How to Understand Health Insurance Coverage

Health insurance coverage can be confusing. If you have ever had to sort through health plans when you started a new job, you are likely aware of this fact. Once you have coverage, it can be scary not being 100 percent sure that you are covered if something unspeakable should occur. The good news is that there are some ways to better understand your health coverage or health coverage options. By taking some simple steps, you can more easily do so.

Things You'll Need

• Health plan
• ID number

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Instructions

How to Understand Health Insurance Coverage

• 1

  Review the materials that were sent to you when you or your employer signed you up for a health insurance plan. Health insurance companies are required to send documents when you enroll in one of their plans. Review the documents carefully. Pay special attention to the areas of coverage, so you know what the plan covers and what it doesn't. Some plans simply cover visits to certain doctors once a year; others only cover catastrophic events, while others cover a great deal more.

• 2

  Call your health insurance company, and ask questions about your coverage. There should be a phone number on your insurance information where you can call your company. Call, and give them your policy number. Inform the agent who you speak with that you have some questions about your plan. He will either be able to answer your questions for you or connect you to someone who can. Ask the agent to explain your coverage in detail so that you know what type of services are covered and what percentage of those services are covered. For instance, your visits with a primary care physician may be covered up to 90 percent, meaning that you would be responsible for a co-payment of 10 percent of the cost. You will also want to know if there are specific doctors you must choose from. In some cases, if you visit a doctor outside of your plan's network, you will have to pay a higher percentage of a co-payment.

• 3

  Check out your healthcare coverage online. Many health insurance companies allow you to access your information online. This way you can comb through your coverage areas until you fully understand your plan. If dental and vision are included in your coverage, the specifics of those plans will be included, too. This is a convenient way to access your information whenever you have a question.

• 4

  Make sure that you understand your deductible if you have one. You may be allotted a certain number of visits before you have to meet your deductible amount, or you may have to pay a certain amount of money against your deductible before your insurance plan starts to cover your expenses. Understanding your deductible may cause you to avoid unnecessary doctor visits.