To The Editor:
Anyone who has ever taken a loved one to the emergency room for treatment knows it can be harrowing. After dealing with lines of people, mandatory paperwork and the nervous waiting, most people are just relieved to finally see an actual live doctor enter the exam room.
At that moment, the farthest thing from your mind is to ask if that physician is in your network. And that question still doesn’t seem that relevant if, say, a radiologist is brought in to look at an X-ray, or if the on-call anesthesiologist is needed.
But reality comes crashing in the mail one or two weeks later, when those specialists send you bills for hundreds, if not, thousands of dollars of services you assumed were covered under your health insurance plan. You figured the ER asked for your insurance card; why would they send in all these doctors who don’t accept your plan?
Time to panic, sell the car, cash in your pennies – not so fast. As a health insurance broker, and a member of the New Jersey Association of Health Underwriters, I’ve often been able to help in getting these issues resolved.
Just because the medical provider and your HR department tell you to pay the bill, if it doesn’t seem right to you, check with your broker. Health insurance brokers continue to play such a huge role in New Jersey as consumer advocates. We’re the ones who frustrated policy holders call in to play mediator between the hospitals and the insurance companies. We read the fine print, and ensure patients and their families are not caught paying a nickel more than they are absolutely required to.
Even as we contemplate the coming of health insurance exchanges, more and more regulators and legislators are realizing that there needs to be a role for the health insurance broker. Buying health insurance isn’t like buying a sweater online; you can’t return a mammogram. Licensed insurance professionals must continue to be the consultants regarding any purchase of health insurance, whether it is done online or in your office.
When in doubt, get your phone out and tell your broker about it.
Toby Stark
Stark Associates Insurance
Newark
