Purchasing medical insurance fills you with a sense of security and confidence that you and your family are well covered. But your responsibility does not end with purchasing a medical insurance policy. Any financial product comes with a number of features and benefits, and you should take the time to understand what benefits and facilities you are entitled to receive from your medical plan. If you are fully informed about your medical plan you will be able to use it to your full advantage. Here are some tips to help you accomplish that goal:



Go Through Medical Insurance Policy In Detail

Carefully go through the policy and member handbook to learn about the benefits, coverage, and limits. It is a good idea to subscribe to a magazine or newsletter published by your insurer. These resources are particularly helpful in familiarizing yourself with the plan and company policies. Also, make sure that you are notified every time there is a change in the network of providers or covered services. You can also consult the Summary Plan Description (SPD) of the policy for additional information.

Always Maintain Records

Maintain a separate file to keep all the medical insurance related documents. Don't throw away the plan brochures and other documents. Keep all the memos along with correspondence from your employer relating to health benefits. Also save the SPD.

Medical Insurance And Hospitalization

Even though you are in perfect health right now does not mean that you will never need hospitalization in the future. So go through the policy to find out what hospitals fall under the network of your medical insurance plan. It is also important to learn beforehand as to what sort of medical conditions are defined as a health emergency, and whether these health emergencies are covered by the medical insurance policy. If your primary care doctor does not provide you with a certificate for emergency medical care, your hospital expenses will not be covered by the policy.

What To Do If Dissatisfied With Medical Plan?

In addition to being fully aware of your benefits and rights as member of a medical insurance network, you should also learn what your options are in case of any dissatisfaction or grievance with the service or care provided. As a policy holder you are entitled to get copies of your medical test results and other information. You can also request to change your primary care doctor if you do not like the treatments or care received. All policies come with an appeals process, which can be used to appeal the insurer's decision in case you or your doctors do not like it.

Lastly, do not shy away from contacting EBSA for customer service assistance if you do not receive satisfactory response to your grievances.