Get The Most... After You're Insured
Her are a few suggestions on how to get the most from your insurance policy, if needed.
1. Take A Moment To Review Your Policy.
Quality health insurance coverage is never cheap. You owe it to yourself to take a few moments review your coverage, its requirements for use, limitations, etc. Be sure you understand how best to use your coverage if needed (such as "Pre-Certification").
2. Be Aware Of Any "Pre-Certification" Clause Or "PPO" Network
Many temporary health insurance policies contain a "Pre-Certification" or "Pre-Notification" clause. Simply put, this says that you must notify the insurance company prior to hospitalization or other large anticipated medical claims. Failure to do so could reduce your coverage.
Pre-Certification enables the insurance company to be sure that you receive adequate and appropriate care, to pre-negotiate fees and charges, and to arrange for payment.
Check to see if your short-term health insurance plan uses a "PPO" network. If so, use the PPO medical providers in all but emergency situations. A PPO doctor or hospital will usually contact the insurance company on your behalf. However, you should double-check, as it is your responsibility the insurance company is contacted for Pre-Certification purposes.
Exception - a medical emergency: In a medical emergency, seek treatment immediately. Then you or a representative should contact the insurance company ASAP. Consult your insurance policy for details.
3. Hospital Emergency Room Visits.
Hospital emergency facilities are often convenient and especially so after normal business hours. But typically, your health insurance will not pay for expenses incurred during a hospital emergency room visit which is not of an emergency nature.
*In a medical emergency, seek immediate treatment at the nearest appropriate facility.
Here is a general definition of a medical emergency: a medical condition manifesting itself by acute signs or symptoms which could reasonably result in placing a person’s life or limb in danger, if medical attention is not provided within 24 hours. (Usually, symptoms are sudden and unexpected.)