Little mistakes can lead to large healthcare costs. And the worst part is that nobody tells you how you can avoid overpaying for health insurance. We believe that you shouldn’t have to be an expert to save money, so we’ve compiled a list of 12 common mistakes to help you steer clear of surprise bills and extra healthcare expenses.
1. Getting caught up in the terms. Understanding the terms that health insurance plans use is the first step to knowing just how much value your plan provides. One day health insurance providers might start using words that are easy to understand, but right now even the most basic health insurance terms can seem like a foreign language. That’s why we’ve provided simplified definitions of common health insurance terms below.
Premium: The monthly amount that you’ll pay for your health insurance.
Deductible: Insurance plans require that you pay a certain amount for healthcare services before they start footing the bill. So if your deductible is $2,000, then for most services you’ll pay 100 percent of your medical costs until that amount reaches $2,000. After that, your health insurance provider will start paying but you’ll still have some out-of-pocket expenses.
Copay: The fixed amount you pay upfront for a healthcare service, even if that service is covered by your health plan. A doctor’s visit might have a $30 copay, while a visit to the emergency room might have a $300 copay.
Coinsurance: The percentage portion of the bill that you must pay for any essential benefits you have received.
2. Focusing on monthly costs. Just because a health insurance plan has the lowest monthly costs, that doesn’t mean that it’s the cheapest plan. Sometimes a plan that has lower out-of-pocket costs and a higher monthly bill might be the most affordable option overall, depending on how often you go to the doctor and refill your prescriptions. It’s all about taking all of your healthcare needs into consideration.
3. Preventive v.s. diagnostic care. Thanks to the Affordable Care Act, your health insurance provider has to offer a large number of free preventive services. But there’s a difference between a preventive service and a diagnostic service. A breast cancer screening will be free but a follow-up visit or any lab tests will cost you.
4. Forgetting to use your health insurance plan’s perks. Most health insurance providers offer perks to their members in the form of gym membership discounts, fitness trackers, and free nurse hotlines. Using these perks won’t save you a ton of money, but some savings here and there can add up.
For example: Instead of rushing to the ER when there’s an injury, call your nurse hotline and they’ll let you know if it needs urgent medical attention or can be handled with simple home remedies. Do that a few times a year and you’ll end up saving thousands of dollars.
5. Not asking if your doctor is in-network. Avoid surprise bills by calling your insurance provider and healthcare facility before your visit to confirm that the doctor you’re seeing is covered by your health insurance plan. And when you are referred to another physician or to a separate facility for lab tests, you need to double check that they’re in-network, too. Unfortunately, you’ll have to do this often, but it beats overpaying for healthcare.
6. Failing to take advantage of tax credits. If your income falls within a certain range, then you’re eligible to get a discount on your health insurance bills through tax credits. Many people are able to use them to substantially lower their monthly health insurance costs. Read this article to figure out if you qualify to receive health insurance tax credits.
7. Forgetting to check the drug list. Oftentimes, health insurance providers will post the list of medications they cover on their website. But that list changes on a monthly basis so you’ll have to call to confirm that your medications are covered. This way, if your drugs aren’t covered one month to the next, you can have a plan in place to offset the costs through manufacturer’s coupons, like GoodRx.
8. Not asking for prices up front. You can call and ask how much a visit or a procedure will cost. Knowing this will help you avoid any surprise bills. Pro tip: Oftentimes, you’ll receive a discount if you pay with cash.
9. Paying before you get the EOB. A whopping 80 percent of medical bills are filled with errors. After a hospital or doctor visit, you receive a lot of paperwork. Avoid overpaying by waiting to pay your bill until your health plan sends you a document called an explanation of benefits (EOB). An EOB shows you 1) what service you received, 2) how much you were charged, and 3) how much your health plan paid.
Compare your EOB with the other paperwork you received to see if you can find any discrepancies between what your plan said it would cover, the actual healthcare service you received, and what your health plan paid for. It also helps to look out for duplicate charges, incorrect patient information, and canceled tests.
10. Failing to make use of free preventive care. It’s better for you and your wallet if you take as many preventive measures as possible with your health. Fortunately, the Affordable Care Act requires health insurance companies to cover numerous health screenings at little to no cost to you.
11. Procrastinating. We get it. Open Enrollment takes place during the busiest time of the year, making it easy to let signing up for health insurance fall through the cracks. But not having health insurance is just not worth the cost and sacrificing your peace of mind.
12. Not asking for help. You don’t have to deal with health insurance on your own. There are so many resources available to help you with every part of the health insurance process, saving you money and time.
And we’re more than happy to help you avoid all of these health insurance mistakes. Health insurance is complicated and time-consuming. We love using our expertise to make the system work for people like you. And we enjoy doing this so much that we do it for free (yes, really).
We explain it all here. And even if you don’t want to sign up for our services, always feel free to reach out with any questions you may have.