You are not alone if you experience difficulty understanding your health insurance. In a recent survey, 34% of Americans said they have limited understanding of what services their plans actually cover and 35% had only fuzzy knowledge of their deductibles, premiums, caps, and co-pays. Even worse, what happens when you use your insurance and start to receive bills for things you thought were covered?
Here at United Agencies, our Claims Advocacy desk is dedicated to helping you resolve those issues. In the past year, United Agencies has saved our clients literally hundreds of thousands of dollars.
Below are some tips that will help us resolve your claims issue more efficiently and effectively.
- Talk to your HR contact at work or call us for a copy of your Summary of Benefits. This will help you to get a picture of what is, and is not, covered.
- For PPO members, once services are rendered you will receive an Explanation of Benefits (EOB) from your insurer. It is important that you keep them. Look them over, reconcile the EOB with your experience, and cross check with your doctor’s bill. Make sure they match.
- If you do not receive an EOB, call your provider (doctor, hospital, specialist, lab, pharmacy) for an itemized bill.
- For HMO members, call the insurance carrier ( Aetna, Blue Cross, Blue Shield, HealthNet, United Health Care) using the number on the back of your ID card. Ask questions.