The best way to make the optimum use of your insurance is to stay informed all the time. This can be done in the following way:
- Reading the handbook of the Health Insurance Policy in spite of being briefed from the insurer
- Understanding the information on benefits coverage and limits as because summaries would never be sufficient regarding that
- Reading magazines or newsletter on the plans is important source of information on its working
- Health benefit workers know more than common people so talking to them also helps
- It is important to know how the plan will inform client about any changes while still in the plan
One should take charge of their ‘Own Health’ and its insurance by:
- Doing regular screenings with the help of doctors
- Changing the lifestyle so that certain risks might be avoided
- Understanding one’s own health by asking questions to doctors
- Instructions by doctors are to be properly understood so that you can follow the instruction
- Any problem regarding the instruction should be properly cleared out from the respective physician so that changes can be made before hand
People should keep track of their own health issues like:
- Keeping a log of any symptoms that you are suffering recently which can help your doctor in better diagnosis of the disease
- Each family member should have their own health files with histories of illness, shots, treatments and hospital visits written on it
- Paper work for all the drugs as well as lab reports of all the tests suggested by the doctor or ever taken for any reason should be kept by the patient
There are certain steps to get optimum care from any health plan. They are certain question that needs to be known like:
- What are the working hours for the different medical care offices?
- What happens if a patient needs care after the working hours?
- How can any appointments be fixed?
- How much a patient has to wait before receiving services from medical care?
- Where are the tests for done? (Doctor’s office or laboratory)
- Who will attend you for your medical care? (Primary doctor or Nurse or Assistants to Physician)
- If there is any service numbers available? There are some hotline toll free numbers where services are available for some health problem and you need not go to doctor for each and every problems
Hospital care available for emergency cases is different from normal case. Usually except for emergency you need to have prior approval from primary doctor. Otherwise the whole cost of the service have to paid by the client. There are some of the queries that needs to be handled like:
- Which hospitals form part of the insurance plan?
- Whether there is any limit to the number of days a person can stay in a hospital?
- Who takes the decision of discharge from the hospital?
- Whether the cost of follow up treatment is covered by the insurance?
- If any serious medical problem arrives then who takes care of the need and who provides the care?
- If opinion of any other doctor in case of treatment or surgery is needed then how does the plan cover it and also whether it is encouraged within the plan or not?
Emergency care needs to be handled in a different way of its own. This is because for emergency patient, care is needed much faster. Hospital needs to be located near to the place of occurrence. As such it is important know what kind of medical problems are defined to be emergency. Sometimes you are transferred to the network hospital after the condition stabilizes. The emergency requirements are informed and should be informed to the plan within a time frame. Some queries here that are frequently faced are:
- What is emergency care and what conditions are included within the emergency care?
- After normal duty hours how are emergency cases handled?
- What needs to be done if the emergency care is needed outside the area?
For dissatisfaction regarding the care or service offered within the plan the insurance agency needs to be informed. Records regarding the whole service are to be properly kept so that in case of such problems the agency can be noted in an official manner. Dissatisfaction with plans or doctors or hospitals can be made and changes can be made. Most insurance plans have keeps options for appeals from both the doctor’s and the clients’ side in case of any disagreement.