3 Health Insurance Tips to Save Money

Health Insurance, can’t live with it, can’t live without it. Haven’t we all felt like ripping up our medical bills at some point in our lives?! Have you ever been surprised by how much a procedure cost when you thought it was going to be covered by insurance? Sick of waiting on hold forever or getting the run around when calling the insurance company? Gosh, me too! Let me help you save money, time and frustration with these 3 health insurance tips!

Always check-in with your insurance company before a new procedure, therapy or treatment

It is super important to always check-in with your insurance company before starting any new procedure, therapy or treatment. You want to confirm that your insurance company is going to cover it. To me, it was always important to find a provider in-network (verses out-of-network). Ideally, this means the insurance company will be covering more of the overall cost. You can check-in with your insurance by phone or going online. I usually prefer to use the companies app to avoid the long phone wait times, but sometimes this is unavoidable.

You want to confirm with your insurance company that your new procedure is covered, that the provider doing the procedure is covered, and that the location where the procedure is taking place is covered. This also goes for treatments and new therapies you may be needing. It is crazy how insurance can cover a doctor but not a procedure, or cover a therapy but not a certain provider. You want to be crystal clear that it is all in-network!

Another important thing to ask your insurance company is what the estimated cost will be. Some insurance companies have cool apps that have price estimators for different procedures and how much they cost at different hospitals and cities. If possible, it would be ideal to shop around. Some doctors and hospitals may charge more for the same procedures than others. The insurance company may claim that they don’t think they should pay more if another doctor charges less and you will then have to pay the difference! For example, I was able to check to see how much a vaginal versus c-section twin birth would cost. I, then, was able to compare it to other hospitals. 

Specifically check that the anesthesiologist is in-network

If the hospital, procedure and doctor are all in network, then shouldn’t all the other medical professionals be covered as well? Well, you’d think, right? This has actually been a big problem, I’ve heard about it on NPR and it happened to me. Everything was considered in-network but surprisingly the anesthesiologist was not! This can be a costly oversight! It is super important that you specifically ask your insurance company if the anesthesiologist will they be considered in-network. You don’t want any extra surprises or costs!

Medical diagnoses are very important

Medical diagnoses are actually extremely important to insurance companies. This can decide if the insurance company is going to pay for the therapy, treatment, procedure or not. There are certain medical diagnoses that insurance companies won’t cover. For example, my daughter needed feeding therapy for her oral sensory food aversion. Our health insurance at the time claimed that they wouldn’t pay for her feeding therapy because of the sensory diagnosis. If it was an oral motor issue or something physiological, they would cover it. However, they claimed they wouldn’t cover a sensory diagnosis unless she also had an Autism diagnosis – which she doesn’t. Crazy right?! This happens all the time where insurance companies pick and choose what is covered based on the medical diagnosis. 

You can’t ask your provider to lie about a medical diagnosis, that is fraud, but you can advocate and petition to the insurance company. Hopefully you have an awesome pediatrician or provider who will advocate for you or your child as well. Some offices may be reluctant to do this because it does take more effort on their part. They need to fill out more paperwork and spend time on the phone with the insurance company. The worst part is, you may spend hours petitioning why this treatment is necessary due to the diagnosis and they still won’t cover it! This has happened to us. It is extremely frustrating and expensive. 

I get it guys, I know how frustrating working with medical insurance companies may be! I have spent HOURS on the phone trying to fix these costly technicalities. My hope is that you all can take these tips and learn from my personal experiences to help save you money, time and frustration!

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