While tiers are important, do not consider a plan that is unaffordable. If consumers cannot pay their premiums, insurers will cancel their plan.
(PRWEB) November 15, 2016
Adria Goldman Gross, FIPC, one of the nation’s leading medical insurance advocates, has been featured in a new USA Today article advising consumers on how to pick the right health insurance tier during the current Affordable Care Act (“Obamacare”) Open Enrollment period, which ends on January 31, 2017.
The article, which was published in the print edition of USA Today on November 1, 2016 and is available online, urges consumers seeking a health insurance plan to heed Ms. Gross’ advice with respect to the following:
- While tiers are important, do not consider a plan that is unaffordable. If consumers cannot pay their premiums, insurers will cancel their plan.
- Carefully review the summary of benefits for any plan under consideration. This identifies what medical services the plan will pay for, and just as importantly, what it will not pay for.
- Be aware of the implications and rules for each plan type. For example, consumers who choose HMOs will need their primary care physician to make referrals for any specialists. Alternatively, a PPO offers more leeway in choosing doctors.
- If consumers want to keep their current physician, they should check each plan provider’s network directory to ensure that he or she is listed. Consumers can also call their doctor’s office and ask whether they accept a specific plan(s) under consideration.
- Examine each plan’s drug formulary (i.e. the list of covered drugs), to ensure that any medications currently prescribed will be covered.
- If the information they need is not available online, or if the information is not clear, then consumers should contact the insurer’s customer service line before they purchase a plan.
Consumers are also encouraged to read Gross’ bestselling consumer advocacy book “Solved! Curing Your Medical Insurance Problems,” which focuses on several key issues including: Obamacare appeals, how to be “fee-wise” about medical bills and insurance coverage, out-of-network protection legislation, how to challenge an incorrect or inflated medical bill, questions to ask after a suspected hospital over-charge, Medicare considerations, and more.
The book, which has generated dozens of 5-star reviews on Amazon.com, has also received critical acclaim across the country and is endorsed by consumer protection advocate Ralph Nader.
About Adria Goldman Gross
Adria Goldman Gross, FIPC, is the CEO and founder of MedWise Insurance Advocacy, as well as a New York State-licensed insurance broker and consultant who uncovers discrepancies in diagnostic or procedure coding, exposes dubious loopholes through which insurance companies attempt to deny claims, and helps attorneys, individuals and families resolve medical claim matters. She is also a bestselling co-author of books that are both endorsed by consumer protection advocate Ralph Nader: the recently-published Solved! Curing Your Medical Insurance Problems, and Multi-Payer Medicine Nightmare Made in the USA.