It's funny how when you deal with a thing every day, you have a whole new experience when you are on the other side of the equation.  Having gone through a minor medical thing recently, I echo what the writer of this fabulous article has to say.  It's one thing to sell insurance products.  It's quite another thing to consume them.  Being a broker is very different from being a patient, and I feel for my clients very deeply, especially after the last month!
 
I was talking with an associate about this very thing recently.  She had gotten an exam at a specialist in her home state (caution: only certain group PPO policies allow this.)  Her family got a bill from the doctor delivered to their home saying she owed $500.  Guess what?  That was just a preliminary bill from the doctor, and it hadn't processed insurance correctly yet.  Dozens of phone calls later, she got the issue sorted, but was exhausted by the task.  Lesson being, even insurance agents go through the exact same frustration dealing with billing issues.  And we know exactly what to say to these companies!  Don't let this be you; over payment is not your friend.  It will create even more problems chasing down your dough.
 
Gosh, how awful to go through this when you're not well.  Let's all be patient with ourselves with this, ok?  Especially in times of stress, please remember these key takeaways:
 
1. Don't pay a bill that hasn't been adjusted by insurance.  You'll see a column that says something like "adjustments" which will clarify this.  If you have questions, always call.
2. You are only responsible for the number listed on your Explanation of Benefits (EOB) from the Insurance Company.  If this number doesn't line up with a bill you got from the doctor or hospital, call the doctor first.  Remember if you've paid your copay, you don't have to pay it again when the EOB comes in.
3. You have payment options.  You don't have to go broke paying off a bill all in one-fell-swoop.  Negotiate with the doctor, hospital, or facility.  It's always best to set up a payment plan through their agreement though to avoid confusion.
4. Breathe.  You're not stupid.  This is complicated.  No organization communicates well, and it falls on the consumer to fix this.  Get help!  Lean on your broker for support when you're lost or confused.  Because of HIPAA rules, I can't always directly help you but I CAN advise you what to do next.
5. DO NOT CANCEL YOUR POLICY!  I know there's no fine for not having insurance.  I know it's expensive to pay monthly and then you're mad when you get a bill for more costs.  But I promise you, one hospital stay without insurance for a minor issue can put you out thousands of dollars.  If you *knock wood* find yourself uninsured and dealing with medical expenses, you're going to wish you had that policy.  If you can't manage your policy, talk to your health insurance agent.  We can arrange a new policy for you next enrollment opportunity, explain your benefits, or simply be a sympathetic and helpful listener.  You're not alone!  We're all in this together.

 

Thank you, Kathryn Mayer, for your wonderful insight.  Make sure you check out the full article here:  https://www.employeebenefitadviser.com/opinion/how-my-hospital-stay-made-me-rethink-employee-benefits?utm_campaign=intraday-c-Feb%2025%202019&utm_medium=email&utm_source=newsletter&eid=14199793da6cc0a0a803fbe9e84929c9  


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