Talk to a debt counselor toll free:800-300-9550
Our Clients Rate Us Excellent
Based on 3234 reviewsTrustPilot Reviews
You might have to be Sherlock Holmes to determine who is in network and who isn't. While this might seem like a fairly simple question, you may find you have a problem answering it. The insurance companies publish lists of their in-network doctors but can be sort of lax about keeping them maintained. Even if you do your homework you could find that you're on the outside looking in if your doctor leaves your network. Unfortunately, this isn't very uncommon either because doctor-insurance contracts can often be terminated with little or no notice.
You can back down your insurer
Do you believe that your insurance company refused to pay a claim or made an error in billing you? Then you can appeal the decision. To do this you will need to go first to your insurance company. If you don't get satisfaction there, you'll have to go to your state insurance department. Where do most disagreements come from? It's usually about whether or not treatment was necessary or when the language of your plan was unclear. Believe it or not, a very high percentage of disputes that reach the appeal stage are resolved in favor of the consumer.
You may be surprised by surprise charges
You really have no way to anticipate which providers will be involved in your care. As an example of this, you could go for an ultrasound at an in-network center but then get a bill for the full cost of the out-of-network radiologist who read your ultrasound. The good news is that many insurance companies now offer cost-estimation tools to help you avoid these unpleasant surprises. You can also call your insurer and doctor before you get a procedure and ask whether any of people involved in it are out-of-network. Of course, in the case of an emergency it's just about impossible to do this.
You could end up paying more for the "cheapest" plan
Deductibles, copayments and coinsurance are other components of your health insurance bill in addition to your premiums. What this means is that plans with low premiums could result in higher costs for some consumers. One health insurance comparison website, HealthPocket, analyzed the plans available under the ACA and found that the plans with the highest premiums – called platinum plans – can actually be the best buy for some people because their out-of-pocket minimums are low.
Those high deductibles are not going away
If you have a high deductible plan you will have relatively low premiums. However, you may be required to pay out-of-pocket for many services until your spending hits a threshold. After that, your insurance kicks in. This is supposed to incentivize you to shop for better deals, which would reduce costs to the overall system. As you may know, most Affordable Care plans have relatively high deductibles. In fact, the average bronze plan, which is the one with the lowest premiums – has a deductible of $4959. You might think that this unfairly burdens you because the costs of medical services are seldom transparent. There have been studies showing that if you might cut back on unnecessary care when faced with higher costs, this can result in a greater expense and complications if you come down with a serious illness.
There are things about Obamacare you don't know because you haven't been told. To learn what they are, just watch this video ...
The lesson to be learned
The net/net of this is that if you want to get the best plan for you and your family under the Affordable Care Act at the lowest cost, you need to be a very smart consumer. As you have read, you should go to your state health insurance exchange and compare the various plans available along with their deductibles, co-pays and coinsurance requirements – as well as their premiums. Read everything carefully so that you know exactly what to expect before choosing a plan. While this might take time and effort, it’s the only way you can ensure that you’ll be getting the best healthcare plan at the most affordable cost.