|Thinking About Health|
|Written by Trudy Lieberman, Rural Health News Service|
What does your insurance pay for? And how can you tell?
If you’ve signed up for Obamacare or have begun using the coverage you already had, you’ve moved from the buyer’s stage to the owner’s stage. Like owning a car, you have to read the fine print in the owner’s manual to know what to do when things go wrong. In particular, you need to know who pays what for your care.
And that brings me to those hard-to-understand Explanations of Benefits insurers and doctors send out sometimes months after you’ve had treatment. The EOBs appear to show what insurers or Medicare have covered after they’ve evaluated or paid a claim on your behalf.
In reality, those EOBs are so confusing, it’s hard to resist throwing them in a pile and forgetting about them. Yet they will take on even greater importance as people enrolled in Obamacare policies realize they have bought high-deductible insurance, which may leave them to pay several thousand dollars out of pocket before insurance kicks in.
A man I know recently had three cardiac studies, including a stress test at a New York diagnostic testing center. The center sent a bill for $2,100. It showed an “adjustment” of $1,474, a “balance” of $197 and a column called “received” with an amount of $547.
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