FORT WALTON BEACH, Florida–June 18, 2015—Between high deductible plans, co-insurance, co-pays and private insurers versus the health insurance exchange, we all agree that health insurance can be difficult to understand. Add the ongoing changes associated with the Affordable Care Act, and you find yourself with a very confused consumer.
According to the U.S. Department of Health & Human Service's website, "The Affordable Care Act puts the consumers back in charge of their health care."
Being in charge also means there are additional responsibilities for the patient. One of these responsibilities is to understand your health insurance plan and whether your doctor participates in this plan.
"It can be very frustrating when you get a bill from your doctor that you were not expecting," said White-Wilson Medical Center CEO Alan Gieseman. "White-Wilson is here to help the patient navigate the changes in the health care system, as many of these frustrations can be avoided when we understand our health care policy and coverage."
To help consumers understand health insurance and their responsibilities as the patient, White-Wilson Medical Center has provided answers to these frequently asked questions.
Does my doctor take my insurance?
It is important to know what insurance company you are insured by, and the plan you have with that company. To determine if your doctor participates with your plan, you can check your insurance company's online provider directory.
Be sure to verify that your doctor participates in your specific health plan. For example, your doctor may participate in many Florida Blue plans; but not accept the Blue Select plan.
If you need help determining if a White-Wilson doctor participates with your insurance company, please call customer service at 863-8105.
How do I know if I will owe money?
There are different levels of patient visits, and charges vary depending on level of care provided. It is your responsibility as the patient to understand your insurance coverage prior to making an appointment.
If you are insured through your employer, your Benefits or HR manager should be able to help you understand your benefits. If you have a health exchange or other individual policy, your insurance company will be able to provide you with specific benefit information.
Patients should also ask about additional costs during their appointments.
How does the co-pay work?
Some health insurance plans have an office visit co-pay that must be collected at the time of service. The co-pay is generally applicable only to the patient visit, so any procedures, labs, x-rays or shots may be subject to co-insurance in addition to the co-pay.
What is co-insurance?
Co-insurance is the patient's share of covered health care costs after deductibles have been satisfied. When a patient has co-insurance, they are responsible for a percentage, such as 20%, of any covered service. Your co-insurance charge is determined by the contracted rate your insurance carrier has with your doctor.
How does my deductible work?
Many insurance plans have deductibles that must be met before the insurer will pay for any health care services. Your insurance company applies any health care expenses you incur towards your deductible, so it is important to still file your insurance at every visit. Your insurance company will not pay for any health care services until your deductible is met, and patients are responsible for 100% of health care costs until their deductible is met.
Claims that went towards satisfying a deductible may not be filed for payment at a later date, after the deductible is satisfied.
What if I do not have health insurance?
White-Wilson accepts patients without health insurance, otherwise known as self-pay patients. At White-Wilson, self-pay patients that pay at the time of service receive a 30 percent discount for care received. Self-pay patients should ask their doctor's office what their self-pay policy is prior to scheduling an appointment, and if payment plans are available.
About the White-Wilson Medical Center:
White-Wilson Medical Center is one of the largest multi-specialty physician groups on Florida's Emerald Coast. With 75 health care providers, more than 20 different specialties, and multiple locations throughout Fort Walton Beach, Destin, Niceville and Navarre, White-Wilson provides a range of health care services to fit most needs. White-Wilson employs state-of-the-art technology, coupled with skilled and experienced providers, friendly and caring staff and the convenience of "one-stop" shopping. Visit
white-wilson.com for a list of specialties and services.
