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Health insurance companies like to save money. For example, when you have surgery, you might get a bill for using an out-of-network anesthesiologist. But you shouldn’t have to pay extra for a matter you had no choice in.
Fighting back against this kind of trickery is easier than you think. Here are some little-known ways to get the health coverage you deserve.
Don’t Pay If You Don’t Have A Say
If the above situation happens, draft a strongly worded letter stating you had no say about the anesthesiologist and won’t pay any additional fees. This is likely to work every time, but few consumers know about it.
You May Be Eligible For More Coverage
You could be eligible for more benefits than your plan is telling you about. It’s unlikely that your plan is letting you know about state-mandated coverage, for example. One good place to check is Families USA (www.familiesusa.org), a consumer group that keeps tabs on state rules.
To Get Tested, Talk Up Your Symptoms
If your best friend is diagnosed with colon cancer and you want the $675 test to put your mind at ease, mention to your doctor that you’ve had some blood in your stool and a lot of gas lately -- or even just that your bowel habits have changed. Your plan has to pay for the test if you have these complaints.
Stall First, Answer Questions Later
Companies sometimes look for info you may have accidentally omitted when you applied for coverage. If an omission is found, you can be denied coverage. Don’t answer questions that sound like fishing expeditions.
Letters Are Your Best Bet
The old-fashioned letter is by far the best way to communicate with your health plan. If you use the phone, it takes forever and when you’re done there’s no record of it.
Doctors Can Be Good Weapons
Ask your doctor for help. He can tell the insurer he’s going to complain to the state board that regulates health plans.
A Little Research Can Go A Long Way
Arming yourself with info doesn’t guarantee coverage, but it’s a proactive step in the right direction.
There Are Ways To Get Drugs Cheaper
In many cases, drugs have generic versions that are just as effective but cheaper than the newer ones. Always ask your doctor (or the pharmacist) for generics. And if you really need a medicine that doesn’t have a generic version, order it by mail; many plans have a less-expensive mail-order pharmacy option.
An Advocate Can Help You Win
Some patient advocates help you interact with your doctor, while others specialize in insurance disputes. Advocates can even get policies changed.
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