Navigating the healthcare system can be frustrating and expensive. Here are a few things every patient should double-check before and during their doctor visits to avoid unnecessary bills and confusion. Thi
1. Always Ask if They Still Take Your Insurance
Just because you went there last month doesn’t mean they still accept your plan. Doctors and clinics can drop or change insurance contracts at any time, and many don’t notify patients.
If they’re out of network, you’ll pay more — sometimes a lot more. Even your annual check-up, usually covered at 100%, may not be covered at all. Don’t assume. Always ask.
2. Make Sure Services Are Prior Authorized
If your doctor orders a procedure, ask them to confirm it’s been approved by your insurance company.
Why?
If not approved ahead of time, your insurance may deny the claim, leaving you to pay the full cost or a higher out-of-network rate, and some companies will make you pay a penalty. Not all providers handle this step automatically — double-check.
3. Ask Why They’re Ordering Tests or Procedures
Every scan, lab test, or specialist referral they order gets billed to you or your insurance.
Ask:
- “Is this necessary?”
- “Is there a simpler or cheaper way to check for the same thing?”
This helps you understand your care and avoid over-testing.
Also, be cautious during physicals: If you bring up multiple unrelated issues, they may bill you extra, even though the physical itself is usually free.
4. Talk to Them About Prescriptions
Brand-name drugs can be expensive. Ask if a generic version is available — they work just as well for most people and cost much less. Sometimes, a brand name works better for people. Talk to your doctor about this.
Also ask about:
- Long-term or short-term side effects that they don’t tell you about or is obvious (prime example = statins)
- Non-drug alternatives (like diet, exercise, or lifestyle changes)
- Safer medications that do the same thing
5. Referrals – Do Your Own Check
If your doctor refers you to a specialist, make sure that the specialist is in-network. Providers used to refer only in-network, but that’s no longer guaranteed.
Ask:
- “Do you have a specific reason for referring this person?”
- “Have you worked with them before and trust them, or were they just on a list?”
If possible, ask for multiple names so you can research and choose who you’d like to see.
You can check the network status by:
- Calling your insurance company
- Using the search portal listed on your ID card
- Contacting your agent (I help all my clients with this!)
If your current agent isn’t assisting you, call the insurance company directly, and then give me a call. I’d be happy to be your agent going forward. 😊
