When it comes to receiving all of the Medicare benefits you deserve, it pays to be vigilant!

Today’s New York Daily News article about improper medicare claim denials highlights why it is so important for Medicare recipients to be persistent about their care.

One of the biggest mistakes we make as healthcare consumers is accepting the first (and even sometimes the second or third) denial from our insurance company as the final word.  Some industry experts believe that over 60% of claim denials are incorrect.

When dealing with a Medicare denial of claims or services, keep appealing!  File appeals with your supplemental insurance provider.  Even if the insurer turns you down more than once, be persistent.  It helps to have a thorough knowledge of your policy’s benefits, because that will give you the firepower you need.  Your doctor or hospital’s billing department may also be able to assist you.   Medicare.gov is also an excellent resource for seniors facing unfair denials.

It’s important to realize the health insurance industry model:  Insurers need to take in more money than they pay out in claims to turn a profit.  A multi-billion dollar industry, insurers have become well versed in doing just that.  Medicare patients (as well as all privately insured Americans) owe it to themselves to appeal claims/service denials.  Also, plan parameters are ever-changing.  Make sure to give your policy a thorough check-up every year during Open Enrollment.  A few hours now could save you thousands of dollars in the future.  Need help making your insurance choices?  The experts at Exhale Health can help.

Stay smart, and be well!