Health Insurance Plan

Avoid Health Plan Pitfalls

Finding a great medical insurance policy can be a definite boon, but choosing from the myriad of options available can be confusing. Being an educated consumer can definitely protect you against health insurance fraud. You don’t have to be an expert but knowing the terminology of your plan can help you to make the best decision. Be familiar with terms such as co-pay (the difference between what the health insurance plan covers and the doctor charges), premium (what you pay before your benefits kick in) and fee for service (a type of health insurance in which you submit claim forms and are reimbursed for covered procedures). If you are not sure what something means, be sure to ask your agent or broker to explain it to you in simple and clear language.

Some indicators of a bogus health insurance plan may include the following:

• You are billed for services that you never requested or received.
• You do not receive a copy of your health insurance policy at the time of purchase.
• You fail to receive a receipt for cash premium payments.
• The paperwork for your health plan is so hopelessly complicated that you cannot even understand the basics of coverage.

Any one of the aforementioned situations should lead you to question your carrier or maybe even take legal action.

Protect Yourself from Health Insurance Fraud

Here are a few ways to protect yourself from health insurance fraud and get the best plan.

• Request written copy of your health plan. You should automatically receive a copy of your paperwork at the time of purchase and a receipt of payment. Fully review all terms of the health insurance plan before putting pen to paper.
• Make sure the insurance company is licensed as an insurance carrier in the state in which it operates and in your state. An insurance company can be set up as a legal corporate entity but still not have the licensure to operate as an insurance provider.
• Ask to see a copy of your broker or agent’s license. It is required by law that agents and brokers carry proof of licensure at all times. If you are not sure, check with the Insurance Licensing Bureau to verify qualifications.
• Do plenty of comparison shopping between health insurance plans and verify your carrier’s financial status with rating companies such as Standard and Poor’sand A.M Best. The carrier should have a rating of A or higher for the company to be considered as a sound insurance provider.

A Word About HMOs

HMOs are a viable option for a health insurance plan. It is advisable to check the rights accorded to you under your HMO within your state of residence. Be sure to ask the following:

• Does the HMO allow you to receive emergency medical treatment without prior approval?
• Does the plan allow you to get a second opinion if diagnosed with a life threatening condition?
• Are you allowed to see a doctor out of network if no qualified specialists operate within the plan?
• Does the HMO provide the option of seeking experimental medical procedures or treatments if conventional treatment fails to alleviate the condition? Will the plan allow for a secondary review by an independent committee if coverage for that experimental procedure is denied?

Your medical insurance should be compliant with current state legislature. Knowing your rights can help you make a better choice for your own healthcare and the healthcare of your loved ones.

Related Insurance Links

• Florida High Deductible Health Plan
• Medical Insurance
• Student Health Insurance
• Health Insurance Quotes
• Health Insurance for Small Business in Ohio
• Long Term Care Insurance
• Dental Insurance.