How to manage your child’s health insurance

DON’T let your child’s health insurance expire. If you are changing insurance plans, don’t let one policy lapse until the new one goes into effect. Pay premiums in full and on time. It can be difficult and expensive to get new insurance.

The following are ideas to help you and your family better understand your child’s health coverage:

• Read and review any booklets explaining the plan under which your child is covered. You may find more on the company’s or the insurance carrier’s Web site.
• Ask for written information on benefits if you do not have it, and be sure you understand the details. Get a copy of your plan’s summary description (SPD), which tells you how the plan works, what benefits it provides, and how to get the benefits or file your claim. If you think you might need more insurance, ask your insurance carrier if it is available.
• Talk with the employee benefits person at your job (usually a person in the human resources department) if you have questions or do not understand what you’re reading.
• Make a list of any questions about benefits, deductibles, and coverage.
• Get answers directly from the insurer or managed care group that covers your child.
• Be sure you understand what you need to do to make sure that services are covered.
• Identify one contact person (if possible) in customer service at the insurance company with whom you can discuss claims and services. It will help to have one person who becomes familiar with your situation. This person may be a case manager.
• Meet with a hospital or clinic financial counselor or a person from the patient accounts office where your child is being treated to learn about billing procedures and what you can expect.
• Discuss any concerns about your insurance with your child’s cancer team social worker. He or she can help you understand how the system works and where to get help.
• Ask for help from a trusted friend if you feel overwhelmed in dealing with these matters.
• Develop a system for keeping records. For example, you may keep records arranged by visit date or by health provider, whatever works for you.

Dealing with medical bills

• Submit claims for all medical expenses even when you are not sure if they are covered.
• Keep accurate and complete records of claims submitted, pending (waiting), and paid.
• Keep copies of all paperwork related to your claims, such as letters of medical necessity, explanations of benefits (EOBs), bills, receipts, requests for sick leave or FMLA leave and correspondence with insurance companies.
• Get a caseworker, a hospital financial counselor, or a social worker to help you if your finances are limited. Often, companies or hospitals can work with you to make special payment arrangements if you let them know about your situation.
• Send in your child’s bills for reimbursement as you get them. If you become overwhelmed with bills, get help. Contact local support organizations, such as your American Cancer Society (ACS) or your state’s government agencies, for extra help in finding resources.