Guide Posts of Strength
Click any sign on the guide post to read Key Information.Health Insurance Specialist
Judy Pollock
Emerywood Hematology / Oncology, High Point, NC

If you think you understand your health insurance coverage, just wait until you are diagnosed with cancer. Suddenly you have to be fluent in lingo like “net individual family out-of-pocket” expenses, “EOB” and “preauthorization.” You also have to thoroughly understand invoices, provider negotiated discounts and patient co-payments.

Cancer care is expensive and those expenses are a big fear. Understanding exactly what your payment responsibilities are will ease your worries.

Judy Pollock has worked face-to-face with cancer patients and one-on-one with their health insurance providers for over a decade. It’s her job to help patients understand how their health insurance will cover their cancer care. She tracks insurance claims, investigates denials and initiates the appeal process when necessary.

“I have found that many people do not fully understand their insurance policies,” Judy observes. So Judy is happy to have the opportunity to take cancer patients and their families on a “guided tour” of what you need to know about your health insurance coverage if you are diagnosed with cancer.

Key Health Insurance information:

The first and most important tip is to bring your most current health insurance card with you to your doctor’s appointment. If you don’t have that card in your wallet, find it and keep it with you – you will be using it a lot and you don’t need the stress of fumbling for the card.

If you can’t find your current insurance card, call your carrier and get a new one sent to you – you need that card now more than ever.

Please note: Make sure you know the password to access your health insurance information online. You may want to keep a list of those websites, usernames and passwords. Stress can make it difficult to remember this information so it’s important to keep that information accessible.

Receipts – keep every single one – even the receipts for co-payments. If there is a discrepancy and you think you have paid but don’t have a receipt, it will be hard to prove. If the person you pay does not offer a receipt, ask for one.

And this brings up another important tip – put all of your medical receipts in a special folder or envelope so you don’t have to search the house to find receipts, invoices, EOBs, etc. Keeping the insurance and billing information organized will help you feel more comfortable. Chaotic recording keeping will just make you feel more out of control.

If, at any point, you don’t understand your bills, call the billing office from which they were issued. Someone there will be glad to review the information with you.

If managing your insurance and bill coverage online is not up your alley, let a family member or a friend help you with this. Let people help you – and most of us know someone who is savvy with the computer.

Know Your Policy

Learn everything you can about your insurance coverage. If you have Internet access to your insurance information, use it. If you haven’t become familiar with the online information (and don’t worry if you haven’t – you are not alone), now is the time to learn how to access your insurance information and navigate the site.

If you have Medicare and supplemental policies, go through that information and learn the details of your coverage.

Do you have a flexible spending account?

  • If you do, make sure you know who to contact about that account, how to file for reimbursement and where you are in your spending and reimbursement for the year.
  • Most providers can help you print out a summary and help you file new claims. Some providers even have an automatic payment filing and payment system and that will save you a lot of work. But you have to authorize the company to do this.

Do you have any changes to your insurance status? A new address? A change of marital status? A new child?

Are you eligible for Medicare? If so, you need to talk with your insurance provider about the choices available to you now that you have cancer.

Do you have a cancer policy? If you do, take it out and review it with the company. Also tell your physician’s billing office about the cancer policy and they will help you figure out how the policy will help with your expenses.

Ask For Help

Remember: There are NO stupid questions.

Many medical offices have a person who coordinates insurance claims so see if your doctor’s office has a staff member who can answer your questions.

Also realize that your insurance company has staff members who are paid to help you with your insurance questions.

All you have to do is ask for help. So where do you start? Here are some questions to ask:

  • What does my health insurance cover?
  • What is my co-pay for office visits, lab tests, surgeries, hospital charges?
  • What is the out-of-pocket maximum amount I will have to pay?
  • How much more do I have to spend to reach that amount?
  • How do I find out how much the insurance company will pay for a certain test or procedure?
  • What is an explanation of benefits (EOB) and how do I read it?

Links / Apps

For information about specific health insurance providers, visit:
www.humana.com

www.bcbsnc.com

www.uhc.com

www.medicare.gov

www.medicaid.gov

www.aetna.com

www.cigna.com

www.wellpathchp.com

www.shpnc.org

www.tricare.mil

For definitions of frequently used insurance terms, check out this glossary from the National Association of Insurance Commissioners.

Or: the Insurance Information Institute Glossary.

Key Info Know Your Policy Ask For Help Links and Apps

 

Key information

The first and most important tip is to bring your most current health insurance card with you to your doctor’s appointment. If you don’t have that card in your wallet, find it and keep it with you – you will be using it a lot and you don’t need the stress of fumbling for the card.

If you can’t find your current insurance card, call your carrier and get a new one sent to you – you need that card now more than ever.

Please note: Make sure you know the password to access your health insurance information online. You may want to keep a list of those websites, usernames and passwords. Stress can make it difficult to remember this information so it’s important to keep that information accessible.

Receipts – keep every single one – even the receipts for co-payments. If there is a discrepancy and you think you have paid but don’t have a receipt, it will be hard to prove. If the person you pay does not offer a receipt, ask for one.

And this brings up another important tip – put all of your medical receipts in a special folder or envelope so you don’t have to search the house to find receipts, invoices, EOBs, etc. Keeping the insurance and billing information organized will help you feel more comfortable. Chaotic recording keeping will just make you feel more out of control.

If, at any point, you don’t understand your bills, call the billing office from which they were issued. Someone there will be glad to review the information with you.

If managing your insurance and bill coverage online is not up your alley, let a family member or a friend help you with this. Let people help you – and most of us know someone who is savvy with the computer.

Know Your Policy

Learn everything you can about your insurance coverage. If you have Internet access to your insurance information, use it. If you haven’t become familiar with the online information (and don’t worry if you haven’t – you are not alone), now is the time to learn how to access your insurance information and navigate the site.

If you have Medicare and supplemental policies, go through that information and learn the details of your coverage.

Do you have a flexible spending account?

  • If you do, make sure you know who to contact about that account, how to file for reimbursement and where you are in your spending and reimbursement for the year.
  • Most providers can help you print out a summary and help you file new claims. Some providers even have an automatic payment filing and payment system and that will save you a lot of work. But you have to authorize the company to do this.

Do you have any changes to your insurance status? A new address? A change of marital status? A new child?

Are you eligible for Medicare? If so, you need to talk with your insurance provider about the choices available to you now that you have cancer.

Do you have a cancer policy? If you do, take it out and review it with the company. Also tell your physician’s billing office about the cancer policy and they will help you figure out how the policy will help with your expenses.

Ask For Help

Remember: There are NO stupid questions.

Many medical offices have a person who coordinates insurance claims so see if your doctor’s office has a staff member who can answer your questions.

Also realize that your insurance company has staff members who are paid to help you with your insurance questions.

All you have to do is ask for help. So where do you start? Here are some questions to ask:

  • What does my health insurance cover?
  • What is my co-pay for office visits, lab tests, surgeries, hospital charges?
  • What is the out-of-pocket maximum amount I will have to pay?
  • How much more do I have to spend to reach that amount?
  • How do I find out how much the insurance company will pay for a certain test or procedure?
  • What is an explanation of benefits (EOB) and how do I read it?

Links / Apps

For information about specific health insurance providers, visit:
www.humana.com

www.bcbsnc.com

www.uhc.com

www.medicare.gov

www.medicaid.gov

www.aetna.com

www.cigna.com

www.wellpathchp.com

www.shpnc.org

www.tricare.mil

For definitions of frequently used insurance terms, check out this glossary from the National Association of Insurance Commissioners.

Or: the Insurance Information Institute Glossary.

 


Guide Posts of Strength