Understanding Health Insurance benefits

With the Affordable Care Act (ACA), more people have access to health insurance. This is important when deciding whether to use your insurance for healthcare, as the main advantage is financial support, which can be significant. Many cannot afford to pay for healthcare outright, so insurance helps cover costs.

Determining Your Insurance Coverage

If you are thinking about using your health insurance for treatment, here are some key points to consider:

1. Insurance Acceptance: Check if your plan is accepted at our practice (see below for currently accepted insurances).

2. Deductibles: Find out if there is a deductible you must meet before your insurance will reimburse you for medical fees and how much of it you have left to pay.

3. Out-of-Pocket Costs: Understand your portion of the costs, such as a copay (a fixed amount you pay for each visit) or coinsurance (a percentage of the fee).

You can get this information in several ways:

• Look for a member handbook or explanation of benefits you received.

• Log into your insurance company’s website to access your account information.

• Call a member representative using the contact number on the back of your insurance card.

If your plan covers out-of-network benefits or is a PPO (Preferred Provider Organization), my services may still be covered since I am a licensed nurse practitioner. Note that insurance companies generally do not reimburse services provided by unlicensed professionals in private practice.

After meeting your deductible, your insurance will likely require you to pay a copay or a percentage of the fee (coinsurance) for each office visit.