Chief Executive Officer, Gastrointestinal Associates, P.C.
In the third installment of our three-part series about healthcare-related topics we should consider as we wind down the year, we’ll discuss reviewing your health insurance. Check out the previous posts about finding the right doctor here and planning for your colonoscopy here.
While there is no feasible way to examine every health insurance provider, plan and scenario, there are some things you should consider, along with helpful tips, when seeking healthcare services. With just a bit of research, you can find the information to help make the process smoother.
Things to consider
If you are looking for a new provider – from a primary care doctor to a specialist – first check to see if the provider or specialist is covered within your plan’s network. This can help minimize out-of-pocket costs.
Find out if you need a referral. Some insurance plans require referrals for specialist visits, which means you need to first visit your primary care physician. If your doctor refers you to a specialist, make sure that the specialist is in your plan’s network as well. Also confirm whether or not you need to make the appointment or if your doctor’s office will make it for you.
It’s also a good practice to understand your co-pays for specialists, procedures and prescriptions. These can vary greatly, and there are resources available to help manage costs.
There are several ways to get information about your plan, and we recommend that everyone review coverage at least annually to stay up to date.
Some employers and insurance companies send annual benefit summaries that often provide top level information for commonly requested things such as copays and coverage, as well as expanded detailed information.
Insurance companies also offer websites and phone numbers – often found on the back of your insurance card. Websites will have detailed plan information and phone lines are staffed with trained professionals to help answer questions.
Your employer’s HR department or an insurance specialist at your doctor’s office also can guide you to resources or answer questions.
Healthcare providers are committed to helping you find the care you need within the guidelines of your insurance. At Gastrointestinal Associates, we are readily available and want to assist you in navigating your insurance for GI services. Do not hesitate to call us if you have questions about your coverage. We hope you have enjoyed this series on “Things to do before 2022” and send you our best wishes for a happy and healthy 2022!