tax-exempt health account. If you expect to be healthy, this may be a good choice for you.

Read your health plan.

Read what products and services are covered before you pay for them on your own. Take advantage of covered services, such as dental checkups and cleanings twice a year. You may find out that your health plan covers some of the costs for flu vaccines and other services.

Student health insurance.

Find out about student health insurance from your child's school or college, especially if your child plans to study abroad.

Be Medicare aware.

Medicare is the U.S. government's health insurance for persons age 65 or older. It also covers people under age 65 who have disabilities. Find out when you will be eligible for Medicare from www.medicare.gov or by calling 800.MEDICARE (633.4227).

•  When you are enrolled in Medicare, you get Medicare Part A. This covers medical costs when you are in the hospital.

•  Medicare Part B covers things that  Part A does not. Examples are doctors' fees, outpatient hospital costs, physical therapy, etc. You pay a monthly premium for this.

•  Medicare Part D helps cover the cost of prescribed medicines.

Fill in the gaps.

Find ways to pay for services not covered by your insurance plan.

•  If you have Medicare, you can buy Medigap, Medicare Select, or Medicare Advantage HMO insurance to help pay for services not covered by Medicare. Contact your state health insurance department to find out about your choices for each of these health plans. You need only one of these. For free help choosing a Medicap policy, call your State Health Insurance Assistance Program.

•  Look into extra coverage from providers, such as Aflac.

Pay premiums on time.

If you don't, your coverage could be cancelled.

Know about COBRA.

This stands for Consolidated Omnibus Budget Reconciliation Act. COBRA is temporary health insurance. It applies to former employees, retirees, spouses, former spouses, and dependent children who are no longer covered under an employer health insurance plan. It lets you keep the same health insurance for 18 months (sometimes longer) if you pay for it yourself. Find out more about COBRA from www.dol.gov/dol/topic/health-plans/cobra.htm. Know, too, that it may cost you less to buy your own health insurance than to pay what COBRA will cost you, especially if you are in good health and have no pre-existing health problems.

Find out who to contact when the insurance company denies a claim.

Sometimes claims are rejected by mistake. When this happens, you can usually clear up the mistake by calling or writing a letter to your insurance company. Keep copies of all bills, letters, and notes from phone calls. Put your policy and claim numbers on all letters or e-mails. Call your insurance company if you don't get an answer within a few weeks.

Keep up-to-date.

Find out how you learn about updates and changes in your health plan. Do you get notified by mail or by e-mail? Do you need to check the health plan's Web site? How do you add a new dependent to the plan? Also, find out when you can change the plan you have. Often, you can only do this during open enrollment.

Know before you go.

Call your health insurance company before you have a medical service. Some services are only covered if the insurance company approves them first and/or if they are done at certain locations or by certain providers.

One may be enough.

If both you and your spouse both have health insurance through work, choose the plan that works best. Decide if it is better to keep separate plans or if it would cost less for either of you to join the other's plan. Your employer may let you take cash or other benefits instead of health insurance. Keep the better policy if you can and “cash in” on the other one. Also, find out which policy covers your children better. Think about future needs, too. For prenatal and delivery costs to be covered, a woman may need to be a member of the plan for nine or more months before she gets pregnant.

Take advantage of FSAs.

Find out if your employer offers a Flexible Spending Account (FSA). This lets you set aside some money for medical expenses for the year. You could choose to set aside $1,000. This is usually taken out of your paycheck, but you don't pay federal income tax or Social Security tax on this money. But be careful how much you put into your FSA. You lose any money you don't spend on health care in the year. Look at last year's health care expenses for a ballpark figure on what you think you will likely spend. Don't count any money that is taken from your paycheck for insurance premiums. Do count deductibles, co-pays, and treatments your insurance doesn't cover.

Use it before you lose it!

If you are going to lose your health insurance, you are part of a growing trend in the U.S. Schedule doctor visits and other health care services before expenses will no longer be covered.

Before you travel, check out your health insurance coverage.

Are you covered where you are going? If not, ask your health insurance provider how to get coverage while you are gone. You can also find out about travel health insurance from www.travelrinsurance.com.

This website is not meant to substitute for expert medical advice or treatment. Follow your doctor’s or health care provider’s advice if it differs from what is given in this guide.

 

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