Content Overview 
- Summary
- Keep Track Of Out-Of-Pocket Medical Expenses
- Keep Your I.D. Card With You In Your Wallet Or Purse
- If You Have A Choice, Balance Premiums, Deductibles, Co-Insurance, Stop Loss And Benefits
- Minimize Out Of Network Costs. For example, if You Agree To Surgery, Make Sure All Members Of Your Surgical Team Are Part Of Your PPO.
- Negotiate Fees With Out-Of-Network Health Care Providers
- Avoid Paying Money In Excess Of Usual, Customary And Reasonable
- Think Of Case Managers As A Resource
- Stay On Top Of Insurance Company Reimbursements
- Be An Informed Consumer When Purchasing Drugs, Tests Or Treatments.
- If You Smoke, Quit.
- If You Need An Off Label Or Experimental Treatment, Work With Your Doctor To Get Coverage
- Don't Accept A "No" From The Insurance Company.
- How To Choose And Maximize Use Of Doctors And Specialists
- Take Advantage Of Your Plan's Mental Health Benefits
- How To Keep Your Doctor When You Change Health Plans
- Insurance Policies Are Not Set In Stone.
How To Maximize Use Of A PPO Health Insurance Policy
Negotiate Fees With Out-Of-Network Health Care Providers
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Studies show that the success rate is high enough that it is worth negotiating fees with a health care provider. It may be uncomfortable the first few doctors you ask, but what do you have to lose?
Consider the following:
- Ask out-of-network providers before a service if provided if he or she will accept the in-network fee for services or accept what Medicare pays. To find out what Medicare pays for the procedure, see www.cms.hhs.gov
. Then look for physician's fee schedule. - Keep in mind that the American Medical Association says doctors have an obligation to compassionately consider the patient's ability to pay.
- Most doctors have different fee schedules for the same service depending on who is paying for the service.
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