In a time of flux in healthcare policy at the federal and state levels, consumers need guidance in steering through the complexities of the healthcare system.
The new presidential administration may bring changes in the new year, but changes also may come from your own healthcare plan as the new plan year begins. It is important to check your plan documents for changes in your copays, deductibles and network participation of doctors and hospitals.
Regardless of how public policy, healthcare systems and insurance plan designs evolve, healthcare and insurance costs will continue to be significant factors in consumers’ personal budgets. While there is much that could be said about using health insurance benefits and managing medical and dental costs, five simple tips can go a long way toward clarifying what is most important to remember.
Key to the tips is the concept of the provider network: the group of all doctors, hospitals, laboratories and other healthcare providers that agree to accept an insurer’s contracted rate as payment in full for their services.
Regardless of the type of health plan — for example, a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO) — there is almost always a strong financial incentive for the consumer to use in-network rather than out-of-network providers.
By: Robin Gelburd
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