If you’re like most people, you have a fuzzy understanding, at best, of what your medical insurance will or won’t cover and why. That’s because most of us frankly don’t care until we need it. We prefer to do other things rather than pore over manuals full of information we don’t even fully understand to figure out ahead of time what’s covered and what isn’t.

Not knowing, however, can cost you hundreds or even thousands of dollars. The fact that there are many types of medical insurance policies, and countless variations on each type of policy means you probably aren’t going to be able to sort it all out yourself unless you happen to be a licensed medical insurance agent, but there are some things you should look into before you need medical attention. Here are some of the basics, all of which should be detailed in your policy. If they aren’t, ask your benefits person or call the medical insurance company yourself:

• What is your insurance company’s policy concerning trips to the emergency room? Virtually all insurance companies will cover a trip to the ER if it’s obviously warranted, but different insurance companies have vastly different ideas of what does or does not justify a trip to the emergency room. The last thing you want is a bill from the hospital, as they are much more expensive than a doctor’s office visit. Incidentally, the last thing your insurance company wants is a bill from the ER for exactly the same reason.

• What is your insurance company’s policy concerning medical clinics? Most communities have walk in clinics which have much more amenable hours than traditional doctor’s offices. And if you happen to slice your hand open after five o’clock, you would think the insurance company would prefer you go there than the emergency room. Not always the case, as it turns out. It’s better to know before you need to go and better to give your insurance company a large ER bill than to get soaked with a smaller walk in clinic bill that you need to pay yourself.

• What is your medical insurance company’s policy regarding specialists, chiropractors, etc.? Some types of insurance allow you to see a specialist directly, others make you get a referral from your general practitioner.

• Which doctors can you choose from? Some insurance companies let you pick your own doctors, others restrict who they will pay for. Always know ahead of time which doctors your insurance company will cover when you visit.

Photo via farleyj