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Understanding Your Health Insurance Benefits

Please contact your insurance company prior to your appointment to avoid any issues with insurance coverage and to review your plan for office visits and diabetes supplies. There are many insurance plans available today and they do not always cover all expenses. Understanding your coverage will enable you to plan ahead and avoid unexpected costs.

Here are some helpful hints:

Before your visit, contact your insurance company to make sure Joslin Diabetes Center is in your network for coverage and you have all the referrals in place that you will need.

You may be responsible for paying a co-pay, co-insurance, and/or deductible. In some cases you may be responsible for non-covered services. Co-pays are collected at the time of service. If you have multiple specialty visits on the same day, more than one co-payment may be required.

If you receive insurance through an employer, their human resources/benefits department can often answer your questions.

When talking to your insurance company, keep a record of:

  • Date and time
  • The name of the person with whom you spoke
  • The specific questions you asked
  • Summary of the answers you were given

Insurance cards are a good source of information. They often contain details about websites and phone numbers for customer service representatives you can contact for assistance. Always bring your insurance card to your appointments to make sure Joslin has the most up-to-date information on file.

Questions to Ask Your Insurance Company

  • Is my Joslin provider in the network?
  • Do you cover Diabetes Self-Management Training/Education and/or Medical Nutrition Therapy (MNT)? If you do, please provide specifics about the number of visits and the reimbursement per visit.
  • Do I need a referral from my PCP? Am I limited as far as where I can receive these services?
  • Do I have a deductible or co-pay? How much is it?
  • Do you cover diabetes supplies, including blood glucose meters? Which supplies, brands, quantities?
  • Do you cover medications? Are there restrictions as to types, brands or quantities? Must I purchase them from a particular source?
  • Do you cover lab tests? Are there restrictions as to types, locations, and how often they can be done?

For Referral-Related Questions: Call our Managed Care Coordinator at (617) 309-2492

Page last updated: September 01, 2014