Archive Page 2


How to avoid overpaying your doctor

For anyone who’s been to the hospital, you know the paperwork afterwards can be overwhelming.  Between the hospital bills, the surgeon, the anesthesiologist, the doctor you’ve never met before who must have come in while you were on the operating table…the bills start flying in.

Here’s a tip- WAIT to pay your provider bills until you’ve received confirmation from your insurance.

Since every claim must be submitted to your insurance first, you’ll receive a statement from your carrier for everything.  The statement is called an EOB (Explanation of Benefits)

One big problem is that some providers (not all) like to get paid right away, and don’t bother to wait for the insurance company.  So, they send the bill to you, the same time they send it to your insurance.  Since the billed amount is usually higher than the insurance company’s “allowed amount”, if you pay the bill, you will more than likely pay too much.

What’s worse, the provider may not refund you the overage, they may just give you a “credit” towards you next visit.

So, the solution?  Make a file that you drop every doctor invoice into.  As soon as your insurance company sends you an EOB, pull out the file and match the doctor’s invoice with the EOB.  If it matches, pay the doctor.  If it doesn’t, call the doctor’s office and request a corrected invoice.

This way, you can be sure to never over-pay for your patient responsibility costs.  *Note – be sure you don’t wait longer than 30 days to call your provider’s billing department, as some providers are quick to send you to collections.

For the best health insurance options in Washington State, visit us online at or give us a call for expert advice at 360-464-1622.


Pharmacy costs make our premiums higher

Have you ever compared the actual costs of your prescription drugs from one pharmacy to the next?  What you may find might shock you.  Unfortunately, those differences don’t matter to most of us who just pay a copay for our Rx.  We just simply go to the closest pharmacy to our work, or the one on the way home.

When we pay a copay for our Rx, then we really have no idea of what the actual costs are.  But we should, because those costs are being passed on to our insurance carrier which will ultimately affect our future premiums.

Many health insurance companies are changing their Rx coverage from co-pays, to co-insurance.  Instead of paying $20 for that brand name drug, the cost would be 30%.  The point is to give an incentive to policy holders to shop the local pharmacies, and talk to their doctor about lowering their prescription costs.

Prescription drug costs make up over 1/3rd of total claims costs.  To save the insurance company and yourself money, always talk to your physician about generic medications, as well as alternatives that may provide the same results, and provide you a lower copay.

Understanding and being aware of the actual cost of our prescriptions is something we can all do to help reduce the spiraling cost of health care.

Regence BlueShield has a helpful website for looking up drugs and their alternatives.  Another tip: switch to mail order if you have a chronic condition.  Many health plans have a mail order program that will give you 3 months supply for 2 months copay.

For help finding the best health coverage in Washington State, visit us at or call 360-464-1622


Individual Health plans in Washington will see a slight premium increase eff Jan 1st 2010

Legislation changes or rulings by The Washington State Office of the Insurance Commissioner will sometimes mean higher premium costs for Washington residents.  Usually because of a new mandate increasing the coverage your health insurance provides.  Whether you want the new coverage or not, the mandates increase the risk to the insurance carrier, thus increasing your costs. 

This go around, the increase is not much (not like the 3% increase a couple years ago).   For many clients of the Washington Health Insurance Agency, they’ll see only a slight $1 or $2 increase.  Some will not see any increase at all. 

The increase is due to a couple of changes to the Organ transplant coverage:

    •Organ Transplant Lifetime Maximum—SB 5725 requires health plans to limit transplants to a separate lifetime maximum of not less than $350,000. (up from $250,000)

    •Organ Transplant Waiting Periods—HB 1308 requires health plans to reduce organ transplant waiting periods by the amount of time a person had prior creditable coverage.


What is Consumer Driven Healthcare?

The basic principle is this:  When we have to spend our own money (not the insurance company’s), we’re more likely to shop and compare costs.  Just like we do when we buy a big screen television, or whatever else we want to buy.

Any health plan that has a higher deductible, makes us stop and think a minute about the real cost of healthcare.  Especially when we have to pay for those costs ourselves.

Higher deductible health plans also have the advantage of being a lot cheaper, and for those of us who don’t spend a lot of time at the doctors, it can mean a real savings for the wallet.

For help finding the right health insurance plan in Washington State, call us at 360-464-1622 or visit

Recent Twitter Updates

  • The Healthplanfinder released it's annual open enrollment report this past week. Great read and evaluation how... 2 years ago
  • The Center for Medicare and Medicaid Services (CMS) issued its final Market Stabilization Rule this morning.... 2 years ago
  • Republican leaders delay vote on American Healthcare Act. 2 years ago
  • Beginning this week, our Agency will be closed every Friday until October when the busy season rolls around... 2 years ago
  • The changes to the ACA have already started, as anticipated - still much to occur. We will keep you updated as... 2 years ago

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Join 3 other followers