Thursday, December 16, 2010

Never had health insurance before, really dumb on the subject?

I just singed up with health insurance that also provides dental. I haven't seen a doctor in 13 years (since i was 8), so i am extremely ignorant to the process. Do i just go to the doctor and show them my card? Do I have to file a claim every time i see a physician or dentist, and is the copay all i have to pay up front, or do i have to pay the full bill and get reimbursed later? Also what can i do to prevent myself from obtaining charges that i was unaware about?
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Your first step is to select a doctor who is in network for you, that means they accept your insurance and are contracted at a discounted rate. Any network physician will file your claims for you, 99% of all practices now file claims on behalf of the patients. In a physicians office you will only pay the copay upfront. Now sometimes you will still have a small amount left over depending on your coverage for injections, blood draws, immunizations, ekg's or any extra procedures in office. If you only see the doctor with nothing else done, then it is just the copay. Now a dentist is different, the amount will depend on what your having done and your policy. Most policies pay for routine cleanings every 6 months with no copay. Any other dental work is usually a percentage of the service. Again make sure you use a network physician. It is impossible to avoid all unknown charges, it all depends on the scope of your policy, your deductibles and how much of a discount you get through your insurance policy. It may all seem overwhelming, but you will get the hang of it. Just always read your explanation of benefits and ask questions when confused.
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