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Get The Most
Information for Short-Term and Intermediate-Term insurance buyers. |
| 1. Be Aware Of
The "Pre-Certification" Clause In Your Insurance
Contract. |
|
Nearly all 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 dramatically, so we emphasize
that you and all family members be aware of this provision.
Pre-Certification enables the insurance company to be sure
that you are receive adequate and appropriate care, to
pre-negotiate
fees and possibly to arrange for payment.
When using a Short-Term or Intermediate-Term insurance plan, it is your responsibility
to contact the insurance company for Pre-Certification, or to be sure
that your doctor contacts the insurance company on your behalf.
Failure to pre-certify with the insurance
company usually results in a severe reduction of benefits. A simple rule of thumb is
if in doubt, contact your insurance company.
Exception: a medical
emergency: In a medical emergency, seek treatment immediately.
Then you or your representative should contact the insurance company
ASAP or
within 48 hours. Consult your insurance policy for details.
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| 2. Take A Moment To Review Your
Insurance 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
above).
People often focus on what is covered. However, policy
exclusions (what is not covered) could be equally as
important. Take a few moments to review your policy when it
arrives.
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| 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.
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, the
symptoms are sudden and unexpected.)
In a medical emergency, seek immediate treatment at the nearest
available facility.
If it is not a medical
emergency, but you want
to see a doctor ASAP, call your family doctor regardless of the
time - day or night. (Most doctors work with other doctors to
maintain a 24-hour on-call arrangement.) If you don't have a
family doctor, check your telephone book for "Urgent
Care" or "Walk-in" medical clinics. These types
of facilities often have expanded business hours and some are
open 24 hours.
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4. Ask
For A "Cash" Discount. |
|
If you need to see a doctor while on
Short-Term
health insurance, we suggest that you always ask (when making the
appointment) for either a "PPO" or "cash"
discount. It is possible - even likely - that you will save
20% or more on your doctor office visit.
You will rarely see a fee schedule
posted in a doctor's office. Here's why.
Fees vary
from patient to patient, depending on the type of insurance and
how the bill for service will be paid. A doctor's office should
offer you their lowest office rate because:
-
The doctor's office will be paid at time of service.
-
They will have no
insurance paperwork to handle.
Explain that you will pay by cash
or credit card at time of visit (most likely anyhow, unless you
have exceeded your deductible) and that you will file your own insurance
claim. Most doctors' offices will
happily agree.
Note: the
Temporary
(or Intermediate) Health insurance offers you access to a PPO Network, so
no negotiating is required if you receive covered care "within
network."
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Questions? See FAQ,
or E-mail Us,
or call us USA toll-free: 1-888-227-9449. |
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