It’s easy to shy away from learning about health insurance – it’s overwhelming just to get past all the acronyms that flood your mailbox when your new insurance cards arrive. Between ACA, EAPs, EOBs and HSAs, sometimes it’s easier to throw our hands up in the air and avoid determining how to best use health insurance. Instead, take a few minutes to look for key terms in your benefits booklet, talk with your HR representative, or the representative who sold you the policy.
In order to determine your cost for health care services, here are some questions you’ll want to ask your potential healthcare provider:
- What type of service am I receiving?
- Where will I receive this service?
- Who is performing that service?
- Does my insurance company consider the provider IN or OUT of network?
These are questions that any provider’s office will be able to answer, so ask them! Then you will be able to find out from your health insurance company what you’ll need to pay to receive specific services. You can call the number on the back of your health insurance card, go to the website for members, or look in the benefits booklet you received when your policy began.
Your insurance company will be able to provide you with your individual benefit for different types of services. Unless your insurance company covers certain services at 100%, you will be expected to pay a co-payment, co-insurance or the full amount for a service which will go toward your deductible. So what’s the difference between all these things? Let’s define these terms.
- Co-payment: A fixed amount required by a health insurer to be paid by the insured for each visit or drug prescription.
- Deductible: A specified amount of money that the insured must pay before an insurance company will pay a claim.
- Coinsurance: A specified percentage of the total cost of the medical expenses after a deductible has been reached.
It’s important to understand that these rates are determined by your insurance carrier, not your health care provider. Healthcare providers can determine the amount they will bill your insurance company or any non-billable fees they may require from you, but your insurance company determines the amount you are required to pay as long as you see an IN-network provider.
The Chrysalis Center offers mental health counseling and nutrition counseling in an office setting with licensed therapists and registered dietitians. Mental Health counseling and Nutrition Counseling are separate benefits. Our administrative staff will help you determine the cost you are responsible for when it comes to either service. We are in network with Blue Cross/Blue Shield, United Healthcare, Aetna, Medcost, Tricare and Medicare.
If you are considering mental health or nutrition services, take the time to find out how you can use your health insurance to pay a portion or even cover it in full. You may just find out that you have excellent benefits for these services!
About the author
Alexis is the Practice Manager at Chrysalis Center and performs multiple functions to support the business. Among those are supervising the administrative staff, acting as the Intake Coordinator, Human Resources and Marketing. Alexis was born and raised in Wilmington, graduating from NC State University in 2003. While not leading the team at Chrysalis Center, she enjoys spending time with her husband, Wes and her two boys: Mason (5) and Banks (2)