Are you doubtful about your insurence agent? Here is a set of questions that you need to ask your agent to check out his or her credibility.
What will be my maximum yearly stop loss before I get 100% coverage?
Stop loss is the amount you are supposed to pay from your pocket before you receive complete coverage for the year. Usually, it's lesser than $5,000. There are some insurence companies that don't provide stop loss. Such insurers set limits for their payment during claim, but set no limits for your payment! There have been cases where people bought policy worth $5,000 to $20,000 of medical expenses and were stuck with no stop loss. So, be cautious!
How many deductibles am I supposed to pay?
Deductible is the percentage you have to pay during a claim. There are various deductibles such as therapy, laboratory tests, chemotherapy, separate accident deductibles, and others. However, some companies grab the opportunity to exploit clients through deductibles. For example, one company may consider therapy and testing, while the other may not consider it in the same process. And if your claim falls between the two, you may end up paying the whole bill. The wisest thing to do is have just ONE deductible. There are no voids in between and the company will cover everything as stated in the policy.
Is my deductible per year or per confinement period?
Some companies define deductive amount as "per period of confinement." They might fix 90 days as confinement period. For example, suppose your deductible is $2000. You undergo medical treatment within your confinement period. In this case, you will have to pay one deductible. If you are hospitalized on the 91st day with the same problem, you will have to pay another deductible, i.e., $2000! Suppose you are hit by another illness within the 90 days' period, apart from the first one, and need to take medical help, you will have to PAY $2000 AGAIN! This may turn out to be a financial catastrophe for you! Therefore, it's of utmost importance to clear things out with your insurence agent.
I have undergone medical treatment that is not covered in my policy and my insurer doesn't use networks, what's the amount I have to pay?
A policy that offers networks is good. Insurence companies and medical providers render "Network Pricing" to the customers. When you visit a network provider with insurence policy and you undertake a treatment that's not covered, you still get a substantial discount that your insurer would receive just because you are insured. Several companies offer national networks. The advantage is that even if you are out of town, you can avail your insurance benefit anywhere across the nation.
For the last question, if your insurence agent answers that you are supposed to pay the full retail price, he or she is genuine. In case the insurance company does not make use of networks, any other answer than this is deceptive.
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