Years ago, I remember having insurance but not even giving the details of it a second thought. We had it, it covered anything and everything, and that was that...or so I thought. But then we'd get a bill from the doctor's office. We had entered a world of co-pays, deductibles, in-network benefits and out-of-network benefits.
Later I learned from my mother-in-law about HMO's. When she became involved, Health Maintenance Organizations had just begun and, at that time, she could only choose from a small handful of doctors. Although I think that has changed to where one can usually choose from more doctors, still HMO's often require a referral from the primary care physician in order to visit a specialist. If your insurance requires referrals, please be pro-active in making sure you have the referral - or that your primary doctor gets it to the specialist - before you go to the appointment.
Sometimes your company may change insurance plans. One year we had the same insurance company as the year before, and even the same member number, but the prefix letters that came before our number had changed. At that time I did something that I later thought was really stupid. I threw away the old cards. Fortunately, I was able to obtain a copy from a doctor's office we had visited. Now I have three policies to keep track of for the past three years. And yes, you really can receive a medical bill in 2010 for an office visit or lab test in 2008. (I'm trying to resolve one of those bills right now.) If that happens, you need to know which insurance company to call and your member number (and prefix).
Speaking of resolving issues, please always be kind and patient when you call the insurance company or medical practice. They are real human beings, with their own trials and tribulations, even their own illnesses, who really do want to help you...provided that you treat them with a little respect. And if it turns out you have a bill that you really do need to pay, don't panic. You can often get on a monthly payment plan.
I used to think that I could just make my own payment plan. "You should be happy that I sent you some money" was my unspoken attitude. I even had a doctor who said, "Send us whatever you can, as long as it's once a month." That's fine, if they tell you that. But unless they do, I would definitely call - no matter how annoying it is, or how fearful you might feel about picking up the phone. If you and the practice agree to a payment plan, and you make your payments, then no one will nag you and you won't be sent to collection for a bill and have it adversely affect your credit rating.
If you really, truly feel you can't make the payments they want you to make, you can ask them if you can make smaller payments. If they want larger payments than you feel you can make, then ask them if they have a hardship plan. If they do, you will need to show your income and expenses, but if you qualify, it might help. At a time some years ago when my husband had just started a business, and we had a large deductible to pay on a four day hospitalization, we got our bill cut in half due to hardship. Then I talked them into small payments on what was left. The woman was annoyed at how little I wanted to pay, and warned me that if a payment was late we would be sent to collections...but it was what I was comfortable with at the time. And in a few years, we had the whole bill paid off in spite of financial difficulties at the time.
So, to summarize, I have learned the following over the years:
1) Know what insurance you have. Do you need referrals? Do you have co-pays? Do you have deductibles? How much are they?
2) If you need a referral for a specialist, make sure it gets there before you do (or take it with you).
3) If your insurance changes, keep the previous year's information in a safe place.
4) If you receive a bill stating that the insurance didn't pay for a visit or procedure, try to resolve the issue with the practice and/or insurance company.
5) If you still owe money on a bill, pay it or make arrangements to get on a payment plan. I've found medical people to be better about this than any other business.
May you be blessed with good health, good care, and prosperity.
