Getting the Most Value from Your Health Insurance

Health and wealth are closely connected, and health insurance is often the bridge between the two.

In the United States, great health care is often very expensive. Better Health Advisors works with people who are undergoing treatment for various medical conditions, and we see firsthand how important it is to make the most of your health insurance.

Even high-net-worth families feel the financial pain of medical bills. One client reached out to us after visiting a specialty hospital for treatment. The hospital didn’t take insurance, so the client had paid $200,000 out of pocket. The client asked us, “Is there anything you can do to help me get that money back?”

We understand health insurance, so we took action. We worked with an outside company to code every item in the client’s 450-page medical record. We then submitted that documentation to their insurance company, which paid him back the full amount. The client received a check for $200,000.

People tend to call a health advisor when they need help finding top doctors or facilities, arranging treatment for a particular health issue, or coordinating care for a patient with a chronic illness — but a health advisor’s services don’t stop there.

Your health insurance can have a significant impact on your wealth.

Health and wealth are closely connected, and health insurance is often the bridge between the two. This is why we encourage clients to take a close look at their health insurance coverage at least once a year.

Health insurance may feel like any other monthly living expense, but when a family member needs treatment for a serious health issue, your insurance becomes a powerful tool. It makes a difference what kind of health insurance coverage you have — and whether you understand your plan well enough to get the most out of it. This is when it helps to have a health advisor in your corner.

A health advisor looks at the big picture, including your health needs, your providers, and your insurance coverage, and then explores how to save you money. Depending on the specifics of your situation, this might include: 

  • Finding a great doctor that is in-network on your existing plan. A health advisor can identify the best providers covered by your current insurance, set up appointments for you, and make sure your doctors have up-to-date information about your health.

  • Recommending that you switch to a different insurance plan. A health advisor can compare your insurance plan with others to determine if a different plan would get you in-network access to better doctors. Health insurance plans often change from year to year, so even if a plan was right for you when you first signed up, it may no longer be the best option.

    When looking for new insurance, it’s important to be aware that insurance brokers often have a financial incentive to recommend certain plans. An independent health advisor can make unbiased recommendations on the best health insurance plan to meet your needs — whether you’re selecting insurance for yourself, your family, or your company.

  • Communicating with hospitals and medical facilities on your behalf. If you need expensive treatment, the fee may be negotiable, or the facility may be willing to offer a discount.

    One of our clients had a child who needed an inpatient eating disorder recovery program. The client was considering several options, each costing several hundred thousand dollars. They asked us for help making the selection. Instead of the ones they had in mind, we found a great in-network program that cost them nothing, because their insurance covered it.

  • Communicating with your health insurance company to get them to cover your claims. Working with a health advisor who will handle these matters on your behalf not only lowers your stress level but also improves the likelihood that the insurance company will cover your claim. The health advisor can make sure the insurance company gets the information they need and that it’s presented in the right format, as in the example I mentioned earlier about getting a client’s $200,000 claim covered.

  • Collaborating with your wealth advisor. When faced with a major health expense, such as an upcoming hospital visit, you’ll want to consider how it affects your overall financial plan.

    This is especially true when a loved one is entering long-term care. If a family member moves into a nursing home or assisted living facility at age 65, they may live there for 20 years. If it costs $200,000 per year, that becomes a four-million-dollar expense. Aligning your wealth advisor with your health advisor can help your family plan for large or long-term healthcare expenses.

  • Combining all of these elements. A health advisor will often take multiple avenues simultaneously to address a particular issue.

    Here’s what this looks like in practice: A client needs an organ transplant that will cost several hundred thousand dollars. We’re currently talking with their current insurance company, exploring whether they would be better off switching insurance, and checking with the hospital’s foundation to find out what kind of donation support is available.

If you have questions about whether your health insurance plan is the best match for your needs, or you are facing other big decisions about your health, reach out to an expert health advisor for assistance. 

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