Health Insurance: How To Maximize Use Of Your
The keys to maximizing use of your health insurance policy are to understand the general rationale behind the type of policy you have and how the provisions you care about fit into the overall scheme. Understanding how a policy works helps figure out how to get what you need at the least out-of-pocket cost.
There are two basic types of Medicare: Original (fee-for-service) Medicare and Mediare Advantage
- Original Medicare (traditional Medicare)
- If you have Medicare Advantage,you have a health insurance policy with a private insurance company that meets bsaic requirements set by Meciare. The policies fit the same descriptions as non-Medicare policies noted below.
- For information about how to maximize use of Medicaid, click here.
Private Health Insurance
To learn about the different types of health insurance policies, see the following. If you don't know what type of health insurance policy you have, click here.
- Fee-for-service (indemnity) plans (the type in which you get to choose your medical care and who provides it), see: How To Maximize Use Of A Fee-For-Service Health Insurance Policy
- HMOs (the type in which the care you receive and by whom is controlled by the insurer so you need approvals before getting): see: How To Maximize Use Of An HMO
- POS plans (the type in which you can see in-network doctors for minimal cost or pay more and go out of network): see: How To Maximize Use Of A POS Health Insurance Policy
- PPO plans (the type with discounted medical care): see: How To Maximize Use Of A PPO Health Insurance Policy
- NOTE: If your insurer has one, it is advisable to make friends with a case manager. Case managers are supposed to help maximize health care while minimizing cost. A case manager can be an important source of information, can help coordinate your care and can influence the insurer on your behalf. See: How To Talk With The People At Your Insurance Company (Make A Friend)
- If you run into difficulty, appeal, and keep appealing. It pays off. Also look for help from other sources of influence to help convince the insurance company to say "yes", such as the Human Resources department of your employer, or the broker who arranged the insurance. See: How To Appeal A Health Insurance Claim With The Best Chance Of Getting A Yes