Health Plans: Which one do I choose?

It's time to choose a plan. Perhaps you've started a new job or are no longer on your parent's health plan as a dependent. Maybe you've had a "Qualifying Life Event?"

What's a HDHP? What's an FSA/HRA/HSA and the differences between them? What's an "open-network" plan? (These plan types can be VERY surprising sometimes and unfortunately at your expense.) Is a PPO better than an HMO?

Should I go with "regular" Medicare, or a Medicare Replacement plan? Will it affect my social security income? If so - How much?

These are common but incredibly important questions. Health Insurance is not a one-size-fits-all product. A plan that might seem to work for a friend or family member you know might not work for you. You don't want to find out after it's financially too late.

MIPCAS, L.L.C can help with commercial ("traditional") and Medicare/Medicare Advantage and Medicaid based plans:

- Explaining your health plan options in terms you can understand.

- Providing clear comparisons and contrasts of your plan options so that you can make a solid, informed decision.

- Once you have chosen a plan, MIPCAS can create a quick reference outline of how your plan covers the most commonly ordered healthcare services, such as outpatient imaging, surgery, ER, Urgent Care (UC), prescription drug coverage, etc.

**MIPCAS, L.L.C does not sell insurance plans of any kind.**

Behind-The-Scenes Insight and Guidance

Your physician has said you need a diagnostic test or surgery of some sort. Who's in-network with your plan? Where's the most cost-effective place to have your test completed? Is it something your plan even covers?

If so - How?

 MIPCAS, L.L.C can provide you with knowledge and insight of the steps you (or we - if you'd prefer) can take to not only answer those questions, but ensure the chances of your claim being denied by your health plan are greatly reduced.

MIPCAS can help you with:

- Assist in identifying your in-network diagnostic centers, hospitals, Urgent Care (UC) providers, Primary Care Physicians (PCPs), Emergency Room (ER) providers and specialists /physicians.

- Be your "secret shopper." Having a test or procedure done at one hospital could cost completely different than at another hospital even when the hospitals might be under the same name. The difference could possibly save you hundreds - or even thousands - of dollars from coming out of your pocket.

- Coordinating with your ordering physician's office and your rendering service provider with prior authorizations. The sooner a prior auth need is identified and initiated with your plan, the better your chances are of not having to cancel your appointment (thus delaying your care) due to waiting for your plan to make a determination.

**MIPCAS, L.L.C does not sell insurance plans of any kind.**

Health Insurance Claim Denials: What happens next?

You've had your test or procedure and now your plan has denied the claim, resulting with you receiving a massive bill. What happened? Do you really owe this? Can this possibly be resolved? If so - How?

MIPCAS, L.L.C. can help you with:

- Identifying exactly why the claim was denied and where any medical provider or health plan responsibility may be for possible resolution. Perhaps something on the claim was missing, such as a billing or diagnosis code, or maybe your plan has your birth date entered incorrectly and it didn't match the birth date that was shown on the claim. (Sounds crazy, right? But it actually happens!)

 These common denial examples are often beyond your control as a patient. You need to know  the best course of action for possible resolution. 

- Provide you with the steps needed to possibly appeal the denial. Appeals can sometimes be a tedious process, but could be very well worth it when done.

- Coordinate between you, your plan, and your provider's billing office as to possible resolution throughout the appeals process from start to finish.

**MIPCAS, L.L.C does not sell insurance plans of any kind.**