When people go to buy a car, they know exactly what they're paying for. They know the year, the model, how big the engine is, and most certainly how many miles they have to go before the warranty runs out.
It's not the same when people purchase a healthcare policy. Yes, they may know their deductible and co-pay, whether or not they have out of network benefits. But rarely do they know things like whether or not a DME or Orthotic falls under their usual deductible or if it falls under a completely separate deductible. By the way, most of the time DME products do fall under a separate deductible.
When it comes to health insurance even the most highly educated are at a loss of what their healthcare pays and doesn't pay. That's understandable since those that work with healthcare claims every day struggle to keep up.
Become educated about what you're paying premiums for every month. You probably know what you're spending your money on in every other aspect of your life -- your healthcare shouldn't be any different just because it's complicated.
If you don't know what your policy covers, how in the world do you know whether or not you're being billed for something you shouldn't be? You don't! If you don't know what your policy should cover and at what percentage, how can you argue when you're billed the wrong amount? You can't!
Your best weapon in getting your claims paid is to know your policy inside and out. In the long run, knowing what you're paying for every month will help you avoid paying for something you shouldn't be paying for.