4 Ways to Get Your Medical Expenses Covered

The last thing anyone suffering from a long-term health condition needs is to become embroiled in a drawn-out fight with an insurance company over treatment payments. The best protection is preemption. If you’re having a scheduled procedure, talk to your health-care provider and your insurance company ahead of time. “You’ve got to make sure up front that the treatment is going to be covered,” says Nora Johnson, vice president and director of education and compliance for Medical Billing Advocates of America. Here, she shares the key questions to ask so you don’t end up paying out-of-pocket for your medical expenses.

Is this treatment considered experimental? Insurance companies will only pay for procedures that, in their view, are well-proven to be effective. “If your doctor says, ‘There is a new treatment that I think could really work on you,’ of course you’re going to say you want it. But the doctor may not know, and you may not know, that the insurance company considers this treatment experimental,” says Johnson. If that’s the case, ask your doctor whether he or she can help you argue that it should be covered anyway. You may have to file an appeal with your insurer and, if you do get permission, be sure to get it in writing. Indeed, it’s a good idea to get written preapproval for all procedures, even if it’s not required.