Ask Questions

January has been a month of me asking questions. You may be thinking what is she talking about. Lots of items came to light throughout the month that required more information. Here is a sampling of what came up:

I was listed as a “non-owner” on our auto insurance. I had no idea what that mean and had to do the research to find out more.
I received two bills one from the lab for bloodwork and one from doctor’s office for a physical. It was my understanding that this was covered through my medical insurance as a preventative visit at no cost to me. Again, multiple calls and asking for my medical claims to be adjusted.
Receiving less than expected in a paycheck. More calls to get to get to the bottom line
And the list goes on.

Never be afraid or think your questions aren’t worthy of an answer. In my case, it’s my money. Call and ask questions until you are satisfied with the answers.

For me, I was able to save money on our auto insurance after a lengthy phone call, the medical insurance company paid the bloodwork bill in full after appeal, the doctors bill was adjusted and I owed less than 50% of the bill and I am still working to understand resolve the paycheck issue. So far, I with these questions we have saved close to $300. That’s worth my time and efforts.

It’s Time To Update Your Health Insurance

It’s that time of year again for open enrollment for medical insurance. For Medicare you have until December 7 to make any changes to your secondary insurance and/or prescription coverage until December 15.

To enroll and/or make changes to your Affordable Care Act health insurance, you have from November 1 to December 22 in Connecticut. Check your individual state for your specific deadlines.

If you are coverage is through your employer, fall is typically the time to make changes as well. Please check with your individual state or company for possible changes to the deadline date.

If you want some general questions to think about to compare your options, here are some that you can consider when making your health insurance selection that is best for you:

1.   What type of insurance is this?
2.   What is the monthly premium cost and how much am I responsible for paying?
3.   Are there subsidies available for us?
4.   Do I have out of network coverage?
5.   How much are the deductibles for both in and out of network care?
6.   How much do I have to pay to see a healthcare provider?
7.   Do I have medical coverage out of state and out of the country?
8.   Will I be able to use my current doctors?
9.   What additional benefits are included (prescriptions, dental, vision, etc.)?
10.   Are preventative visits (physicals, routine tests etc.) covered without a deductible?
11.   What is the procedure for going to a specialist and/or the emergency room?
12.   How are disputed claims handled?

Ask these and more questions to make sure you have all the information to make the most informed choice for you and your family. Mark your calendar today to do this during your open enrollment each and every year as medical plans changes and so do your needs. If you miss the open enrollment period, you can only make changes if you have a life changing event.

Negotiating Medical Expenses

I am pulling back the curtain and showing you how I negotiated discounts on my hand surgery.

Back at the end of last year, I needed to have a medical procedure. It wasn’t urgent, so I chose to wait until work slowed down and my out of network deductible was met and I had vacation time to use. I wanted to use my doctor, whom I know and trust. We have been patients of the practice for years, and he has done a few surgeries for the family, but he was out-of-network.

I have admit that insurance sometimes baffles me, but I was bound and determined to figure it out. After discussing the details with my doctor, I chose to have the procedure at the hospital’s surgery center – which that cost was in-network. First step done easily and I wouldn’t have to pay for anything.

Next, I contacted the surgeon’s business office to discuss the fee. I knew I would have to pay something and the 80/20 isn’t really 80/20. I had a lot to learn here. I learned that an out of network provider doesn’t have to get prior approval from my medical insurance, so they couldn’t tell me what I would owe ahead of time. They could only tell me the surgeon’s cost. Then to understand this better, I spent well over and hour on the phone with a really helpful person at the insurance company. I found out what the insurance would probably cover – that was actually about 58% of the cost – not really close to the 20%. I was now two business days before the surgery and still trying to figure out if I have the money to pay my part or was I going to cancel the surgery at the last minute.

Lastly, I learned from my insurance company that I could be responsible for the anesthesiologist as well, if they were out of network. I contacted the surgical center and was given the number for the anesthesiologist and contacted them. Since they were in network, this step was fairly easy. But, they did bill me for the full amount after the surgery. So back on the phone with the insurance company to straighten out this bill, that I wasn’t supposed to pay for.

Now I still had to deal with the surgeon’s fee. I decided to contact the doctor’s office and explain my situation. I really wanted to the have the surgery and I wanted it with that doctor, but I was struggling with the portion of the fee that I would have to pay. (My portion would have been a couple of thousand dollars) After 24 hours, the office got back to me, and the surgeon reduced his fee to a number I was comfortable with and that I could afford. Yes, this took a lot of effort on my part but my budget said thank you.

Bottom line, you can negotiate with all types of services and possibly come to an understanding. I did it this time, with several calls and a few hours of my time. For me this was worth the time and effort, to end up paying a few hundred dollars, a number my budget liked.