Health insurance can be challenging to navigate. Here are effective strategies to find the best plan for you while advocating for your needs to reduce your health insurance costs.
“DENY DEFEND DEPOSE.” These words, once inscribed on bullet casings from a tragic event, resonate as we confront the complexities of our healthcare system.
This phrase stems from Jay Feinman, author of the 2010 book Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It. In a discussion with a financial expert, he expressed his disbelief at the public's reaction to the incident, discussed the soaring costs of health insurance in America, and outlined what actions individuals can take.
The Rising Costs of Health Insurance: Understanding the Situation
Financial Expert: There are countless issues within this system, prioritizing shareholders over patients and homeowners. Can you clarify what's truly happening and how we arrived at this point?
Jay Feinman: Improving the insurance buying process is essential. Many people don’t grasp what they're purchasing. They often fixate on costs, while stronger regulations are necessary. Insurance can be difficult to comprehend; individuals typically avoid thinking about negative events. Consequently, companies market based on price and service but often neglect to clearly outline the coverage offered, leading to unexpected surprises during claims.
Jay Feinman: The complexity of health insurance stems from multiple parties involved, including providers and pharmacy benefit managers. While the Affordable Care Act has improved the situation, there's still room for better guidance in purchasing insurance.
Shifting Focus: What We Should Consider in Health Insurance
Financial Expert: When discussing health insurance, many individuals tend to fixate on immediate costs instead of the overall expenses. How can we encourage a more comprehensive evaluation of this purchase?
Jay Feinman: Health insurance differs significantly from other types, as most people incur healthcare expenses annually. While homeowners’ insurance may never be used, health insurance should primarily be viewed as protection against substantial financial burdens.
Jay Feinman: By visiting healthcare.gov or state marketplaces, consumers can access clearer descriptions and pricing for common health conditions. For instance, if a woman is expecting a baby, she can compare costs across various plans. This focus on potential large expenses rather than minor costs leads to more informed decisions.
Self-Advocacy in Medical Settings
Financial Expert: As a consumer, what steps should I take? What inquiries should I make to safeguard my interests when seeking medical services?
Jay Feinman: It’s often challenging, but I advise individuals to understand that they are not at fault when claims issues arise. The system is designed this way. I encourage seeking information upfront.
Jay Feinman: Ask your doctor, “I chose you because you’re in network or my plan covers this procedure at a specified deductible or copay. Is that accurate for all services I will receive? Are there any additional costs I should be aware of?” Patients should remain patient, assertive, and courteous, as the person they’re speaking with may not have authority. Gathering information in a general manner is key.
