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How to Cover Medical Expenses


Between the rising costs of medical expenses and the increased complexity of health insurance plans, many people find themselves owing thousands of dollars after being seen by a medical provider. Even if you have health insurance, high deductibles and co-insurance can make your bills add up quickly.

So what can you do to avoid this costly situation? There are actually quite a few things. Read on to find out.

Understanding Health Insurance Lingo
The best way to figure out how to pay for your medical expenses is to avoid being charged in the first place. This can be difficult because there are so many different types of plans, providers, and networks that go along with health insurance. To help you figure out what your plan includes, here are the most common terms you’ll encounter.

Provider Network: A group of providers who have a contract with your health insurance company.

In-Network: Within the provider network, in-network providers give services at a rate that is pre-negotiated with your health insurance company. Make sure that you select a doctor or hospital that is in-network for your plan.

Out-of-Network: This refers to any provider that does not have a contract with your health insurance plan. You’ll be charged much higher fees from an out-of-network provider. Unfortunately, even if your hospital is in-network, not every doctor or specialist is in-network. You must confirm that every x-ray, lab, test, and exam you receive is provided by someone who is in your network.

Out-of-Pocket Costs: The amount of money you pay for your medical expenses after you health insurance has covered their portion. Before you have any procedure done, review what portion you’ll be responsible for. Remember you must meet your deductible before insurance pays for anything, and you might also have a co-insurance. That’s when you pay a percentage of all costs associated with your treatment.

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Find Out Your Local Rights
In the wake of consumers being over-burdened by medical bills, some states have begun to enact “balance billing” laws. Each state takes a different approach, so look into what kind of protection may be offered where you live.

Currently, the states with enacted balance billing laws include:

  • California
  • Colorado
  • Florida
  • Maryland
  • New Mexico
  • New York

Common Medical Procedure Costs
So just how expensive can different medical procedures be? Here are some of the most common major procedures and surgeries today, and their average price tags before insurance kicks in.

  • Root canal: $1,000 per tooth
  • Facelift: $11,000
  • Knee replacement: $49,500
  • C-section: $50,000
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