You are here: Home Managing Your ... Health Care: How ... When You Receive A ...
Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Health Care: How To Save Money

When You Receive A Medical Treatment

Next » « Previous


Before Treatment

Before agreeing to receive any nonemergency medical treatment, find out how much it will cost you.

Step 1. If you have health insurance or Medicare, be sure that the treatment is covered.

  • Ask your doctor for assurance that the treatment is "medically necessary." If it isn't, insurers are likely to refuse to pay. If there is any question about whether a treatment is medically necessary, check with your insurance company before undergoing the treatment. If you have Medicare, this may be difficult to do, but it is worth making the call in any event. (NOTE: Even if an insurer agrees before a treatment that it is covered, that doesn't mean the company won't reevaluate the situation once all the facts are in. So if you get prior approval, be sure to note the name of the person, the date of the conversation, and his or her contact information. If you can get the approval in writing, that's even better).
  • Look in your summary of your policy, or the policy itself for "Exclusions" or "Not Covered." If there is any question whether the treatment is covered, contact your insurer.
  • If prior approval is needed, get it. Insurers can be very sticky about this requirement. Courts have been known to confirm that an insurer doesn't have to pay if the policy requires prior approval and you don't get it.

Step 2. If your coverage doesn't pay for treatment outside of the insurer's network or pays a lower amount than for treatments provided in network, check to see whether the treatment provider is in network. If not, look for an acceptable provider in network. If there are none, ask  your insurer for an exception. (If the company refuses, see Appeals: Arguments To Use

Step 3. Do the math to figure out how much you will personally owe. For example, include:

  • The amount of any deductible that hasn't been used yet. (A deductible is an amount you pay each year before the policy takes over).
  • Co-pays or co-insurance. (The part of a medical bill you pay)
  • Related costs such as transportation to and from the treatment facility, lost wages, home care, cosmetics or even new clothes.

During Treatment

Keep track of every drug, test and procedure you receive. If you're not up to it, ask a family member or friend to do it for you. This information will b needed to verify the bill.

After Treatment

Don't pay what you don't owe.

Step 1. Check to be sure the bill ony includes services you received.

  • Compare the "Explanation of Benefits" you receive from an insurer or "Medicare Summary Notices" you receive from Medicare with the list of what you actually received.
  • If the two don't match, call the health care provider. There could be a coding mistake

Step 2. Check to see whether you actually owe whatever you're billed. If the reason for a bill isn't clear, ask your health care provider for an itemized bill. 

Step 3. If you owe money, you can negotiate a lower amount.  Health care costs are not set in stone. In fact, there are generally various amounts depending on who is paying the bill.

Step 3. If you don't believe you owe the money, follow the procedure described by the insurer. If you don't get a positive response, appeal - and keep appealing. Statistics show that it's worth it. To learn more, see: Health Insurance: Appeals.

Please share how this information is useful to you. 0 Comments


Post a Comment Have something to add to this topic? Contact Us.

Characters remaining:

  • Allowed markup: <a> <i> <b> <em> <u> <s> <strong> <code> <pre> <p>
    All other tags will be stripped.