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BY IRENE C. CARD and BETSY CHANDLER
NEWJERSEYNEWSROOM.COM
YOUR HEALTH INSURANCE
1. Pay your premium on time. This is so very important! Most insurance companies do have a grace period if you are late with paying the premium, but you do not want to enter that grace period if you can help it.
In order to make sure your coverage does not lapse, and in order to not create lots of aggravation and extra work for yourself and/or your insurance agent, pay the premium on time!
2. Submit claims promptly. Most insurance companies have time limits on processing claims. You must submit the claim to them within a reasonable time frame if you expect them to process and pay the claim.
If you just cleaned out your desk and found claims from 5 years ago that have never been submitted, you can forget about submitting them now. Find out what the time frame is for your plan, and submit promptly!3. Understand your benefits. If you know how your plan works, you will be able to maximize your reimbursements, and minimize your out of pocket expenses, as well as your frustration. Your health insurance policy may not be half as exciting as the latest Sidney Sheldon novel, but there are other ways to get the information if you do not care to read the policy.
If you have insurance through your employer, speak with the human relations department or ask to call the agent who put the plan in place for a quick explanation. If you purchased it on your own, call your agent, or call the insurance company directly.
4. Follow-up promptly on unresolved claim issues. Set up a plan for submitting claims and follow up if you have not heard back within 2 months of submitting.
5. Be sure to get referrals if your plan requires it. This in itself can save you lots of money! Many plans will reduce or completely deny benefits if you fail to comply with this procedure.
6. Comply with precertification requirements. Call the 800 number prior to being admitted to a hospital or having certain surgical procedures done on an outpatient basis. Obviously, when you are dealing with a life threatening emergency you should get to the hospital as quickly as possible and worry about calling the 800 number later.
7. Know if your plan covers routine physical examinations and to what extent. Will the plan pay for the first $500 of preventive services in a given calendar year? Do you have a small co-pay such as $15 or $30 if you see the doctor in the office for a physical? Will your plan pay for a routine physical every year – or every three years?
8. Keep your ID card with you at all times. If you are biking or running etc., tuck it into your pocket, or sock; make sure it is with you. At all other times, it should be in your wallet, providing your wallet goes with you on a daily basis.
9. Start investigating insurance options at least three months before your 65th birthday. You may need to make changes depending on if your insurance is self-purchased or through an employer. Give yourself enough time to research your options and be able to make the best possible choice for your personal situation.
10. If you are over age 40, explore long-term care insurance. Long-term care insurance is designed to protect your assets and help with the expenses of care that you may need as you age.
Irene Card & Betsy Chandler are both licensed insurance professionals working at MIC Insurance Services, a health insurance services company. If you have questions relative to this column or other related topics, we invite you to call (973) 492-2828, or visit our Web site at www.micinsurance.com.
