Yes, it is possible to avoid some surprise medical bills. Really? It will take some work on your part, but it is certainly worth your time to closely investigate any medical care, whether preventative or otherwise, to manage your health care expenses carefully.
Don’t assume anything. While your doctor make be acquainted with the parameters of your health insurance, coverage changes. Often. What make have once been covered, may no longer be a part of the plan. This means that you will have to research all components of your plan before embarking on any health care journey.
Let’s start with preventative care. While the ACA does mandate that an annual physical be covered, it is possible that not all parts of your examination will be included. Once again, what is and isn’t included depends upon your own health insurance. Doctors use six digits codes to identify the service provided. Should you suggest something specific, then the ensuing treatment may not be considered part of the physical. In addition, what may be viewed as a comprehensive office visit may not be 100% covered.
While many preventative screenings are covered by insurance, be careful when you undergo what may seem like a preventative treatment. For example, if you are scheduling a colonoscopy and have had one before, you should review the upcoming procedure with your doctor. Depending upon the results of your last procedure, this colonoscopy may be considered diagnostic, not preventative, and may not be covered by insurance.
A key component of medical care is blood work, from both a preventative and a diagnostic standpoint. It also can be a considerable expense. Many doctors prefer one lab over another, and will use that lab unless told otherwise. You may also need to go to a facility outside of your doctor’s office to have the blood drawn, with the results sent to the doctor. Don’t hesitate to remind your doctor which lab is in your plan.
Should you require surgery, it is absolutely critical that you investigate every last service that will be a part of the procedure. There has been some media attention given to anesthesiologists, and the fact that they are often not in-network providers for surgery at an in-network facility. In addition to checking on the physicians that will participate in your surgery, double check the facility, especially if it’s a surgical center. Don’t be afraid to ask for confirmation in writing. Also question whether there is a facility fee attached to using the surgery center. These fees are often not covered.
Don’t wait for legislation to address surprise medical bills. You’ll be waiting a long time. Own your health care.