Claim Information

Claims Help, Financial Help, and other Cost Savings ideas
As agents, we can help you with claims, and financial help, where available.  Most people with health insurance, or Medicaid, or Medicare, typically have low or reasonable out of pocket expenses, in addition to their monthly premium.  Some plans pay more than others, but premiums are usually higher.  There are ways to estimate your costs in advance of services.  Below are some ideas that may help you save money with premium, or out of pocket expenses;  

• Healthcare BlueBook.  This site provides the approximate member cost for in-network services
  
• Health Savings Account Health Plans allow consumers to pay for qualified medical expenses tax-free.  Read more here.
• Understand how your benefit programs work and read your benefit summaries 
• Use Preferred Providers whenever possible
• Use Preferred "National Providers" when out of your carriers immediate service area. Check for health plan national networks here.
• Make sure all providers have your complete current insurance carrier information
• Check your bills carefully, and review all of your Explanation of Benefit reports
• Negotiate final bills directly with hospitals, providers and diagnostic providers whenever possible
• Check for eligibility for the Advanced Premium Tax Credit here.
• Employers may be eligible for the Small Business Health Care Tax Credit.  Check here.
• Check for financial assistance.  If you are within 200% of the federal poverty level, hospitals may write-off your medical bills as charity care.  If you are within 300% of the federal poverty level, then hospitals may help with some of your medical bills. Calculate your % of fpl here.
• Payment arrangements are usually available.  Try all financial assistance options first.  If you make payment arrangements, and then find out later that you may have qualified for relief, you may be asked to stay with your original payment arrangement.
• Understand the appeal process.  If you find charges greater than what you see on www.healthcarebluebook.com, then you can inquire at the plan
• Keep your paperwork together and take notes.  Write down the names of the people you talk with and their phone numbers.
• Do not delay responding to medical bills, because medical providers will send bills to collections.  Additional relief may be available due to the virus.
• Make sure to get pre-determination for medical or dental treatments whenever possible
• Discuss scheduled surgeries or complex medical treatments with your insurance carrier prior to service
• Contact your agent if you need assistance