Understanding health insurance and you: Part 3

Communication shapes every relationship—even your relationship with your insurance company. In this article, we’ll show you simple ways to get more out of those conversations.

You’ve probably heard the saying, “knowledge is power.” The same is true with health insurance, it’s important to understand how it works. At Humana, we’re here to listen, answer your questions, and help you find solutions that fit your needs.

What to do before contacting your insurance provider

Before you contact your insurance company, follow these steps to prepare:

1. Review your Summary of Benefits. This may have the answer to your question or concern.
2. Gather relevant materials. Get your member ID card and any relevant materials, such as a bill or a claim, and have them on hand.
3. Go into the call knowing what you want to say. For example, if you’re calling to see if an upcoming procedure will be covered, get the diagnostic and procedural codes from your doctor in advance.
4. Contact your licensed health insurance sales agent first. Your agent can either assist you on the spot or reach out to your insurer on your behalf.
5. Contact your local insurance office. If you’re not sure who your insurance agent is or if you don’t have one, try contacting the local insurance office for your insurance provider. Humana members can simply Google “Humana” and their city or town name to find the nearest office.
6. Call the customer service line. If your agent is unable to help or you’re not able to connect with your local office, you can call the customer service line on the back of your insurance card.

How to have better phone calls with your healthcare providers

Want to help get the most out of your insurance plan? Here are a few tips for better phone calls:

1. Call early. Try calling first thing in the morning, so you’re more likely to have a shorter wait time.
2. Take notes. Take notes during the call, including the time and date of the call as well as the name of the person(s) helping and what you discussed.
3. Speak with a Case or Care Manager. You can ask to speak with a Case or Care Manager if you need to discuss a medical question. Often, these jobs are held by registered nurses who may have more medical knowledge than the average customer service representative.
4. Ask questions. Don’t be afraid to ask questions or get clarification on plan benefits. Insurance can be confusing, so if you don’t understand, be sure to speak up.

Get more from your coverage 

The more you understand your insurance and health plan, the more confident you’ll feel using it. Knowing what’s covered and where to go for help means you can get the most out of your benefits. Think of your health insurer as a partner, here to support your goals and help you maintain your health.

Choosing the right plan is only the first step. Finding the right care is just as important—and Humana is here to help with both. Learn more.