Do I really have to read my whole health insurance policy?
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Dr. Mehmet Oz answered:Don't assume a health insurance policy is adequate because you have confidence in the insurance company; every policy is different, and if the wording in yours leaves you without a pot to…cook in, the caliber of the company may not mean a thing (you signed on the dotted line, didn't you?).
To make sure you know the ins and outs of your policy, you need to read that entire insufferably boring booklet with all the policy rules and limits and bylaws and heretofores and therewiths. Get it from your human resources department or the insurer. If it makes it more enjoyable, read it aloud and set it to song.
Find out more about this book: YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatmen...
Don't assume a health insurance policy is adequate because you have confidence in the insurance company; every policy is different, and if the wording in yours leaves you without a pot to…cook in, the caliber of the company may not mean a... More -
Betty Long, RN, MHA answered:Prior to delving into the legal mumbo-jumbo of your 'official' policy and running the risk of not understanding a darn thing, there is a document called the "Benefit Plan Summary" or "Benefit Summary Plan." Either way, it is---and should be---the 'easy to read' high-level version of what is and what is not covered by your health insurance plan.
Typically, the summary is presented in columns, one column being 'in network' benefits and the other being 'out of network' benefits (if any).
As Dr. Oz answered, you can request this document from the Human Resources department at your employer or by calling the Member Services department at your health insurance company. Don't be surprised if they direct you to their webpage to find it. Ask the representative if they can give you the specific URL so that you don't spend all afternoon on the internet trying to find it.
Prior to delving into the legal mumbo-jumbo of your 'official' policy and running the risk of not understanding a darn thing, there is a document called the "Benefit Plan Summary" or "Benefit Summary Plan." Either way, it... More
