What You Can Do
Of all the factors that make up health insurance premiums, the one that our customers can control is utilization - a measurement of the actual claims expenditures by members.
Health care coverage is made available for when it is needed. By using services when there is no need, you are actually taking money from yourself. Remember, your health care plan does not cover the cost for medical services - you do through your premium dollars.
- Learn how your body reacts when you get sick. There is a fine line between avoiding unnecessary medical services and allowing a health condition to worsen before seeking care. By being aware of your own physical condition and knowing what happens to you when you have a cold, get the flu, etc., you will be better able to assess when you require care and when you can wait out an illness. By knowing yourself, you will be more likely to get the care you need and avoid the most costly services that are required when conditions are allowed to progress.
- Develop a healthier lifestyle by eating nutritious foods, getting enough exercise and eliminating unhealthy lifestyle habits, such as smoking.
- Avoid costly visits to hospital emergency rooms, unless you are experiencing a true emergency. A medical emergency is defined as the sudden and, at the time, unexpected onset of a health condition that requires immediate medical attention, where failure to provide medical attention would result in serious impairment to bodily functions or serious dysfunction of a bodily organ or part or would place the person's health in serious jeopardy.
- When you do require care, make sure you get the care you need in the most cost-effective manner possible. Can you use a generic rather than a brand-name prescription drug? Will outpatient services suffice rather than a hospital admission? These are questions to ask your doctor when you require care.
- It is also important to realize that it is okay to openly discuss treatment with your doctor. If you believe your doctor is requiring too many office visits or too frequent therapy treatments, discuss the need for them. It is okay to ask why you need the service and what it will do for you. However, be careful of disregarding your doctor's advice in matters that you do not completely understand. It is okay to question, but it may be in your best interest not to disregard advice all together.
- Another way to help control high insurance premiums is to help eliminate fraudulent practices. In its most familiar sense, fraud means receiving payment for services that were never received, but it also can be as simple as including an ineligible family member (such as ex-spouse or a dependent child who has exceeded the age maximum for their coverage) on your insurance coverage. If you suspect fraudulent activity, write to Suspected.Fraud@bcbsks.com or call our toll-free hotline at 1-800-432-0216 (ext. 7693 or 8768). All information is kept confidential, and if you wish, you may remain anonymous.
We are committed to providing our customers with cost-effective insurance coverage. With your help, we can accomplish this goal
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