Advertisement

What should I know about an insurance company before joining?

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Be a sly detective and find out just how strong (or weak) that insurance company is before you entrust your life and sacred fortune to it. You can check it out by answering these questions: What does your doctor and her staff think of this insurer? Always ask for their opinions (the billing manager is your best bet). Ask them how well the company handles appeals process, and how quickly it pays claims. If the insurer is no good in this last category, it's no good. How is the insurer's record? Managed care plans are regulated by federal and state agencies. Indemnity plans are regulated by state insurance commissions. Phone your state department of health or insurance commission and ask about the insurer's record, and see if they've had any sanctions or bankruptcies. Have any of their clients hollered "Fraud?" Check out the National Association of Insurance Commissioners Web site (http://www.naic.org); you can check out individual companies by using the Consumer Information Source database. How does the insurer rate with the National Committee on Quality Assurance? Check its Web site at http://www.ncqa.org. An "excellent" score means that claim handling is superior to other insurers. Does the company offer at least two plans? Insurers who offer only one plan are shaky because they are blocking your ability to customize a program. Has the insurance company existed for more than 5 years? Half fail within the first 3 years, so think twice about going with a new company. Does the CEO have more than 10 years of experience in health care? If there's a network, by what criteria does the insurer choose its doctors? Similarly, by what criteria does the insurer choose hospitals in its network? Are most of doctors in the network clustered in a small geographic area, and have a narrow mix of specialties? What kind of treatments does the insurer consider experimental? Does it offer reps and nurses who speak Spanish or other languages, if that's an issue for you?
YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatment

More About this Book

YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatment

Everyone needs to become a smart patient. In fact, in the worst cases, your life may even depend on it. Number one bestselling authors and doctors Michael Roizen and Mehmet Oz have written this...

Continue Learning about Health Insurance

7 Questions to Ask About Health Insurance Before Taking a Job
7 Questions to Ask About Health Insurance Before Taking a Job
Congratulations on the job offer! Once salary negotiations have ended and you’re almost ready to sign on the dotted line, it will be time to delve int...
Read More
How does a health savings account differ from a flexible spending account?
RealAgeRealAge
Both health savings accounts (HSA) and flexible spending accounts (FSA) offer you ways to cover your...
More Answers
How to Choose a Health Insurance Plan at Work
How to Choose a Health Insurance Plan at WorkHow to Choose a Health Insurance Plan at WorkHow to Choose a Health Insurance Plan at WorkHow to Choose a Health Insurance Plan at Work
Ask these five questions to save money and ensure you and your family get the right care. You were offered a new job and you’ve accepted the position—...
Start Slideshow
What Does Florida Blue Do That Is Different from Traditional Insurance Companies?
What Does Florida Blue Do That Is Different from Traditional Insurance Companies?

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.