MANAGING YOUR INSURANCE - PAYING FOR MEDICAL CARE RECEIVED

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PAYING FOR MEDICAL CARE RECEIVED INSIDE/OUTSIDE THE USA

If you are receiving medical care in the USA, it is important for you to look on the web site of your present insurance company and find a healthcare provider in their network. This way you will receive the full benefit from your plan.

If you go to a provider in the company’s PPO network, that provider will call the insurance company to see if your insurance is valid. If you have not yet reached your deductible, often the provider will ask you to pay up front for medical care received. But in some cases they will bill the insurance company directly.

Generally the provider will take care of your medical needs and then invoice your insurance company for care received. Of course, the provider may ask you to pay up front and then you will be reimbursed by the insurance company; however, in most cases they will invoice the company. This is always better for you, for the insurance company will often re-price the bill, thus decreasing the charges of the medical provider. This will save you money. The insurance company will send you an Explanation of Benefits explaining how much the insurance company is paying your insurance provider.

If you have major surgery done overseas, the hospital will often call your insurance company. If the insurance company pre-certifies the surgery, the insurance company will often provide a “guarantee of payment.” If the insurance company does not do this, then you will need to pay up front.

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Health Insurance in the USA

"Jeff, I just wanted to say a quick "Thank You" for the newsletter, or "Quarterly E-Bulletin." I don’t know if this is all your work or a team, or you buy content, or just who puts it together; but I’ve gotta say it’s one of the few pieces of its kind that I actually *read* top-to-bottom. [The "Quarterly Bulletin" is written by Jeff, assisted by the GNI staff.]"

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(KD, California)

"Trish, Thanks so much for your follow-up on this. We actually got a check in the mail already, covering all the charges minus the $250 deductible. I was surprised and pleased that we got it so quickly! Thank you again for taking care of us. You have been extremely helpful, Trish."

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