What to Ask Your Insurance Company Before Hiring Help
You’re ready to hire help. Maybe it’s a private nurse. Maybe a companion aide. Maybe someone to manage it all so you can sleep again.
But before you say yes to support, there’s one call you should make first: your insurance company.
Why? Because one wrong assumption can lead to thousands in unpaid claims.
Here’s exactly what to ask—so you’re informed, not overwhelmed.
1. Is This Provider In-Network or Out-of-Network?
Some services are covered—but only if the agency is in-network.
If they’re out-of-network, you could be stuck with the full bill, even if the care is essential.
Ask:
“Do you cover [Agency Name] or [Provider Type] in-network?”
“Can you send me a list of approved providers?”
2. What Specific Services Are Covered?
Don’t just ask, “Do you cover home care?” That’s too vague.
Instead, break it down:
Is skilled nursing covered?
Is personal care (like bathing or dressing) covered?
Is respite care covered?
Are companion visits or supervision covered?
Ask:
“Can you list the approved services under my current plan?”
“What CPT or billing codes should the provider use for coverage?”
3. Are There Limits on Hours, Visits, or Duration?
Even if care is approved, there are often caps:
2 visits/week
30-day duration
No weekends or holidays
Know this before you build your care plan around unreliable support.
Ask:
“Are there visit or hour limits for this service?”
“What’s the authorization period for care?”
4. Is Prior Authorization Required?
Some services are technically “covered,” but only if you get permission ahead of time.
Skipping that step? Denied claim.
Ask:
“Do I need prior authorization for [service type]?”
“Can you walk me through how to request that?”
5. What’s My Copay, Deductible, or Coinsurance?
Coverage doesn’t mean free.
Even approved services may leave you with a 20% bill—or more.
Ask:
“What are my out-of-pocket costs for this?”
“Has my deductible been met?”
6. Can You Send This Info in Writing?
Get everything in writing.
Phone reps are helpful, but mistakes happen. Written confirmation protects you—and gives you something to show the provider.
Ask:
“Can I get a summary of this call by email?”
“Can you mail me the benefit breakdown for home health?”
Willow & Wells = Help Navigating the Fine Print
We don’t just provide care—we help you understand how to pay for it.
If you’re confused, stuck, or frustrated with the runaround, we’ll help you sort it out. One call. No pressure. Just clarity.
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If you’ve ever felt overwhelmed, overlooked, or just plain exhausted by the system… You’re exactly who we made this for.
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