Can you name your health insurance premium off the top of your head? What about your deductible or max out of pocket? When I was first diagnosed these answers were no. After living with Paroxysmal Nocturnal Hemoglobinuria (PNH) for six years I now know it is my responsibility as a patient to understand my health insurance plan to the best of my ability. I don't feel the need to give a lesson on the ins and outs of health insurance, but I do think it’s worth saying that it is vital to research and understand your own health insurance plan.
Here are some questions that I have found helpful when researching health insurance.
What is your monthly premium?
What is the deductible on your plan?
Is it high or low?
Is it an individual deductible or family deductible?
After your deductible is paid, how much will you the patient still be responsible for until you reach your max out of pocket?
What is your max out of pocket?
Does your insurance have flat rates after reaching your deductible or are you paying percentages?
Does insurance cover or pay a portion of your drug costs?
What type of insurance plan are you looking at? HMO vs PPO, etc.
Being diagnosed with PNH in my mid 20s forced me to learn a lot about my health insurance the hard way. I have more stories that I can count about medical bills, denied claims, prior auth nightmares, the list goes on. Through these lessons I also learned that being knowledgeable about my coverage made me a stronger advocate for myself and my care. Research your health insurance, you will be happy you did.