First time being on own health insurance. How does one go about using it?


First time being on own health insurance. How does one go about using it?

In: Other

You probably got a list of medical providers from your insurer. Look up a primary care provider.
Look up reviews for the provider and the organization they work for. Repeat until you find a good one.

Call them and ask if they’re taking new patients.

If you have a specific ailment you want treated, make an appointment. Otherwise, wait until you’re due for a checkup to make the appointment. Then go wild.

Here is a tricky one for you. Our in-network providers accept our insurance. But their BILLING department is actually out of state. (I honestly have no idea here.)
So we still get billed $X00.00 or so for our visits.
But our insurance sends us a check to pay the difference.

Just really need to pay attention to the fine print.

You go to the doctor, not knowing how much they charge for their diagnostic services.

The doctor tells you what’s wrong and writes up a diagnosis and a treatment without telling you how much it is.

You do the treatment not knowing how much it is.

30-60 days later, the bill arrives with the rate that your insurance company and the doctor had handshaked on in their provider contract, that you can’t see.

You pay the bill that you can’t verify the charges. You also get 10 other bills from other providers like labs and specialists that your doctor used, without telling you about or telling you how much they cost.

Loving it so far?

Educate yourself on how your insurance covers ER visits. Some insurance charge you a copay. Some charge you a percentage of your total visit cost. Some charge you both.

I have lost count of how many people who have previously been on either their parents insurance or Medicaid and are gobsmacked when I tell them their ER visit carries anywhere from a $100 to a $450 copay.

You should to take this into account and ask yourself if getting some IV fluids and Tylenol for your cold is worth the ER copay or if it would be ok to wait and call your primary care physician in the morning. Office visits generally run around $25.