Have you ever read an explanation of benefits from your health insurance carrier and thought “What did I just read?” You’re not alone. Sometimes it’s difficult to sift through the jargon of what’s covered and what’s excluded from your health plan and before you know it, you’re thoroughly confused about whether or not a procedure,a doctor’s visit or a hospital stay was fully or partially covered, or in some cases, not covered at all.
This is often a frustrating experience, though many of us have no idea about the way benefits work and what is covered and not covered by our current health insurance plan. And before you break out that checkbook you want some answers.
So, who can you turn to when your uncertain about your benefits?
Fortunately, you have a few options: One is to talk to your organization’s human resources (HR) professional. Human resources personnel are responsible for many duties at your organization, including managing your companie’s health insurance plan for its associates. While they may not be able to help you to the level that an insurance provider’s customer service staff can, an HR professional can answer basic questions about the types of services covered under your health insurance plan and offer insight into your current situation.
The second and best option is to talk with someone who works for your health insurance provider. Most likely your insurance provider has qualified customer service staff who specialize in deciphering insurance speak and can efficiently and clearly communicate the extent of your benefits to you via phone or by sending a more detailed explanation via fax or mail. Contacting your health insurance provider’s customer service staff is the best choice, as they will know the ins and ou