OPINION

Health and Wellness: Know your health insurance

Ann Cochran - Dallas County Health Department
Special to Dallas County News and Perry Chief

On Jan. 1, the No Surprises Act took effect, which provides protection from unexpected charges for medical care from out-of-network providers or facilities. This includes insurance through your employer, the Marketplace, or an individual plan you purchased. If you’re uninsured or you decide not to use your health insurance for a service, with the new policy, you can often get a good faith estimate for the charges beforehand.

For services received in 2022, you can file a dispute if you receive a medical bill $400 over the estimate you were given. Most insurance cards show a member services phone number and/or website for your questions. If you plan to have a procedure done, contact your insurance company to get pre-authorization. At that time, you’ll be told whether the provider and facility you’ve chosen are in your network. All health insurance is required to help pay for 10 Essential Health Benefits. They include:

  1. Outpatient (clinic) care
  2. Lab tests
  3. Prescription medications
  4. Preventive, wellness and chronic disease management
  5. Emergency situations
  6. Hospitalization
  7. Pre-natal and infant delivery
  8. Behavioral health, including substance use
  9. Services and devices needed after an injury
  10. Dental and vision for children