What you need to know in 2022
With open enrollment upon us please choose carefully. As a provider I can tell you that the insurance plans that are "cheap" are not at all cheap. You will have a HUGE deductible, high cost-share, and large copays. This is not your provider's fault if you choose the $10 a month plan, or try to save money monthly. When you choose state funded plans many providers are not able to see you. If you want mental health appointments for example, the pickings are slim on these "Low Cost" health plans. You will be responsible for all of your charges.
Side note: Your copays are kicking back in. The insurance companies are not your friends, they are multibillion dollar corporations and cannot sustain the CEO's payroll when paying your copay. Your deductible has reset for the new year.
Telehealth is still an option, but your insurance company will dictate what software your provider uses at the provider's expense, so understand that while your insurance covers telehealth (most times) this is not the case if your provider does not want to use the software your insurance company demands. All of the regulations your insurance company puts on providers is always at the providers' expense.
New Federal regulations have been released forcing providers to provide you with a Good Faith Estimate. In spirit this is a great law, but impossible to implement. Check with your favorite providers to ensure they are not dropping your insurance in the new year. Many providers are leaving insurance panels to save money, and to be able to provide you with the best care they can without the limitations your insurance companies dictate.
Educate yourself on your insurance benefits. Your records are shared with insurance companies, and sometimes your employer through your insurance company when you use your insurance benefits. Remember if your employer pays for your insurance then they technically have access to your "private" records.
Read your contracts carefully, choose wisely. Budget accordingly. Providers have bills to pay too, so make sure that you pay your provider. While the world basically shut down, your provider has been working non-stop, while still going through the same stressors you are about the constant diatribe of the Pandemic, but also with new laws and regulations that add to the daily stress of the job.
Providers are leaving insurance panels daily, they are exhausted by the rules being changed, paid at ridiculously low rates by insurance companies, having to pay the insurance companies to be paid by them. If they are not leaving panels, insurance companies are taking over 6 months to approve a provider to bill your insurance company. 6 months to say yes you are in an over regulated field, you had to pass exams, thousands of hours of FREE work, background checks, finger printing, credit checks, board exams, years of schooling, state board checks to be licensed, yet your insurance company will take another 6 months to say, yes, this provider is able to bill your insurance company.
Insurance companies will deny claims for any reason, this is typically not your provider's fault. Do call the provider and ask why you got the bill. They will tell you and an ethical provider will walk you through the steps to work with your insurance company to get your bill paid. We don't want you to have financial stress any more than you do. We want you to be well, physically, spiritually, emotionally, and mentally.
You are in control of your healthcare, if you want to see a provider that is not Paneled call your insurance and ask them to see that provider. You have to make this call, the provider cannot. Submitting receipts to insurance companies to get reimbursed seems to be coming to an end. So, help your provider help you.
When you see your provider in the new year, no matter what you are seeing them for, you will most likely be seeing a Good Faith Estimate, don't let that number scare you, it's to protect them from violating a federal law that went into effect on 1/1/22 and was given two weeks to implement. Always follow-up in writing of the agreed upon price, and don't delete that email. This price may be different than what is on the Good Faith Estimate. The Good Faith estimate is designed so that you don't go home thinking your bills were covered and get a huge bill 1 year later.
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