Health insurance is a needed and welcome security blanket protecting you from high medical bills. Paying the ever-increasing premiums is not fun, but the protection that the insurance provides is critical when something actually does go wrong - an illness, an accident, or an unfortunate diagnosis.
Dealing with insurance is no fun.
Insurance companies are quick to collect your premiums, but they may be slow when it comes to paying out claims. Dealing with a large insurance carrier (and also health providers) means having to understand cryptic medical codes, confusing bills, plus long hold times if you attempt to talk to an actual person.
Can the process be made more simple?
You can’t control what goes on at the insurance end, but you can take some steps on your end that will make getting your benefits easier:
Know where your policy is and keep the contact information for your agent and the insurance company handy. Make sure your family knows where to find the information, too.
Keep your insurance card with you at all times.
Contact a lawyer and set up a trusted family member or friend with the durable power of attorney - just in case you need someone else to make a health decision for you.
Make sure that claims get filed in a timely manner. Claims have deadlines for filing. Plus, the sooner a claim filed, the sooner it’ll be paid.
File medical records in a safe spot so that you’ll have them when needed to file or dispute a claim.
If you get “no” for an answer, be persistent and don’t give up. Provide relevant documentation. Get your phyisican to provide a statement backing up your claim if necessary. Follow up emails with calls, and vice-versa.
Take really good notes, stating the date, time and name of the representative with whom you spoke. Don’t be afraid to ask “Is this call being recorded?” and also “Is this the correct number I should call about my claim?” If not, get the proper number and begin again with “Is this call being recorded?”
Contact a lawyer if necessary. Not just any lawyer, but one who knows how to litigate against health insurance companies.