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How can I find help understanding my mother’s medical benefits?

We have to go into the doctors office to have a few test run on my mother. They seem to think it is no big deal but I am worried that she won’t be able to afford them. Where can I find out more information on her medical benefits?

Answers

Ask them about how much of the test is covered by her primary insurance which is her Medicare coverage which should cover most of it if not all of it but however if it doesn,t ask about her secondary,insurance,and what it covers,Thanks

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I have been in the Healthcare Management field for over 20 years and I would be happy to help you. First there's a number on the back of her insurance card that you can call for benefit info. Also they should have a websites that you can go to and set up an account with your mother's info. After which you should be able to view copays, coinsurance, deductibles, if prior authorization or a referral is needed prior the an appointment, if there is a limit to the number of appointments for service she is going to be seen for, etc. There is also things like maximum out of pocket which means once she has paid that amount she will not have to pay for services for the remainder of that benefit year. I know it is overwhelming for anyone not trained as there is so much involved in a benefit plan. I can assure though that doctors employ people who are very aware of what is needed prior to an appointment and generally have a good idea of the cost range. I could go on and on...if you have a ? you may contact me and I will try to walk you through it.

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User in Tampa, FL
June 17, 2017

If your mom still has her sanity better get POA to handle any or all her financial and have you on the record that you have access to any or all her financial, medical, ect

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It would be best to reach out too her health insurance and ask what test are covered at 100 percent or partal cover thru your parent Health Insurance.

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What is the name of the coverage she has. I would contact the insurance before hand. My insurance company is always happy to answer any and all questions.

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User in Orange Park, FL
March 31, 2017

CALL THE INS COMPANY LET THEM KNOW YOUR CONCERN AND ASK THEM TO EXPLAIN HER BENEFITS.

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User in Venice, FL
Feb. 20, 2017

You can call the number on her insurance card

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User in Katy, TX
Dec. 1, 2016

Call number on back of her insurance card.

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User in Orlando, FL
Nov. 11, 2016

I would contact your medicare office or a rep from her health ins

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Contact her insurance provider to find out whats all covered

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User in Tucson, AZ
Sept. 25, 2016

You're best option is to first find out from the doctor what tests may need to be run for your mother then call her insurance company to get quotes for each test. Asking the doctor's office questions about medical costs is not always accurate as each patient they deal with has different insurance options. I would suggest going directly to the source of funding: your insurance company.

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User in Glendale, AZ
Aug. 21, 2016

Please be advised that there is help out there for you. I am a Private Advocate and you may if you choose to go onto care.com and look up above all senior and disability, my information is there also, you may find an private advocate to help you resolve this situation. Also note ask the Dr. the reason for the test, sometimes, its for financial gain. No offense. Please be pro-active. Best wishes to you and good luck.

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User in La Salle, MI
July 26, 2016

I would recommend looking it up on line and then speaking to her insurance.  Unfortunately they make insurance so very difficult.  Medicare and humana are great together. 

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User in Watertown, MA
July 25, 2016

Call her insurance company. Drs know nothing about costs

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User in Moneta, VA
July 24, 2016

Looking things up online and doing your own research. I find this to be very helpful!

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Jane in Warren, MI
May 16, 2018

call the service provider, the number is usually on the back of the medical insurance card.

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User in Camilla, GA
July 20, 2016

Google can be your bestie. Also talking to others that you know have dealt with this within their own families can help.

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