Why It's Important to Know What Your Health Insurance Covers Before Visiting Your Doctor

We shell out a bi-weekly amount of money for health insurance every paycheck and we go see doctors when it's necessary, but do we really understand what we're paying for? Whenever my employers tell me to pick a health care coverage package, I usually pick the one that is the least expensive, especially considering I have no current health conditions. But sometimes that decision can really hurt you in the long run if you don't understand what you'll have to pay for should a situation occur, and health insurance companies know that. This is why even if I pick the cheapest plan, I know exactly what I can and cannot do when I see a physician.

In December 2008, I got a full physical with annual medical tests included, and out of $1,512 spent, my health insurance company wanted me to pay the remaining $612.36. I knew I'd read my health insurance coverage fully so I didn't owe this amount. Instead of surrendering to this insane amount, I wrote a letter to the hospital where I was tested as well as my health insurer. Both spoke again and said they could decrease my amount by approximately $50. I still wasn't going for it because I knew what I read, so I asked for a full breakdown of what the health insurer covered versus the hospital versus what I'd have to pay. They mailed this information to me, I looked it over and I asked the health insurer representative to decode all of the fancy talk for different tests to tell me what each test really meant.

The work she had to put in to explain all of this stuff forced her to really pay attention to my fees versus the health insurer. And then I received a bill in March saying I now only owed $25.36. Three months of arguing, and I'd managed to decrease the amount $587. And while I still didn't feel like I owed anything, I did pay the $25.36 to cover the co-payment amount.

What did I learn from this experience? Bill collectors and financial companies oftentimes look at their clients like they're illiterate. They don't expect us to challenge their rates or even ask about them because it's in medical terminology. Sometimes they don't even believe we'd know where to start. Learn.

The House of Representatives passed the Health Care Reform Bill by a vote of 220 to 215 on Saturday, November 7. While President Barack H. Obama continues to fight for health care bill issues and making health care accessible to all Americans and the Senate has to vote on it, in the meantime, those who have health care coverage should take the time to know what is covered and what's not. Those of us who have credit cards should be able to calculate our own interest rates and know our current balance before sliding the card through anybody's machine. Pres. Obama has already signed a law to protect credit card owners from surprise charges and interest rate hikes. But he can't babysit us to make sure we know our own financial history. By actually reading the documentation you receive and preparing for future financial expenses, you know what you're getting into beforehand.

This way, when you get surprise bills in the mail, you can at least have an intelligent debate about the issue or know when to back down. And who knows? Maybe you'll succeed in getting rates decreased or start spending more wisely.