INSURANCE

Q:

What are some of the most common mistakes you see people make when it comes to health insurance?

A:

Unfortunately, many Americans do not have a thorough understanding of their health insurance benefits. This can lead to costly missteps. Whether you have Medicare, an Advantage Plan or insurance from a private or government marketplace, you should take care to avoid these common mistakes: Mistake #1: Not understanding common insurance terms

Everyone with health insurance should understand the most common insurance terms including co-insurance, co-pay, and deductible. These terms represent your portion of your medical expenses.

For the record, a deductible is the amount you have to pay for care you receive before your insurer will cover their portion of the cost. A co-pay is a set fee you pay at the time of service (such as when you go in to see doctor). A co-insurance is the amount (usually a percentage) you will have to pay after you have paid your policy’s deductible. Mistake #2: You pay your bill too soon. After a doctor’s visit, you’ll receive an explanation of benefits, or EOB. It shows the service you received, how much your doctor charged, and what portion of the bill your insurer paid. If you’ve received a bill from your doctor, hold off on paying that bill until you receive your EOB and confirm that your insurer paid its portion before you pay the remainder.

Mistake #3: Not asking if your doctor is in-network

Your costs will usually be lower if you see a doctor in your plan’s network. Call the insurance provider’s customer service department before making an appointment with a new doctor. Or ask your doctor’s office staff to confirm whether your doctor is in your insurance plan’s network.

Mistake #4: Not knowing the difference between prevention vs treatment

Many insurance plans now cover the full cost of some preventive services with no co-payments or other charges. Unfortunately, what is or isn’t covered is not always clear to the patient. To avoid surprise bills, be clear about the purpose of your visit when you make an appointment and ask about the costs involved. Mistake #5: Medications are not covered Before signing up for a health insurance plan, look at its formulary, or list of covered drugs to be sure your plan covers the medications you are taking.

One of the services I offer my customers is to act as a resource whenever they have questions about topics like the ones listed here. As their agent, they can turn to me whenever questions arise. If you would like to learn more about Mutsko Insurance and how we can serve you, call me at 440-2555700 or email me at Lmutsko@mutskoinsurance.com.