A Health Insurance Guide For You And The Family

What if I Have to Go to the Hospital?

The time to find out what rules your plan has on hospital care is before you need it. Planned Hospitalizations Unless it is a medical emergency, your health plan or primary care doctor will probably have to give advance approval (preadmission certification) for you to go to the hospital. Otherwise, the cost of your hospital care may not be covered.

Ask these questions:

• What hospitals are part of the plan network?
• Is there a limit on how long I can stay in the hospital?
• Who decides when I am to be discharged?
• Will needed followup care, such as nursing home or home health care, be covered by the plan?
• If I have a serious medical problem, will the plan provide someone to oversee care and make sure my needs are met?

Ask how your plan handles getting a second doctor's opinion on whether surgery or another treatment is needed. Are second opinions encouraged or required? Who pays?