Smart About Money: Medical Billing

The other day, a friend told me how her daughter, now 26, recently learned something about health insurance.

After graduating from college and taking a full-time job at a regional office of a multi-national foods corporation, this young woman had stayed on my friend’s family medical insurance plan (which has somewhat preferable benefits) until she recently turned 26 and had to leave that plan for her employer’s plan.

Nick Maffeo

The employer’s plan is very good, but different from what she was used to. So after she had a minor dermatology procedure in a doctor’s office, she was surprised when she got a bill for it. She mentioned the bill to her parents and asked why it wasn’t covered by her new insurance plan.

Of course, people who have anything “new” — a car, job, phone, health insurance plan — usually also have a learning curve when they figure out what’s what and how it all works.

On her new plan, my friend’s daughter now has co-pays and a deductible that are different from the plan she was on. Also, up to age 26 and as with many families these days, her generous parents had been paying her very occasional medical bills for her. So there had been a few bills under the old plan, but she was not paying them and often she did not even see them.

The important lesson for this young woman is that she now should definitely get in the habit of familiarizing herself with her health insurance plan. The goal: To have a solid understanding of what is covered, what’s not covered, and how to be prepared to scrutinize medical bills to ensure that she is being charged correctly.

Medical billing can be confusing, and mistakes are made often enough that it’s easy to wish for significant reform to make medical billing much more transparent.

Some people obsess about how opaque medical billing can be, but then some people obsess about everything. There’s no reason to obsess. No matter what your age, there is every reason to take a few steps to make sure you’re being billed correctly for medical procedures, including:

1. Always wait for the Explanation of Benefits (EOB) from your health insurance company. The EOB will clearly show you what the insurance company is paying and it will also show the amount you are responsible for. This is the amount you should expect a medical office to bill you.

2. If you have questions about a medical bill, your first call should be to your health insurance company (for example, Blue Cross). When it comes to billing, your insurer will be in the best position to help you figure things out and they may be willing to contact a doctor’s office directly on your behalf regarding a bill if you think something like a coding mistake has been made.

3. Health insurance premiums, deductibles, out-of-pocket maximums, and co-pays can change and you want to be aware of how any changes will affect you. Also, you want to see if there are options available that might be better for you. Check with your employer’s human resources office to see if there are informational seminars or someone you can speak with.

No one will ever care about your health or paying for your health insurance the way you do. And health insurance is a major expense for most people. Staying on top of how you’re covered is a very significant and “smart” favor you can do for yourself.

Nick Maffeo is the President & CEO of Canton Co-operative Bank in Canton. Have a question? Email to submissions@thecantoncitizen.com.

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Posted by Nick Maffeo on Dec 24 2025. Filed under Featured Content, Opinion, Smart About Money. Both comments and pings are currently closed.