Stay in Humana's Network to Avoid Extra Costs | Humana
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Today’s question: how can staying in-network
help me manage my healthcare costs?
The simple answer is, when you stay in-network,
you end up saving money and avoiding balance
billing.
See, in-network doctors and in-network medical
facilities have agreed to a predetermined
rate with Humana for every procedure, from
broken arms to doctor’s visits to major
surgery.
So, when you see a doctor or have a procedure,
your health insurance pays them the agreed
upon rate.
That’s good news for you because your costs
will be lower too.
But you have to make sure that all the care
you receive comes from in-network providers.
And it’s not always obvious.
Let’s say Juan has his annual physical.
He sees his family doctor, who is in-network.
Juan makes his copayment.
His insurance pays the rest.
Juan’s doctor gets his agreed upon fee and
Juan’s back to his favorite hobby, building
solar-powered go-carts, which he loves.
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Now, let’s say Juan’s friend Steve isn’t
paying attention and accidentally knocks a
toolbox onto Juan’s foot.
Way to go Steve.
Juan’s going to need surgery.
He goes to an in-network hospital, his surgeon
is in-network, but the anesthesiologist is
an out-of-network provider.
When the anesthesiologist billed for his part
of the procedure, Humana paid him what out-of-network
anesthesiologists are paid.
This is less than what the anesthesiologist
billed, and he may send a bill to Juan for
the difference.
This is called balance billing.
Juan’s insurance paid the maximum allowed
amount it pays for this out-of-network service.
But because the anesthesiologist billed more
than that, Juan had to pay out of pocket to
cover the extra amount.
There are a few things you can do to help
avoid balance billing.
First, talk to your doctor or hospital before
every screening, procedure or test, to make
sure that the facility or specialists you’re
seeing are in-network.
Second, review your benefits online.
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Sign in to the MyHumana section at Humana.com
and download your Summary Plan Description.
Third, while you’re on Humana.com, you can
use the Find a Doctor or Pharmacy search to
find care providers, including doctors, hospitals,
pharmacies, urgent care centers and more.
Fourth, you can call the number on the back
of your Humana insurance card and confirm
over the phone that your provider is in-network.
To sum it up, avoid unexpected healthcare
costs by staying in-network every time you
get any sort of medical care.
So, until next time, stay smart and stay healthy.