The last thing you want to be thinking about is having to deal with a medical emergency, but life doesn’t always work in our favor. When life hits hard, it happens when we least expect it. We have no time to prepare, we get no choice to optimize our options, and we just try to make the most out of a terrible situation. There are so many things that will be unaccounted for in a medical emergency, so the least you can do is prepare your health insurance to come to your aid at that moment.
In order to prepare for the worst, here’s how you can make the most out of your health insurance:
1-Understand How Your Health Insurance Operates
By now, almost everyone has their own health insurance. These plans help in covering a lot of medical needs, whether or not it’s an emergency. However, depending on your plan, there can be some gaps and caps in coverage, whether it’s costs we’re talking about or healthcare services.
For instance, Medicare plans offer good basic coverage in case of medical emergencies. However, as the insurance experts at Medicare Wire explain at medicarewire.com/medigap/, their coverage is limited. In case your emergency requires hospitalization, you’ll pay $1,364 for deductible during the first 60 days of your stay. When you exceed 60 days, you’ll also be paying coinsurance in addition to your deductibles, which can quickly reach $1,612 minimum costs. Medicare doesn’t cover prescription drug costs, either. Make sure you understand how your health insurance plan works. If there are any gaps in coverage, consider getting a supplemental plan to cover the gaps in costs and services.
2-Urgent Care Facility Vs. ER
As soon as the emergency occurs, most of us headed toward the ER without giving it a second thought. However, you should consider the pros of visiting an urgent care facility instead. Not only will the ER be too crowded, and you’ll have to wait long periods of time to be attended to, but they also charge much higher fees for tests and medications. If your emergency includes broken bones, burns, or open wounds that need stitches, then an urgent care facility can be a better option.
3-Record Accurate Health Information
Avoid going through any unnecessary procedures or tests by providing accurate medical information as soon as they ask you. Keeping a record on you at all times will help with this if your history is complicated. Your record should include any current or previous diseases, medications you’re currently on, family history, allergies, previous surgeries, and other medical information.
4-Keep All Your Cards with You
Whether the emergency concerns you or one of your family members, always keep your cards on you. You never know when an emergency will take place, so be prepared by having access to them whenever you’ll need them.
5-Understand Your Rights
Whenever you seek an ER, they’re legally required to provide immediate medical care – regardless of whether or not the hospital or care facility is included in your medical insurance coverage network. You don’t need to get approval beforehand either. However, this is only limited to life-or-death medical situations; only those which are critical and urgent. If it’s not, make sure to check with your primary doctor first.
6-Are These Tests Urgent?
Your health insurance will cover the basics of your treatment; the medical procedures and a limited number of hospital overnight stays. It can also provide additional coverage for the tests and prescription drugs depending on your insurance provider, but there’s a catch. If you seek treatment in an out-of-network facility, many of these tests might not be covered. Add to that the fact that they charge higher fees for tests and procedures, it can be wiser to inquire about the urgency of these tests. If they can wait, then you better seek in-network facilities to perform those tests under coverage.
7-Go Over Your Bills
In the case of a true medical emergency, your insurance will kick in to cover the costs, even if you’re treated in an out-of-network facility. However, you might find that you’re charged out-of-network prices for certain services done by physicians out of your network. You’ll have to pay for them on the spot in most cases but keep the bills with you and submit them to your provider to get compensated.
Medical emergencies happen out of nowhere, so the least you can do is to be prepared to handle its financial aspect. Make sure you understand what’s covered and what’s not in your current healthcare plan. Always consider your options of treatment, the tests and procedures required, and any additional costs you might have to cover yourself.