Be a Smart Health Insurance ConsumerRead more about this topic at Trisha's blog. ‘Tis the season for holiday cheer, shopping frenzy – and making health insurance choices for 2007. Maybe you’re like my friend Jim who looks at the cost of coverage and chooses the plan that extracts the minimum from his paycheck. Or maybe you consult your crystal ball, and actually crunch some numbers. The problem is, without looking behind the scenes at the actual coverage a company offers, you might not be getting the best protection for your health or your bank account. Being a sharp patient means being a smart consumer, too. Here are some questions to ask about each plan option to make the best choice for you. First, does the plan let you see your own doctors? Or will you have to change doctors? If necessary, determine how important your choice of doctors is, weighed against the cost of the plan you are considering. Next, make a list of what you need to have covered. Include possible doctor visits, tests such as your annual mammogram, and treatments you know you’ll need. List the drugs you take, and whether they are generic or branded. Then add to your list other aspects you might not have previously considered, such as dental or vision coverage, health club memberships, or alternative therapies. Does the potential insurer actually cover what you need? In particular, look at the drugs you take to determine whether the company insists on generics, or lists high co-pays for your name brand drugs. Then check coverage for tests you need. Sometimes they are covered only if you are over a certain age. Do you plan to have a baby and need maternity coverage? Some companies even cover alternative therapies or health club dues. Can’t find a plan that meets your needs? Then be a good consumer, and let health insurance providers know. Some tell me they are eager to hear from us. Others are not interested – and that should be of concern to you as you make your choice. Contact information for the specific health insurance providers that cover the largest numbers of Central New Yorkers can be found below. It’s important to keep your employer’s human resources office in the loop, too. In many cases, they have a large influence on the coverage options provided to you. Knowing the realities of insurance plans and costs will keep you and your wallet as healthy as possible. Read more about this topic at Trisha's blog. | Do you have a suggestion about a new treatment or therapy you would like covered by your health insurance company? | | The following are the responses provided by each of these health insurers when asked the following: "If one of your customers, or a potential customer, would like to make a suggestion about coverage for a test or treatment your company does not offer coverage for (such as a new therapy, or an alternative or complementary therapy or treatment), who should they get in touch with? Please provide a specific name and contact information for that person. Please do not simply suggest people fill out a form on your website. In some cases, your customers prefer not to use email or the web, and secondly, when web forms are submitted, too often the information simply goes into a black hole of web form results, and never gets to a real person who can help." | | Smart health insurance consumers should consider a poor response or lack of response when it comes to choosing their plan. If a company won't respond appropriately when they know the information will be published, then how can a consumer expect a response when asking as an individual? | | Aetna | | Despite repeated attempts at obtaining contact information over the span of three weeks, no information has been provided. | Excellus Blue Cross / Blue Shield
Regions: Central New York, Utica and Southern Tier | | Excellus BlueCross BlueShield has a number of committees that help develop our medical policies and procedures. These committees are made up of physicians, pharmacists and laymen, and welcome input from the community. Members who would like to share articles or information about new evidenced-based treatments or therapies may send them in writing to the attention of: Medical Director
Excellus BlueCross BlueShield
344 South Warren Street
P.O. Box 4809
Syracuse, NY 13221 | | GHI | | Ilene Margolin: imargolin@ghi.com | | MVP Health Care | | Despite repeated attempts at obtaining contact information over the span of three weeks, no information has been provided. | | POMCO | | Both POMCO and RMSCO responded appropriately and with consumers in mind. If you know your insurance is being administered by either of these companies, then your employer determines your health insurance coverage. If you are interested in enhanced health insurance coverage, your best option is to contact the person in your employer's human resources department who oversees health insurance administration. If you would like to send a copy of that letter to either POMCO or RMSCO, then their agents will discuss your request with your employer. But neither of these companies can make coverage decisions for employers. | | RMSCO | | | United HealthCare | | The customer number is 800-339-5380.Note: while this information was provided by United, it is not what was asked for. | | Smart health insurance consumers should consider a poor response or lack of response when it comes to choosing their plan. If a company won't respond appropriately when they know the information will be published, then how can a consumer expect a response when asking as an individual? |
© 2006 Trisha Torrey Return to Main List of Columns
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