Do you know what your health insurance policy is all about? Sure, you have the card and you pay the deductibles and premiums, but do you really understand all of the fine print that goes along with a health insurance policy?
If not, then it may pay to educate yourself a bit more on your health insurance so that you have a clear understanding of your coverage and your rights. After all, not figuring out the nuances of your health insurance policy until you land in the hospital or emergency room for the first time is probably not the best idea.
Ask yourself the following questions about your health insurance coverage and if you don’t know the answers, make it a point to learn more:
- What is my annual deductible and does each member of my family have to pay a separate deductible? Most plans have a per-person annual deductible, but many plans may only require that you pay a two-person maximum deductible each year. This may come in incredibly handy if each member of your family requires extensive medical treatment over the course of the calendar year.
- What is my co-insurance amount? Once you have met your annual deductible, many insurance companies will pay a certain percentage of your medical bills, leaving you to pay the remainder. However, most insurance companies have a stop-loss number, which is an amount that you are only responsible for paying up to. Anything over the stop-loss amount is covered 100 percent by your health insurance company, eliminating the need for you to pay a co-insurance amount.
- What is my lifetime maximum benefit amount? Many individuals are unaware that most health insurance companies have a maximum lifetime benefit amount, which includes benefit caps per illness. For example, your lifetime maximum benefit amount may be $4 million, but your maximum benefit amount may be just $100,000 per illness.
- What are my doctor co-pays and am I limited to a certain number of co-pays each year? Some insurance companies limit individuals to just a handful of doctor co-pays each year, so it pays to educate yourself on this part of your policy.
- What are my prescription benefits? What are the co-pays? Must I meet a certain drug deductible before I begin receiving prescription drug benefits?
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