- Keep Track Of Out-Of-Pocket Medical Expenses
- Keep Your I.D. Card With You In Your Wallet Or Purse
- If You Have A Choice, Balance Premiums, Deductibles, Co-Insurance, Stop Loss And Benefits
- Minimize Out Of Network Costs. For example, if You Agree To Surgery, Make Sure All Members Of Your Surgical Team Are Part Of Your PPO.
- Negotiate Fees With Out-Of-Network Health Care Providers
- Avoid Paying Money In Excess Of Usual, Customary And Reasonable
- Think Of Case Managers As A Resource
- Stay On Top Of Insurance Company Reimbursements
- Be An Informed Consumer When Purchasing Drugs, Tests Or Treatments.
- If You Smoke, Quit.
- If You Need An Off Label Or Experimental Treatment, Work With Your Doctor To Get Coverage
- Don't Accept A "No" From The Insurance Company.
- How To Choose And Maximize Use Of Doctors And Specialists
- Take Advantage Of Your Plan's Mental Health Benefits
- How To Keep Your Doctor When You Change Health Plans
- Insurance Policies Are Not Set In Stone.
How To Maximize Use Of A PPO Health Insurance Policy
The following guidelines can help maximize use of a PPO type health insurance policy. For information about each guideline, see the other sections of this article:
- Keep your i.d. card with you in your wallet or purse.
- Use in network doctors and other health care providers as much as possible.
- If you want to use out of net work doctors and other health care providers, learn how to minimize the amount you have to pay.
- Make sure you don't inadvertenly use out of network providers. For example, If you agree to surgery, make sure all members of the surgical team are part of your provider's network.
If your insurer has a case manager who helps coordinate care, consider him or her a resource for information and guidance. Try to make friends.
- Keep track of out-of-pocket medical expenses.
- Avoid paying money in excess of Usual, Customary and Reasonable.
- Be an informed consumer when purchasing drugs, tests or treatments.
- Stay on top of insurance company reimbursements.
- If you have a choice, balance premiums, deductibles, co-insurance, stop loss, lifetime maximum and benefits.
- Examine discounts for healthy living.
- If you smoke, quit.
- If you need an experimental treatment, work with your doctor. You may be able to get it covered by the insurance company.
- Don't accept a "no" from the insurance company. Appeal. Appeal. Appeal.
- Choose doctors and specialists with care. Learn how to maximize limited time with them.
- If your plan has mental health benefits, take advantage of the benefit. You don't have to continue if it isn't helpful.
- Learn how to keep your doctor if you change plans.
- Keep in mind that insurance policies are not set in stone. You can negotiate benefits - particularly if you can show what you need will save the insurance company money.