Today’s Tidbit Tuesday: Understanding Your Insurance
Recently, I discussed the importance of knowing your insurance, but I feel it’s necessary to dive deeper into this topic. In my experience, I have found that many people believe that having insurance means that everything is covered, which is not always the case. Let’s break it down.
- Premiums and Coverage
- When you pay a premium for insurance—whether it’s health, homeowners, or auto insurance—it doesn’t mean all costs are covered. Every insurance plan involves some level of cost-sharing:
- Deductibles: The amount you pay out-of-pocket before your insurance starts to cover expenses.
- Copays: A fixed amount you pay for specific services.
- Coinsurance: Your share of the costs of a covered service, calculated as a percentage.
- Common Misconception
- One major area of confusion is the belief that all wellness-related services are fully covered.
While many wellness services are covered, this only applies if you stay in-network.
- For example:
- Annual checkups: Typically covered if done by an in-network provider.
- Pap smears: Typically covered if both the visit and lab processing are in-network.
- Cancer screenings: Typically covered if they are preventive screenings.
- Procedures vs. Wellness Services
- Understanding the difference between preventive services and procedures is crucial. If a service shifts from preventive to procedural, costs can increase significantly.
- Consider these scenarios:
- Dermatologist: Routine skin check might be covered, but mole removal might not be.
- Colonoscopy: A screening colonoscopy is covered 100% if in-network. However, if polyps are found and need removal, this becomes a procedure with additional costs.
Key Takeaways
– Always verify your healthcare providers and labs are in-network.
– Understand what services are covered under your wellness benefits.
– Be prepared for additional costs if a preventive service turns into a procedure.
Understanding these aspects of your insurance can save you a lot of money and frustration. Always review your plan details to know what is covered and what you can expect to pay.
If you have questions please feel free to reach out to me.
