How to Better Know Your Health Insurance: Just Ask

I was just talking to a friend of mine. She is on Medicare as her primary insurance and had Medicaid as her secondary insurance which she qualified for due to a disability. However, when she had to have a procedure done and called to make the appointment she was told that her health insurance had been canceled. It turns out, she was not notified that her Medicaid was canceled and a result, she was unable to set the appointment or get her prescriptions. If she knew her insurance better she might have been better prepared.

My friend had a disability where she couldn’t work. She also suffered from an autoimmune disease, high blood pressure, as well as high cholesterol and diabetes. Her sudden and unannounced change in insurance left her in tears as she tried to figure out what she could do and what path to take. She told me, “I feel like I can’t breathe”. She couldn’t focus on everyday things, she was always panicking and couldn’t remember the last time she had a good night sleep.

How could her coverage be dropped without warning? Because she didn’t know what each insurance was covering before, all of the new costs came as a complete surprise to her.

How can we avoid becoming victimized like this? We need to be vigilant and do our homework on healthcare insurance. Make sure you understand your insurer’s policies and your rights as a patient.

Ways to learn more:

I know in the company where I worked, we had an insurance agent that would come to visit and we would have a Q and A session. You should see if your employer offers something like this. If they don’t you can easily call that customer service number on the back of your card and ask them questions. It’s why they are there. Either way, make a list of questions. You can ask about costs, penalties, prescription coverage, oral surgery and more.

Things the insurance people can help you with:

  • Help in scheduling appointments
  • Assist in emergency service if outside of office hours
  • Educational wellness and preventive healthcare
  • Information and material on your health condition
  • Arrange for assistance on in-home health care post-surgery
  • Help you with transportation to and from doctor appointments
  • Audio accessible, free language services to people whose first language is not English. Most insurance companies offer qualified interpreters and information written in several languages.

I have been on someone’s health insurance for 55 years. Experience has taught me the importance of utilizing the entire team of healthcare professionals under my insurance plan, and that includes the customer service representatives. It’s worked well for me and I hope it will for you too.

 

You’ll receive updates about new resources, patient stories and insights, advocacy work, and alerts about patient-support events.