Ensuring that your specialist is covered by your health insurance

Health Insurance

An unfortunate reality is that at some point in your life, you may require the services of a medical specialist or require sophisticated and expensive medical testing. If you have health insurance, there are a number of steps involved in choosing a specialist and acquiring approval from your health insurance for any visits or medical testing. First you want to get a list of specialists in your area. Next, check with your insurance company to make sure that the doctor you choose is covered and at what percentage.

You should also check with your doctor to make sure that they still accept your health insurance coverage. In addition, you should check to make sure that any procedures your doctor deems necessary are covered by your health insurance as well.

To use an example of the process, imagine that you have had a persistent sore throat. You would head to your primary care physician and have it checked out. However, when checking your throat, your doctor notices that your thyroid is swollen. Your doctor recommends that you see an endocrinologist immediately to rule out any cancer or other serious issues. While that may seem simple enough, your health insurance coverage can make all the difference. Some people have PPO coverage and may not need approval from their health insurance. In this case, they can call the specialist and make an appointment. Easy enough. However, some health insurance coverage forces you to go through a long process just to secure approval for that appointment.

To make things more complicated, your doctor may want to perform tests to determine what has caused the lumps on your thyroid and to rule out cancer. As the patient, you would hope to get all testing done as soon as possible. However, your health insurance may require preapproval for all testing and there can sometimes be a long wait associated with that approval. It is always a good idea to get approval and referrals form your health insurance in writing. By having your health insurance coverage in writing, you are protecting yourself from future medical bills that can be astronomical. The last thing you want is to find out that the cost of your medical testing is your responsibility because you did not get proper approval from your health insurance.

Even if your medical specialist or testing has been covered in the past, it is always advised that you double check with your doctor and your health insurance as coverage sometimes changes without notice. Doctors may no longer accept your health insurance coverage for various reasons and if that happens, you become responsible for all bills associated with your medical treatment. In this case, any referral form your doctor may not be covered either because your health insurance no longer recognizes that doctors treatment and advice. The best way to protect yourself is to double check your health insurance coverage before scheduling any appointments or testing. A simple call to your health insurance carrier can save you thousands of dollars.