Health Insurance That Does Not Follow Their Own Rules

health insurance doesn't follow its own rulesHealth insurance has been in the news extremely often lately and very little of the news has been good.

Between rising healthcare costs and the Affordable Healthcare Act (ACA or Obamacare), our healthcare in this country gets more complex every day.

Our news about health insurance isn’t good either.

Unfortunately, Tori and I have recently fallen victim to our increasingly complex healthcare system.

Here’s what happened to us and how you can prevent it from happening to you.

If we spare just one person from paying more than they should for healthcare, we’ll be glad we shared our story.

How We Overpaid For Healthcare Due To Health Insurance

We’re fortunate that both of our employers offer halfway decent healthcare options at somewhat affordable prices.

Unfortunately, Tori’s health insurance has failed us in a pretty basic way.

Tori has two health plans to choose from each year and this year we decided to go for the higher premium but lower out of pocket cost option. Sadly, it appears that we have not been getting the lower out of pocket costs we expected.

Ultimately, the error is due to Tori’s health insurance but we cannot pass all the blame onto them. We have not paid attention to the details of Tori’s plan. Instead, we have just blindly trusted the insurance and providers to bill us according to her healthcare plan. Never, ever do that. Do not make the same mistake we did.

It appears that Tori’s insurance provider has sent her a bad insurance card. Listed on that bad insurance card are co-pays for various services that we have used so far this year, such as doctors appointments. The copays listed on the card do not match the amount her plan should cost.

Naturally, the co-pays listed on her card are higher than what she should be paying  and the medical providers have charged us these higher co-pays. So far, we’ve determined we have paid about $100 more than we should have for medical services.

We’ll be doing a more detailed analysis of the services we have paid for so far this year and compare them to what we should have paid based on her plan documents. This is a very complicated process, but our employers both offer programs that may be able to help us that very few people ever use.

Employee Assistance Programs Rock

Many companies, ours included, offer employee assistance programs or patient advocate services that can help you sort out your medical bills to make sure you are paying what you should.

We plan to contact these services in the coming days to see what they can do to help us get refunded the amount of money we know we are owed and to see if we should be refunded for any other costs we may have overpaid but missed.

Thankfully, we’re not out a lot of money. We caught the error early and we’re hoping to get it fixed and get refunded the amounts we have overpaid.

The question is, where do we go to get refunded? Do we have to go to the service provider and ask for part of our copay back? Do we have to dispute something with our health insurance company? We don’t have the answers yet but will update you all once we find out.

This is just another reminder that no one will look out for you or your money more than you will yourself. If you aren’t aware of important information, like what your co-pays should be, you could be getting overcharged for your healthcare, too.

This doesn’t just apply to healthcare, though. Many service providers may be over billing you and you simply aren’t paying attention.

Cable providers are notorious for sneaking in extra fees or raising rates. Your cell phone bill may be full of hidden charges. (Tori uses Republic Wireless which has an awesome rate plan and no extra fees.) It is so important you read and understand every bill you pay.

We will now be adding another bill to the list of bills we read line by line, any healthcare bill we ever receive. Don’t let this happen to you. Educate yourself about your health insurance plan today.

Have you ever had something like this happen to you where you ended up overpaying for healthcare? Whether you know it or not, I can almost guarantee every single one of us have. If you have a story, please share it in the comments below so we can all know what to look out for and how to prevent it next time.

Image by: Images_of_Money Text added by: Lance Cothern

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About Lance Cothern

Lance Cothern, a Certified Public Accountant (CPA) licensed in the Commonwealth of Virginia, is the founder of Money Manifesto. You can read more about him here or connect with him on Facebook, Twitter, Google+ or Pinterest.

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