Doctors/ Medical Process in USA :
God forbid, but if something happens to you, here is what you should know abut how medicals work :
* The Medical Benefit Card which is sent by the medical insurance company is an important card and should be acquired at the earliest. Complete the medical forms given to you by your company and return those immediately to ensure that you are registered with the insurance company after you land in the U.S.
* This card entitles you to coverage under certain medical categories only.
* There is a some amount like $50 deductible. Which means if you land into medical problems, you have to pay the first 50 dollars from your pocket. Thereafter the insurance company takes over the payment depending on the coverage plan etc. Many employer sponsored plans have a co-pay concept for Dr. visit. That means, if you visit a doctor's office, you have to pay $10 (or whatever) co-pay and nothing else. Deductible would be applied only for major things.
* There are two acceptable ways of payment for the doctor's services which depends on the doctor. The doctor's receptionist is the best person to ask payment related questions.
Some doctors ask you to pay them (by cash, check, credit card etc.) immediately after the service. The receptionist will then give you a formal bill, which you must send (by postal mail) to the medical insurance company along with the claim form supplied by your insurance company. The medical insurance company will then send you a check after verifying your claim. Other doctors will note down the details of your medical insurance company from your card. They will then send the bill to the insurance company and receive the payment directly. You need not pay the doctor.
But in both the above modes, remember that there are certain charges which the insurance company will not pay and which they don't cover, such as the first $50. So find out the details from the insurance co. about your respective coverage/medical problem etc.
TIP : Please check the insurance network by calling them, before going to doctor, else you will have to bear the complete expense, ranging in hundreds or even in thousands.
# For certain kinds of medical problems where you have to visit the doctor repeatedly, only a fixed number of visits per year are paid by the insurance company and not all.
# How to decide on the doctor to visit?
Ask your colleagues or other Indian friends for a doctor recommendation. You may also check in the directory supplied by your insurance company. Many insurance companies have their directory online. Otherwise check up the yellow pages (phone directory). Look under the "Physicians" heading. Telephone the doctor and set an appointment. Only in cases of emergency, do the doctors see you immediately, otherwise it is always by appointment.
# You can claim the expenses for any doctor prescribed medicine that you have to buy from the drug (medical) store. Usually there would be $10 to $30 co-pay per visit.
# Pain in the lower back and strain between the shoulder blades and a stiff neck are very common due to the kind of spring mattresses and soft foam pillows available in the U.S. and one just needs to get used to it.
# Beware of dental problems since they are usually not fully covered under the insurance scheme. There are three categories in dental problems and coverage is different for each.
* Precautionary: Tooth cleaning, X-Ray, Oral Examination etc. This is covered 100%.
* Minor: Filling, Root Canal etc. This is covered 80%. Rest you have to pay.
* Major: Crowns, Bridges etc. This is covered 50%. Rest you have to pay.
And for all of these services inclusive, usually there is a yearly limit like $1500. If your teeth are too bad and if you need more treatment, you have to spend out of your pocket.
Usually you can go to any dentist. But some doctors are in the network of your insurance company and some doctors are out of the network of your insurance company. If you go to in-network doctor, the doctor and the insurance company have negotiated a fixed charge for the particular treatment and if there is a difference between what insurance company is willing to pay and what doctor charges, you won't have to pay the difference. If you go to out-of-network doctor, you would have to pay the difference.
Also, you have a annual check up free as a part of medical premium which you pay.
Make use of it.
Hope you keep up the good health..!!
God forbid, but if something happens to you, here is what you should know abut how medicals work :
* The Medical Benefit Card which is sent by the medical insurance company is an important card and should be acquired at the earliest. Complete the medical forms given to you by your company and return those immediately to ensure that you are registered with the insurance company after you land in the U.S.
* This card entitles you to coverage under certain medical categories only.
* There is a some amount like $50 deductible. Which means if you land into medical problems, you have to pay the first 50 dollars from your pocket. Thereafter the insurance company takes over the payment depending on the coverage plan etc. Many employer sponsored plans have a co-pay concept for Dr. visit. That means, if you visit a doctor's office, you have to pay $10 (or whatever) co-pay and nothing else. Deductible would be applied only for major things.
* There are two acceptable ways of payment for the doctor's services which depends on the doctor. The doctor's receptionist is the best person to ask payment related questions.
Some doctors ask you to pay them (by cash, check, credit card etc.) immediately after the service. The receptionist will then give you a formal bill, which you must send (by postal mail) to the medical insurance company along with the claim form supplied by your insurance company. The medical insurance company will then send you a check after verifying your claim. Other doctors will note down the details of your medical insurance company from your card. They will then send the bill to the insurance company and receive the payment directly. You need not pay the doctor.
But in both the above modes, remember that there are certain charges which the insurance company will not pay and which they don't cover, such as the first $50. So find out the details from the insurance co. about your respective coverage/medical problem etc.
TIP : Please check the insurance network by calling them, before going to doctor, else you will have to bear the complete expense, ranging in hundreds or even in thousands.
# For certain kinds of medical problems where you have to visit the doctor repeatedly, only a fixed number of visits per year are paid by the insurance company and not all.
# How to decide on the doctor to visit?
Ask your colleagues or other Indian friends for a doctor recommendation. You may also check in the directory supplied by your insurance company. Many insurance companies have their directory online. Otherwise check up the yellow pages (phone directory). Look under the "Physicians" heading. Telephone the doctor and set an appointment. Only in cases of emergency, do the doctors see you immediately, otherwise it is always by appointment.
# You can claim the expenses for any doctor prescribed medicine that you have to buy from the drug (medical) store. Usually there would be $10 to $30 co-pay per visit.
# Pain in the lower back and strain between the shoulder blades and a stiff neck are very common due to the kind of spring mattresses and soft foam pillows available in the U.S. and one just needs to get used to it.
# Beware of dental problems since they are usually not fully covered under the insurance scheme. There are three categories in dental problems and coverage is different for each.
* Precautionary: Tooth cleaning, X-Ray, Oral Examination etc. This is covered 100%.
* Minor: Filling, Root Canal etc. This is covered 80%. Rest you have to pay.
* Major: Crowns, Bridges etc. This is covered 50%. Rest you have to pay.
And for all of these services inclusive, usually there is a yearly limit like $1500. If your teeth are too bad and if you need more treatment, you have to spend out of your pocket.
Usually you can go to any dentist. But some doctors are in the network of your insurance company and some doctors are out of the network of your insurance company. If you go to in-network doctor, the doctor and the insurance company have negotiated a fixed charge for the particular treatment and if there is a difference between what insurance company is willing to pay and what doctor charges, you won't have to pay the difference. If you go to out-of-network doctor, you would have to pay the difference.
Also, you have a annual check up free as a part of medical premium which you pay.
Make use of it.
Hope you keep up the good health..!!
This post first appeared on Settle In America : The Complete Guide For Settlin, please read the originial post: here
