In the ever-changing health care climate, not understanding all the details of your health care insurance plan could cost you extra visits to the doctor, and potentially thousands of dollars.
Deborah Leggett, nurse practitioner and co-owner of Primary Care Clinic of Jackson, compared knowing the price of your health care plan to ordering food at a restaurant.
“Have you ever looked at a menu and thought, where’s the prices?” Leggett said. “You want to know the price ahead of time; why should health care be any different? Educate yourself or it’s going to cost you.”
Being a ‘smarter’ shopper
Lisa Ragsdale, a local marketing consultant with Primary Care Clinic, said talking to your insurance provider and asking them as many questions as possible is important, because there is not one set place for information.
Ragsdale said researching on the Internet and talking to health care providers you trust are other options for consumers.
Depending on your insurance and deductible, primary care may be the best option. Primary Care Clinic co-owners Leggett and Kathy O’Connor said they want to help consumers save money where they can and avoid unnecessary procedures or trips to the doctor.
“If you had Aetna insurance and you had a $25 deductible for primary care — you’ve got to know your insurance because that $25 is generally going to cover the visit to the doctor,” Leggett said. “And anything other than that, if you’ve got a big policy, that is only going to pay to go to the doctor. But then you got $1,500 you’ve got to meet for your deductible instead of applying it to your insurance. They will bill your insurance for $190 for a lab that may only cost $45. They’ve got to look at their plans.”
Leggett said she knew a woman who didn’t see a gynecologist or get a pap smear test for 20 years because she thought she had a $50 deductible, though she had a preventive plan, which includes shots and screenings, and was 100 percent paid for, and was later diagnosed with cervical cancer. She now has to pay for surgery and chemotherapy, which means a bigger bill.
“She didn’t know her insurance; she could’ve gone to primary care and got it done for free,” Leggett said. “She just avoided it all these years.”
Leggett said Primary Care Clinic offers another option for cash-only payers, but they are not “trying to steal patients” and will refer them to other providers if they cannot provide that certain service.
“Our motto is your health is our priority and keeping people healthy is a mission for us,” she said.
Reach Omer Yusuf at firstname.lastname@example.org or 731-425-9637 and on Twitter @OmerAYusuf.
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