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If you are starting a new job, switching health insurance plans, or leaving your parent’s health insurance plan, read the top ten myths about health insurance before you make any changes!
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Myth #1: The plan with the highest premium is “the best”
The Truth: Choose the plan that makes sense for your health needs. If you rarely use healthcare, it is almost always cheaper over the year to sign up for the plan with lower monthly premiums. Remember, premiums are fixed costs you pay every single month, even if you don’t ever go to the doctor. Learn more about the different types of health plans.
Myth #2: Health insurance is b-o-r-i-n-g and I only benefit from it when I am sick
The Truth: Did you know you can use your health insurance to get discounts on yoga mats, meditation apps, skin care creams, nutrition plans, FITBITs, massage therapy, Lasik vision correction, and more? Did you know you can use your HSA and FSA money to buy tons of great items that you use every day? Check out the links to get the details!
Myth #3: The Emergency Room isn’t that expensive…
The Truth: Emergency Rooms are the most expensive places to get healthcare. Unless you have a TRUE emergency, always try to see a primary care doctor or go to an urgent care. Emergency Room visits can easily cost $2,000 and you will have a longer than necessary wait.
If you do need to go to the ER, check out these two articles!
Myth #4: The doctor’s recommendation is final
The Truth: Doctors are highly-educated, very experienced professionals who commit to giving you the best care possible. That being said, not every doctor gets it right all the time. If you ever feel confused, uncomfortable, or unsure of a diagnosis and next steps, it is appropriate to ask questions and to seek a second opinion. Learn more about how to be a great patient and how to find a second opinion here.
Myth #5: If my doctor tells me they are sending my lab, imaging, or surgical order to a specific facility, I have to go there
The Truth: Doctors tend to send orders to facilities they know and have established relationships with. That doesn’t mean they are in your insurance’s network, it doesn’t mean they have the best quality, and it certainly doesn’t mean they can do the service for a good price.
Before you go anywhere for a service, make sure they are in-network and call to ask about the pricing. If you don’t like either of the answers, look for a different in-network provider that can perform the service you need. Learn more about how to shop around, and check out these online lab options!
Myth #6: I should pay a bill from the doctor right away
The Truth: Never pay a healthcare bill until you’ve compared it to the Explanation of Benefits from your insurance plan. Misbilling is common, and you could end up saving hundreds of dollars by waiting to ensure the EOB and bill match.
Myth #7: Healthcare is too confusing to understand
The Truth: Healthcare can be confusing, but so are investments, taxes, the stock market, old literature, Excel formulas, foreign languages, and politics. Once you understand the basics of how your healthcare plan works, you will be able to ask some foundational questions that empower you to be a better healthcare consumer, potentially saving yourself thousands each year. Start by reading your insurance summary of benefits to understand what your deductible is and what services apply to the deductible vs copays. At each appointment or service, ask your provider’s patient financial specialist to explain how your benefits apply to these services, or call your insurance at the number on the back of the card. You’ll find tons of helpful resources here:
How to Avoid Expensive Lab Bills During Your Annual Physical
What to Do If You Get an Expensive or Unexpected Medical Bill
Get Free or Low Cost Medications, Medical Equipment, or Health Services
Myth #8: A procedure, lab work, imaging, or office visit costs the same everywhere
The Truth: Procedures and imaging can range from less than $50 to several thousands depending where you go. Office visits (for those on a high-deductible plan) usually range from $60-$300. Learn how to shop around here, and check out the options for online lab work here!
Myth #9: Everything at my annual physical is free
The Truth: Under the ACA, annual physicals with in-network providers are free to the patient, as they are billed with unique “preventive” codes. However, if you are at your physical and start to tell the doctor about your sore throat, your aching knee, or your fatigue, this changes the coding from preventive to diagnostic as the doctor is now diagnosing your ailments.
This applies to labs in the same way. The idea of preventive lab screenings is that the doctor is screening for something that you aren’t already diagnosed with or seeing symptoms for. If you have a documented and known condition (such as diabetes), the doctor cannot run a preventive glucose test for diabetes. If you express concern about several symptoms commonly associated with heart disease, your cholesterol test (included in the lipid panel) will not be billed as preventive. Learn more here.
Myth #10: If I get sick, I should go to the closest doctor
The Truth: You should go an in-network doctor. Your costs will be much lower if you see an in-network doctor because your insurance company has negotiated a lower rate with them.