Hospital Insurance Concerns

Hospital insurance is a major concern for everyone. You may be wondering if your medical care will be covered by your insurance policy and if all the costs by laboratories, doctors, hospitals and other services will be covered. The short answer is that almost every item will probably be partially covered, and that those percentages covered will be different for different items.

Yes, keeping track of this is going to be a nightmare! Say it and try to get over it. We know it can be very tricky trying to keep track of who got paid, or will get paid. Even accountants can get lost dealing with this.

But we will take it one step at a time and you'll see that it can all work out. Remember that thousands of other people deal with their medical insurance every day and they come out OK.

How to Reduce Medical Costs

We know that cancer treatment can be hugely expensive and we will write more essays about how to reduce medical costs, like getting drug companies to provide their medications to you at greatly reduced prices, sometimes even for free! You can write to us by clicking here, or use the form to the right to give us your email address and we'll put you on our newsletter list to send you updates as we write them.

Each insurance policy is different. Take the time to understand your insurance policy NOW. The amount of coverage your plan provides varies. Coverage depends on:

• your insurance company
• the amount of coverage that is part of your healthcare benefits package
• your specific policy

Find out About Insurance Coverage

Don't rely on what someone told you was covered by their health care insurance. You don't want to learn that your hospital insurance doesn't apply to the facility treating you or the treatment you are receiving - after the treatment has started. You don't want to be obligated to pay out of your pocket.

To find out the details of your hospital insurance and health insurance policy, contact the Customer Service or Member Services Department at your insurance company (the phone numbers are on your insurance card or in your benefits book). They should be able to tell you about your coverage and what your financial responsibility will be for your desired treatment center.

Many treatment centers have financial counselors who will work with you, your physician, and your insurance company so that you can receive care at their facilities. These counselors can help you verify your cancer insurance coverage, answer billing questions, and help address any concerns you may have.

Let's get ready to talk to your insurance company

Get paper and pen or pencil so that you can take notes during the conversation. Don't worry about using up the person's time while you take notes- they really want you to understand and get it right - that's what they are there for.

Write down the name of the person who gives you the answers and the date you speak with him or her.

If the person you start talking with transfers you to someone else, get that name also. Make a note of who answered what questions.

After you write down the answer to a question, read it back to the person. This will help make sure that what you've written is correct.

Use the following questions as a guide when you talk to your insurance company about your coverage options.

Questions to Ask Your Insurance Company

1. What type of insurance plan do I have?
2. Is the hospital, clinic or treatment center in my network? If so, here are some follow-up questions to ask:
   • Does my insurance plan cover physician costs, as well as inpatient and outpatient hospital services?
   • What, if any, are my co-payments?
3. My hospital, clinic or treatment center is not in my network, but my plan has out-of-network benefits.
   • If I choose to go out-of-network, what do I have to pay?
   • What is the amount of my deductible?
4. If I go out-of-network, what percentage of my bill will be paid by the insurance company?
5. Does my policy have an out-of-pocket maximum? (This is the maximum amount that you are required to pay toward the cost of your care)
6. Before I see a doctor at the hospital, clinic or treatment center,
   • Do I need a referral from my primary care physician?
   • Will I need authorization from you (my insurance company)?
7. If I need an authorization from you, how do I go about getting it?
8. Will I be covered for any testing, pathology, or radiology charges that may be incurred as part of my initial consultation with my hospital, clinic or treatment center doctor?
9. Will I need any authorizations after I've seen the doctor,
   • Before starting treatment?
   • During treatment?
10. Is the percentage of my bill paid by the insurance company based on usual, customary and reasonable (UCR) schedules or on the actual charges?
11. If my out-of-pocket expenses reach a certain amount, will the insurance carrier ever reimburse at 100 percent?
12. If so, does this mean that my claims will then be paid in full, or will I still be responsible for the difference between my hospital, clinic or treatment center's charges and usual, customary, and reasonable (UCR) rates?
13. Does my insurance plan offer any additional coverage through special networks for treating medical conditions such as cancer?

We have covered a lot of topics and now you have a lot of questions to ask to make sense of your coverage. Some people set up file folders to hold all of the paperwork involved. This can help avoid confusion.

An example of confusion occurs when a treatment center sends you a bill, but doesn't really want you to pay it. The reason could be that the treatment center is waiting to get money from the insurance or other company. While they are waiting for payment, you might receive double or triple bills.

Remember that this is all about getting you healthy. No good medical treatment facility or doctor will stop treating you because the bills and payment get messed up. So take a deep breath and focus on learning all you can about how to get healthy again. The hospital insurance is important paperwork, but it will get done.

We will write more essays on this topic. Please click here to let us know what topics you would like us to write about.

Protect Yourself From the High Cost of Cancer

According to the recent studies, American men have a 44% chance of developing cancer while the chances for women are about 37%. The general risk of developing colon cancer in the United States is about 6%. For this reason, it's important for everyone, particularly people above the age of 50 years, to go for routine screening.

Whether discovered early or late, cancer is a debilitating disease due to the care, costs and the mental and physical trauma involved. Many times the cost of treatment leaves the patient in heavy financial distress.

Most insurance plans do not cover the total cost of the treatment, which leaves the patient and their family in a lurch. These days people have started purchasing supplemental cancer insurance that can help in covering otherwise uninsured expenses related to cancer illness.

Written by Deborah Theres - 2/24/09

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