UNDERSTANDING YOUR HEALTH INSURANCE

 

We are asked many questions about insurance and have put together a FAQ of health insurance terms and policies. 

If your specific question is not answered here, please call Sally at 699-2622 and she will be happy to answer any additional questions for you.

IS ABSOLUTE HEALTH CHIROPRACTIC IN MY NETWORK OF DOCTORS?

Yes, we are preferred network providers for all major insurance carriers:  Anthem, Aetna, Cigna, United Health, Harvard Pilgrim Health, Medicare and Mainecare.

WHAT’S THE DIFFERENCE BETWEEN A DEDUCTIBLE AND A CO-PAY?

Some people have an annual deductible in their policy.  It is a pre-determined amount of money that must be spent out of pocket before insurance will begin to pay on any claim.

Generally speaking, the higher your deductible is, the lower your monthly premium.  And the lower your deductible is, the higher monthly premium cost.

Once a deductible is met, then insurance will begin to pay us for your claim.  You are responsible for paying all of the deductible directly to us.  Most insurance companies then have a 90%/10% payment after the deductible.  This means that you are responsible for 10% of the cost. Often, we can determine what that cost will be once we receive an Explanation of Benefits from the insurance company.  While the deductible may seem daunting, it is paid directly to our office and therefore we are able to make a payment plan that is comfortable for you.

Many people do not have a deductible in their policy. This means that they have a set co-pay when they visit their Doctor.  Your co-pay could range from $10.00 to $35.00 per visit, depending upon your plan.  This co-payment is required for each visit.

HOW MANY VISITS DOES MY INSURANCE ALLOW TO A CHIROPRACTOR?

Every plan varies with numbers of visits. Typical plans allow for 12, 15, 36, 40 or unlimited visits. We can call your insurance company to pre-determine how many sessions your plan allows.

DO I NEED A REFERRAL FROM MY PRIMARY CARE PHYSICIAN?

We will call your insurance company to see if a referral is necessary for you.

CAN I SET UP SOME TYPE OF PAYMENT PLAN IF I HAVE A LARGE DEDUCTIBLE?

Yes, we have many patients who are on a payment plan.  We establish a fixed sum of money which will be paid to us each month. This is determined by an estimate of costs for your chiropractic care and your own personal finances.  We strive to be as flexible as we can when setting up these plans, so please call our office if this method of payment works best for you.