Avoid Health Insurance Problems
Choose wisely. Select a policy that fully protects you in the event of a catastrophic illness or injury. Avoid plans with unrealistic limits on hospital room charges, surgery, prescription drugs, and other potentially large expenses -- even if that means accepting a policy with a higher deductible. Stay "in network." If you belong to an HMO or PPO, avoid additional charges -- unless your treatment dictates otherwise -- by visiting only doctors who are in the plan's network. Keep records. Copy all bills and statements. Whenever you phone the insurance company to discuss your bill, note the name of the representative you spoke to, the date and time. Get help. Medical Billing Advocates of America (540-387-5870) can refer you to an analyst who, for an hourly fee or on contigency, will check for double billing, overcharges and underpayments. The Patient Advocate Foundation (800-532-5274), a nonprofit group, assists -- for free -- anyone with chronic or life-threatening diseases who needs help navigating the medical insurance system. Appeal. If your insurer refuses to pay for a procedure or therapy recommended by your physician, appeal the decision. "Being persistent pays off," says Jennifer Edwards, a researcher for The Commonwealth Fund. You may not be out of luck even with repeated denials: 44 states allow independent review boards to conduct "external appeals." |
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Womens Health Initiative -- Health Heroines: The Faces of America |  |
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