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Forgive the short hiatus, here is our new blog piece.

The health insurance conundrum. Does thinking about calling your health insurance representative give you palpitations? Are you intimidated by the multiple terms and insurance-speak?? Many people now independently shop for health insurance, and it is especially important to know the basics, and what questions to ask.

In our previous blog post Insurance Speak we provided a detailed explanation of coverage and benefit structure of health insurance. Today we will cover questions that you can ask your health insurance representative when you call.

I think the first thing you should ask is – What is my yearly deductible?

If you met your yearly deductible, then you are set. You only owe copays or coinsurance, and those are clear quantifiable amounts.

If you have not met your yearly deductible, then you should ask – How much money has been applied toward my deductible?

That will give you an idea of how much you still need to spend out of pockets before you get greater coverage once you reach the deductible.

If you are shopping around for a new plan you obviously should ask – What is my monthly premium?

Next, it is important to find out if the provider you are seeing is in-network or out-of network. You should find out if your plan allows out-of-network benefits. Some do, and others don’t and that will determine if the insurance cover the services. Do I have out-of-network benefits?

Lastly, ask if there are any visit limitations or coverage cap on the service you are seeking. For instance some insurances only provide 10 visits per year to see a physical therapist etc. Are there limitations to coverage or visit allowance in my plan for this service?

I hope this knowledge will make you more comfortable with the health insurance maze. Please share your thoughts, questions.

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