Last week, we covered the basics of health insurance and the four primary sources of financial responsibility of those insured. In this week’s post, we’ll conclude our journey through the wonderful world of medical coverage. In all seriousness, this is, admittedly, a very dry topic; it’s important to understand the basics though, and if it seems like insurance is designed to be convoluted, it’s because that’s not too far from the truth. It is, after all, an industry designed to generate profit, and it’s easier to collect that profit when its “customers” don’t entirely know what they’re going to be charged, or how to mitigate excess costs. As a disclaimer, and this should go without saying: no one should have to avoid seeking out medical care for fear of financial debt. If you have a medical issue, it’s best to bear in mind that preventative care should be seen as an investment. For example, a quick trip to the dermatologist after finding a new “mole” on your arm can mean the difference between a quick procedure and years of radiation and other cancer treatments.
The point of the above is that knowing the basics of insurance- from which providers in your area are in-network or out-of-network, to what your coinsurance is for a given procedure- can enable you to find the most financially feasible option possible. It also means that you’re more likely to know when you’ve received an erroneous charge following any sort of medical treatment, and contest it accordingly. There are so many caveats and exceptions to almost any given concept within the “rules” of health insurance that it’s best to learn about your specific plan. We covered the most basic and universal of these concepts last week, but outside of that, calling your provider and researching your coverage options is the best way to find out what your financial responsibilities are. As such, this two-part series isn’t meant to be an encyclopedia of terms so much as it is a jumping-off point, or a public service announcement. That may sound like an unsatisfying conclusion, but we hope you come away from these posts with a fairly sturdy framework from which to research your own insurance plan a bit more.