I always tell my customers to CALL ME with any questions about their health insurance coverage. As an insurance professional, I work with insurance companies every day so I know who to contact regardless of how complicated an issue may be. It is my job as their agent to take care of these matters for them.
If you don’t have an agent you can rely on for answers, here are a few tips to make the process of calling your insurance company a little bit easier:
1. Have all pertinent information handy, including your insurance card, your Medicare card (if you have original Medicare), billing statements from your hospital and/or doctor and your Summary of Benefits. If you are discussing a specific procedure, ask your physician for the diagnostic code he or she uses.
2. Familiarize yourself with the basics of your plan including your co-pays, cost of visits to specialists, out-of-pocket maximum and annual deductible.
3. Be prepared to take notes. Write down the date of your call, the name of the person you spoke with and what they told you. Ask if they can send their response via e-mail so that you can save a copy for your records. Many issues will require more than one phone call, so keeping records will prove helpful should you need to check back.
4. If the insurance company representative promises to get back to you by a certain date, note this on your calendar and be prepared to follow up then.
5. If the insurance company agrees to make an exception to their coverage rules, get that agreement in writing. The alternative is to record your conversation.
6. If you are calling on a parent’s behalf, be ready to put Mom on the line to let the insurance company know it’s okay to talk with you. If possible, set up a conference call including your parent on the call. If you will be handling your parent’s insurance matters often, find out what forms are required in order for you to represent them.
7. If you’re discussing complicated medical issues, ask to speak to a nurse. Many case managers at insurance companies are RNs who can be more familiar with medical issues.
If you take these steps, I think you’ll find the process of getting answers from your insurance company a lot less frustrating. And, if you prefer to have someone do the leg work for you as I do every day for my customers, give me a call to learn how you can become one of my customers.