The latest about medical bills.
The last thing on our minds when we have to visit the hospital is how much everything will cost. However, more and more people are met with unexpected medical bills that are far beyond what they can afford. People who wind up in the emergency room or need an ambulance can be blindsided by hefty, unexpected charges. This often happens after patients visit a doctor or hospital outside their insurance network so coverage was limited. Insurance deductibles that reset every January and must be paid before coverage begins can make these invoices even more painful.
Insurers form networks of doctors, hospitals, and others and then negotiate rates with them. Doctors cannot bill outside those agreed-upon rates for in-network care. For out-of-network care, providers can bill patients the difference or leftover balance between what the insurer paid for the care and what was charged. On top of that, many insurers also make customers pay separate, higher deductibles for out-of-network care before they provide coverage. The result is a bill – which can total several thousand dollars.
Some plans even provide no coverage for non-emergency care outside their network. That’s more common with individual coverage sold on the Affordable Care Act’s insurance marketplaces.
What happens when you’re hit with an unexpected medical bill? If you’re having a planned surgery or procedure, check ahead with both your insurer and the hospital or doctor to make sure they are in-network. Also, ask about any physicians that may assist with the procedure. If you receive a surprise bill, check first for errors in what was charged or if you have been billed out of the network by mistake. Then ask if the claim can be processed again as in-network care, especially if you had no way of knowing it wasn’t beforehand. If that fails, some hospitals may be willing to negotiate discounts or put you on a payment plan.
Do you have questions regarding your health insurance? Then don’t hesitate to contact the experts at Donald Weiss Insurance Services. Our dedicated team is ready to assist you with all your insurance needs.
