Managing your arthritis alreadytakes a toll on your wallet. But a hospital stay or trip to the ER can have harmful financial consequences if you’re not vigilant. Nearly one in three Americans say they’ve been hit with unexpected medical charges in the past two years, according to Consumer Reports National Research Center. Here are some tips to help you ensure you’re not paying more than you should.
坚持使用内部网络设施。Make sure you go to a medical facility that’s covered by your insurance. During an emergency, you won’t want to call to find out which ones are in network, so do it now.
确保供应商也在网络内。If you have a surgery scheduled, call the hospital in advance to find out who’s on your medical team, including the surgical assistant, anesthesiologist, radiologist and pathologist, then make sure all are in-network. If the hospital can’t provide their names, write a request in advance for care only from in-network providers.
For an ER visit, make it clear that you want only in-network providers, says Robin Gelburd, president of FAIR Health, an independent nonprofit for health cost transparency. “Document who you speak with and when,” she says. “That can help if you need to challenge a charge.”
Petition your plan.If your plan doesn’t adequately cover specialists and you have a hard time finding one, write to your insurance company. Ask that your specialist be reimbursed as if he or she were in-network and that any remaining cost you incur be counted toward your deductible.
Get an estimate up front.If you have a procedure scheduled, call the hospital and your insurance plan to get estimates of the costs – in writing, if possible, says Caitlin Donovan, director of outreach and public affairs at the nonprofit National Patient Advocate Foundation. “This may be useful if you need to appeal a surprise bill.”
Request in-network labs and imaging centers.询问你的保险公司你的计划涵盖哪些项目，并要求你的医生向这些公司发送检查和成像的指令。确认放射科医生也在你的计划之内。
Know your doctors.根据一项研究，在网络内的机构和网络内的医生进行的选择性手术中，有9%也使用了网络外的提供者。另一项研究发现，22%去网络内急诊的病人收到了他们没想到从网络外提供者那里收到的账单。
Although some states have passed laws restricting the practice for emergency care, it is still common. A doctor who’s out of network may be part of your medical team, and you can be charged the difference between their fee and your insurance’s payment. This practice is called balance billing.
Check your status.Hospitals can keep patients up to three days under “observation” and still count you as an outpatient, which usually comes with higher copays and (for some Medicare patients) higher deductibles than if you were admitted. Also, observation days don’t count toward Medicare’s requirement for coverage for a stay at a rehabilitation or skilled nursing facility. Ask to be admitted as a patient, says Donovan.
Say “no” to unnecessary items.Don’t be afraid to refuse or question devices you don’t need or can buy cheaper at your local pharmacy, such as slings, braces or walkers.
Author: Sharon Liao
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