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Make sure you understand the fine print on your health insurance policy

Posted Jun 05 2009 4:20pm

Most consumers’ sign up for health insurance plans without fully understanding the 100+ pages of detail that go over the plan specifics.  In fact, most of us select our health plans based a high-level  outline and never bother to read the fine print details that describe coverage limitations that spells out what’s covered and what’s excluded, identifies lifetime limits/coverage caps , deductible terms--- basically things you need to know so you can understand the out-of-pocket you will be expected to pay.  It’ all very confusing and complicated.  And let’s face it, it’s written in a language that consumers find it practically impossible to understand. 


An article in the Wall Street Journal written by Anna Wilde Mathews, The Importance of Deciphering Your Insurance , does an excellent job describing the consequences and complications resulting from not understanding your health policy.  Anna describes how confusing this is to consumers and discusses some specific situations where consumers were stuck with large medical bills because they did not understand their coverage limitations (the fine print) when they purchased their health policy.


Some things to look over very carefully when evaluating a health policy:

·         Know your out-of-pocket maximum, which represents the most you should have to pay for care in a given year

·         Pay attention to the terms of your deductible

·         Understand how your plan covers out-of-network providers

·         Check for excluded benefits and coverage caps, including lifetime and annual limits on payouts

·         Know what services are covered and what services are not covered


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