Certified Application Counselor Practice Test

How can consumers verify their out-of-pocket costs?

1. By checking their insurance policy only

2. By consulting their healthcare provider

3. Via their insurance statement or explanation of benefits

4. Only by contacting customer service

The correct answer is: Via their insurance statement or explanation of benefits

Consumers can verify their out-of-pocket costs by referring to their insurance statement or explanation of benefits. This document provides a detailed breakdown of the costs associated with healthcare services received, including what amounts the insurance covers and what the consumer is responsible for paying. It clearly outlines the financial responsibilities such as deductibles, copayments, and coinsurance, allowing individuals to understand how much they need to pay out of pocket for various medical services. Relying solely on an insurance policy does not provide current cost information, as policies can be complex and may not reflect actual costs incurred after services are rendered. While consulting healthcare providers can give insight into the costs of specific treatments, they may not have complete details on the consumer's insurance plan specifics, which can ultimately affect out-of-pocket costs. While contacting customer service can yield information, it is often more efficient for consumers to reference their explanation of benefits, where this information is clearly outlined and readily available after receiving care.