Julie’s Got You Covered

Beyond the Support Line: Why Insurance Advisors Matter

Julie Sears Episode 17

What Should I Do If I Have Questions About My Insurance Coverage? 

Feeling lost in the maze of health insurance jargon and policies? You're not alone. Julie Sears, founder of Integrity Health Insurance Advisors, brings clarity to the confusion in this enlightening episode about maximizing your coverage.

Julie reveals why calling the customer service number on your insurance card often leads to frustration. While support staff try their best, they're limited by scripts and training. A licensed advisor, however, can provide deeper insights, explore alternatives, and deliver solutions tailored to your specific situation without unnecessary delays or escalations.

When preparing for medical procedures, Julie emphasizes the critical importance of having your insurance advisor review your plan beforehand. This simple step ensures you've met all requirements, especially for HMO plans with specific referral processes. As Julie colorfully puts it, this keeps "all the ducks in a row so that we don't have a random pigeon floating in the pond to mess things up." Her clients have saved significant money by identifying less expensive facilities or alternative approaches to utilizing their benefits through quick consultations.

Ready to transform your relationship with health insurance? Visit IntegrityHealthInsuranceAdvisors.com or call 469-348-4066 for your free 30-minute consultation with Julie. Stop struggling with insurance questions alone – expert help is just a conversation away.

To learn more about Integrity Health Insurance Advisors visit:
https://www.IntegrityHealthInsuranceAdvisors.com/
Integrity Health Insurance Advisors
469-348-4066

Speaker 1:

Welcome to Julie's Got you Covered, the podcast where Julie Sears, founder of Integrity Health Insurance Advisors, takes the fear out of finding the right health insurance. With seven plus years of experience, she's here to make finding the perfect coverage a breeze. Stay tuned for details on how you can snag a free 30-minute consultation. Tuned for details on how you can snag a free 30-minute consultation, Confused about what's covered or not?

Speaker 2:

Julie shares what steps to take when you have questions about your plan and why going straight to an advisor can save you time and frustration. Welcome back everyone. I'm Sofia Yvette, co-host, slash producer, back in the studio with Julie Sears, founder of Integrity Health Insurance Advisors. How's your day been, Julie? Pretty good. How about you? It's been great and we are happy to have you back in the studio. Julie tell us what should I do if I have questions about my insurance coverage. What should I do if I have?

Speaker 3:

questions about my insurance coverage. Obviously, you can always call the support on the back of your card and they should have people available to answer any questions. But a lot of times you're not getting a licensed advisor, you're just getting someone in support who is as knowledgeable as their training has gotten them. So if you reach out to a licensed advisor like myself, we can help answer any of those questions, maybe in a little bit more detail, help you dig into your plan and maybe find the solution for the problem that you're having.

Speaker 2:

What's the difference between calling my advisor and calling the insurance company Is the biggest difference? Just, you'll have a licensed agent on the phone.

Speaker 3:

Yeah, so a lot of times a licensed agent can kind of give more information than someone in support. They're going to be limited by the script that the company has provided and if this, then this kind of answer, and they may have to escalate the call, which obviously just takes more time. A licensed advisor, a licensed agent, will be able to look at your plan and answer a little bit more in depth and hopefully answer your question, you know, completely, without having to, you know, escalate the problem, cause any more delays, find out if a new plan is necessary, any of those kind of questions.

Speaker 2:

So, julie, how can I find out what services are considered in-network?

Speaker 3:

Those services. Most time you can either log into your portal and a lot of times it'll let you know you can find a in-network provider. Services are going to be based on the plan that you purchased. So most of the options through, like the Affordable Care Act, you're going to have a deductible that's going to apply, so those will be covered. You're just going to pay the majority upfront versus if you paid more for some of those. Depending on the tier that you purchased, you may have more services that will be covered prior to that network being applicable. Private insurance same thing. It's just going to depend on the plan that you bought and that's where a licensed agent can come in and let you know what you're looking at prior to those services either whether you're going to pay the majority out of pocket or whether your insurance is going to pay for it.

Speaker 2:

Can you help review my plan before I schedule a medical procedure?

Speaker 3:

Absolutely so. I recommend it to my clients. I let them know I'm always here. Obviously, some of those things can be personal, but of course information is protected and I'm just here looking out for everyone's best interest. I want to make sure that the facility is scheduled properly, make sure that they're billing things properly and that you've followed the right order, depending on what plan that you've got. If you've got an HMO, then you need to know that you've followed the right order, depending on what plan that you've got. If you've got an HMO, then you need to make sure that you've got those correct referrals so that it doesn't get hung up and that you don't have to backtrack and get denied and go through the appeals and do all of that. So just always here to you know, basically bounce it off of and make sure that you've got all the ducks in a row so that we don't have a random pigeon floating in the pond to mess things up.

Speaker 2:

What documents should I have ready when asking about my coverage?

Speaker 3:

If they're a client of mine, I usually have their policy information so I can easily search and find out what they've got and what that coverage entails and what deductibles apply, what out-of-pocket is going to be applicable prior to those services. If it's not a client of mine, then I just need to know what policy they have, so whether they've got the policy information. Sometimes I just need authorization from them to look it up in a database and find out what they got. I can get the nuts and bolts from there and move forward with any other questions.

Speaker 2:

How often should I check in with my advisor about my policy?

Speaker 3:

I have clients I haven't heard from in forever. They're, you know, going about their life and they don't really use much of it, so they're just happy renewing, and that's fantastic. I try to, you know, stay in touch with my clients, make sure they know I'm here if they need them. If you do use your coverage a lot, then you know or a little more frequently than checking in every once in a while doesn't hurt just to make sure that you're on the right path. Make sure that your deductibles are being applied properly and obviously, just that you're using it to the fullest to you know, minimize your out-of-pocket and make sure that everything's being applied properly.

Speaker 2:

So, julie, any final words of wisdom for us today?

Speaker 3:

You know it doesn't cost you any extra to work with somebody. The rates are the rates. Those are set and regulated by the state. So you know it doesn't cost you any extra to work with somebody. The rates are the rates. Those are set and regulated by the state. So you know it doesn't cost any extra to have an agent in your corner. So I highly recommend have somebody you know, if it's not me find somebody that you trust, that someone else has used to just have someone to bounce ideas off of, and if someone's too busy then maybe it's time to find somebody else.

Speaker 2:

Wow, fantastic. Thank you so much today, julie. Any final stories that you'd like to share with us?

Speaker 3:

You know I've had several where once someone has called and we've kind of talked it out, you know they find that there's a lesser expensive facility that they can go to or a different route to utilize their benefits and maximize, you know, their coverage. So it really doesn't hurt to just have a conversation. It doesn't take long. You know I've stored a lot of helpful tips on my browser and in my brain to help people save money, so a quick conversation can actually go a long way and save you a lot of headache and money down the road.

Speaker 2:

Awesome. Well, thank you so much for your time today, Julie. We'll catch you on the next episode. Have a fantastic rest of your day.

Speaker 3:

You too.

Speaker 1:

Thanks for tuning in to. Julie's Got you Covered. Ready to say goodbye to insurance stress Head to IntegrityHealthInsuranceAdvisorscom or call 469-348-4066. That's 469-348-4066 to book your free 30-minute consultation With Julie. Health insurance doesn't have to be scary. She's got you covered.