Saving Money

Cut Healthcare Costs: Part II

Know What You're Getting: Some consumers sign up for cheap programs they think are health insurance. In fact, they may be discount health plans that offer discounts on services from participating medical providers.While these can be helpful in reducing your costs, they are not health insurance. Instead you'll have to pay for the services you receive and you'll have to use a network of participating providers. Still, if you can't get insurance they may help to keep routine costs down. These discount companies usually are not regulated by the state, so you'll have to be extra careful in researching their track record.

Know the Rules: Read your plan carefully so you understand what is covered, which facilities you must use for the lowest co-payment, and procedures for receiving certain types of services such as inpatient or outpatient services or referrals to specialists. Fail to follow the rules and you may find yourself paying more out of pocket. If you don't understand the policy or procedures, ask the insurance company.This is one case where it really is better to be safe than sorry.

Watch the Ceilings: Make sure your policy has a ceiling for out-of-pocket expenses for catastrophic illnesses.This is called a "stop loss" provision, and many insurance policies don't have them. In addition, look for a maximum lifetime benefit of at least $1 million ($2 - 3 million is preferable). One serious medical problem could wipe that out in a moment!

Know Your Rights: Your state may have limits on what health insurance companies can exclude for pre-existing conditions, or may require health insurers to include maternity or substance abuse coverage for example.You won't know unless you ask.Visit Insure.com for more details on your state's health insurance regulations.

Speak Up: If you have a complaint against your health insurance company, you can file a complaint with your state's insurance department. Look in the Government pages of your phone book or visit www.naic.org.

Dispute Bills Properly: If you have a dispute over a medical bill, particularly if you think your insurance was supposed to cover it, don't simply refuse to pay. Doing so may mean the bill will be sent to a collection agency and then damage your credit for the next seven years.

Ask the insurance company how to appeal a claim if they refuse to pay for something you thought should be covered. Put any disputes or appeals in writing and mail them certified mail, return receipt requested. Keep copies of all correspondence and make notes of each phone conversation.

You can also complain to your state insurance commissioner, but don't assume they will resolve the problem for you.They usually look for patterns of complaints before acting on an issue. If you still think the insurance company should pay for a particular bill but refuses, you may want to consult an attorney.