8 Health Insurance Tips to Maximize Benefits for the Expectant and New Mom
By Amy Keohane, co-founder OffYourDesk.net
By Amy Keohane, co-founder OffYourDesk.net
1. Coverage for your hospital stay. If your obstetrician is out-of-network, it’s your responsibility to pre-authorize your hospital stay before you check in. You can find the pre-authorization telephone number on your health insurance identification card, and you should call in the weeks prior to your expected delivery. If your obstetrician is in network, it’s his or her responsibility to make sure you’re pre-authorized.
2. Make sure to review the pre-admission packet that you’ll receive from the hospital or birthing center in the weeks before your expected delivery date. If necessary, contact your carrier to verify your coverage and benefits so you understand what your out-of-pocket expenses will be, if any.
3. Whether you’re utilizing an in-network or an out-of-network hospital or birthing facility, you should contact them prior to your anticipated delivery date and request an anesthesiologist (if necessary) that is in your network.
The services of an-out-of network anesthesiologist could result in significant out-of-pocket expenses, and you can’t assume your anesthesiologist will be in your network, even if you’re at an in-network facility.
4. Enrolling your baby in your plan. Many group health insurance plans (coordinated through employer) require that you enroll your baby in your health plan within 30 days of birth. Don’t wait until “things calm down” – make this call when you get home from the hospital. If your health insurance doesn't have your baby enrolled, your baby's medical claims will be denied. It is also extremely important that you notify your employer groupwhen your baby has arrived. Contact your employer’s Human Resource Department or your Benefits Administrator.
5. We recommend that you research and understand your plan’s coverage for your baby in the months before your expected delivery – knowing the details ahead of time will make the process easier once the baby has arrived. Consult the list of local pediatricians that are a part of the plan’s network so you can find a pediatrician that you like and trust. Check your plan to understand the types of services that your plan covers for babies and children. Does your plan cover immunizations? Well-baby visits? If yes, how many (not all insurance plans cover well-baby visits in the first 30 days)? How much are copayments and what is your deductible?
The services of an-out-of network anesthesiologist could result in significant out-of-pocket expenses, and you can’t assume your anesthesiologist will be in your network, even if you’re at an in-network facility.
4. Enrolling your baby in your plan. Many group health insurance plans (coordinated through employer) require that you enroll your baby in your health plan within 30 days of birth. Don’t wait until “things calm down” – make this call when you get home from the hospital. If your health insurance doesn't have your baby enrolled, your baby's medical claims will be denied. It is also extremely important that you notify your employer groupwhen your baby has arrived. Contact your employer’s Human Resource Department or your Benefits Administrator.
5. We recommend that you research and understand your plan’s coverage for your baby in the months before your expected delivery – knowing the details ahead of time will make the process easier once the baby has arrived. Consult the list of local pediatricians that are a part of the plan’s network so you can find a pediatrician that you like and trust. Check your plan to understand the types of services that your plan covers for babies and children. Does your plan cover immunizations? Well-baby visits? If yes, how many (not all insurance plans cover well-baby visits in the first 30 days)? How much are copayments and what is your deductible?
6. To avoid waiting on hold when you need to call your insurance carrier, Do NOT call between 10am – 2pm! Best time to reach a live operator at most carriers is at 8am ET (except for Cigna – they have 24/7 live operators so you can also call them at night and there tends not to be a wait).
7. Be sure your provider gives you an itemized bill (ie, “ten allergy shots” vs. “allergy shots”) so you can confirm you’ve been reimbursed properly.
8. If you’re planning a summer vacation, check with your carrier to see if there are in-network doctors and/or hospitals near your destination – it can save you a lot of money if something were to happen.
OffYourDesk relieves busy people of the burden of managing health insurance paperwork and maximizes reimbursements of their claims. Our experienced specialists fight so you don’t have to, and they ensure you get back every penny that you deserve from your carriers. Most people have no idea if they’re being properly reimbursed and there’s a lot of money at stake. You’d never think twice about having an accountant handle your taxes; why not let the nation’s leader in comprehensive health insurance claims management help. Check out offyourdesk.net and follow us on Facebook (www.facebook.com/offyourdesk) and Twitter (offyourdesk).
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