How To Understand Health Insurance Plan

How To Understand Your Health Insurance Policy: 13 …

Health WebHow to Understand Your Health Insurance Policy: 13 Steps Insurance Health Insurance How to Understand Your Health Insurance Policy Download Article …

1. Read your summary of benefits. Your health insurance company is required by law to provide you with a "Summary of Benefits and Coverage." This document explains your health insurance policy in plain language. The summary includes a glossary of words and phrases that are commonly used in the insurance industry. Study this glossary to better understand the summary. You also can read details using two examples, diabetes and childbirth. These examples explain what your policy would cover in either of those situations, but can be used to understand other medical situations as well. For example, you could use the diabetes example to understand how your health insurance policy would cover any chronic medical condition that requires regular treatment. A summary of benefits is provided for both individual plans and for plans you get through work. You may have to ask a manager or human resources employee for a copy of your summary of benefits.
2. Understand the law regarding essential health benefits. Under federal law, any health insurance policy sold either to individuals or to small businesses, including any plan purchased through the marketplace, must cover at least 10 essential health benefits. These 10 benefits include: Emergency care Hospitalization Rehabilitation Laboratory tests Childbirth and newborn care Treatment for mental health and substance abuse Doctors and medical care outside the hospital setting Health and dental services for children Prescription drugs Preventive care and chronic condition management
3. Find out whether your doctor or hospital is covered. Each insurance plan has a network of doctors and hospitals that are covered by the policy. If your doctor or local hospital is not in the plan's network, you may have to pay more for those services. Some health insurance policies provide limited coverage for out-of-network health care providers. For example, you may only have to pay a $20 copay for doctors in your network, but 50 percent of the cost for doctors that are out-of-network. Other health insurance polices provide no coverage at all for out-of-network healthcare providers. You typically can find out if a particular doctor or hospital is included in your plan's network by calling your health insurance company or checking on their website. On the website, look for a tab labeled "network" or "find a doctor." From there you can search for the name of the doctor or hospital you want to check. If you travel frequently, you may also want to check your health insurance policy to fi
4. Check if your medication is covered. If you take regular prescription medication for a chronic or long-term medical condition, you typically want to make sure the health insurance policy you choose will cover that medication. Your health insurance company will have a list of drugs covered by your policy. The easiest way to find out if a particular drug is covered is to search for it by name on the list on your health insurance company's website. You also may be able to find out if a particular drug is covered by calling your health insurance company's customer service number. If your medication is covered, how much you'll pay depends on your particular policy. With some plans, you only have to pay a small copay for covered medications. Others require you to meet your deductible before there is any drug coverage.

Detail: Visit URL

Category: HealthView Health