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Medical Insurance

~7000 answered questions
Parent Category: Insurance
Medical insurance is an insurance against loss by bodily injury or illness. It covers doctor’s fee, hospital fee, medicine and other medical expenses. It may be purchased individually or on a group basis. It may also be provided universally by the government.
Answer Well, I went to the welfare office and they put me on access. I was off of it but they put me on it because of the baby
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Generally, no. Cosmetic surgery is not usually covered under most insurance plans. (If we're talking about reconstruction after breast cancer treatment that's different.)What's more, any treatment of complications may not be covered by your health insurance. Typically, insurance companies will not c…
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Dependent CoverageHere are opinions from Wiki s Contributors:Dependent coverage lasts until age 22 on a family policy.In most states, dependent coverage lasts until a child is 18. Although most insurance carriers will let you keep your child under the coverage with specific stipulations - in other w…
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Insurance Coverage for Pain & Suffering Here are opinions from WikiAnswers Contributors: Yes. It is a totally separate issue from medical bills. No, absolutely do not assume that you will get three times medical in addition to the actual medical amount paid. Unless that it states that you w…
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Rhinoplasty may be performed for reasons which are purely cosmetic, purely reconstructive, or a combination thereof. Reconstructive or medically-necessary reasons conventionally include nasal breathing obstruction and traumatic, congenital or severe developmental deformities. Septoplasty also may be…
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No. You have already paid taxes on the money that you used to pay the insurance premiums.   I am an insurance agent that works for a company that sells cancer insurance. Your payouts MAY be subject to taxation if your premiums were paid through your employer, and they pre-taxed them. It is im…
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That would be covered under the terms of your policy. In general that is what supplemental, (secondary) insurance is primarily for. Most "supplemental" plans pay the 20% that Medicare didn't pay only AFTER seeing an "explanation of benefits" statement--i.e. proof that Medicare paid their part. I…
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You need to find out how the insurance company defines dependent. Most companies will say that dependents are your biological/legally adopted children age 19 years and under who you financially support and those up to the age of 23 who are full time students at an accredited school and you fina…
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Insurance laws are based on vehicle coverage rather than driver coverage. Even if each vehicle has the same make and model, each has a different VIN (Vehicle Identification Number. Although no ne else is listed as drivers, other drivers may legally drive your car with permission (e.g. lend your car …
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It is not required. Please keep in mind medical insurance on an auto policy only pays in the excess of what your work med doesnt pay.It is a good idea to have the medical payments on your policy because it will also cover any passengers that are in your vehicle if they don't have health insurance. I…
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%DETAILS% Tell them you want a VERIFICATION of the debt. Use one of their prepaid envelopes to send them the demand. LOL There should be a judgment against you for some amount somewhere in the deal. Check the date of judgment.   If it has been seven years, and they haven't initiated lega…
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You shouldn't be denied coverage because of medication you take for an illness. It would possibly be considered a pre-exsisting condition, and affect the coverage for ADD. Most insurance plans have a pre-existing condition policy. Try another Insurance Company or Agent. Do you have State Disabilt…
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U S Government guide to reliable Health information - healthfinder.gov Check with the Dept of Insurance in your state or the National Association of Insurance Commissioners website (naic.org/state_web_map.htm) for links to the state officials where you live   With all due respect, medical in…
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Answer Not sure Wiki.Answers allows posting direct hyperlinks to affordable health insurance options in the answers, so email me if you want suggestions for you. Include more details on what kind of medical services are you looking to cover. Affordable health insurance If you don't compare y…
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According to one insurance company, the term "variable copay" has to do more with where services are rendered rather than by whom. Many doctors are able to practice at more than one hospital or more than one type of facility. The contracts each particular doctor has with each insurance company a…
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Health Insurance for the Self-Employed While the health care and health insurance debate is continually changing in our nation, the reality still remains that the individual, the small business and the self employed individual are typically overlooked in the health insurance marketplace. Some state…
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%DETAILS% This depends on the individual insurance. I would call your spouse's insurance. I wouldn't say anything about why you lost your COBRA unless they ask especially if you are well now and expect to stay that way. In other words, you don't have a chronic condition. The less you say to healt…
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The premium charged for health insurance is based on a person's health, medical history, age, amounts of deductibles and co-payments and the "richness" of the benefits provided by the policy. "Richness" refers to the extent of benefits provided, the degree of choice of providers, annual and lifetime…
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I would call several companies at random, including the company you are applying at. I would pose as a potential future member and give no identifying information. If they ask for anything such as a phone number, a social security number or anything else than can identify you, simply say that you ar…
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Yes you can and in many cases you should. You will very often find that individual coverage, if you can qualify for it, is cheaper than adding dependents on to your company plan. Because company plans generally cover everyone regardless of health condition they must charge more knowing that so…
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Primary and Secondary Coverage It may depend on your local regulations but typically which policy is primary is dictated by law and by the terms of your insuring contracts. The default is as follows.  Exact Same coverages on both policies / Duplicate coverage The policy with the earliest effe…
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A pre-existing condition is a medical condition that existed before you obtained health insurance. It is significant because the insurer may not cover the pre-existing condition for the duration of the pre-existing condition period. The policy will provide for a stated time period within which it wi…
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Yes, an employer can offer coverage to same-sex domestic partners and/or deny coverage for opposite sex domestic partners. You should ask your HR/Benefits representative for a copy of your plans eligibility rules, which will show who you may enroll and more importantly, when you can enroll them.
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Go to, don't call, go to the hospital administration office and demand to speak to the CEO. Tell the hospital CEO your problem. Tell him/her that the hospital did not tell you that this may happen and that the anesthesiologist is not cooperative and will not give you a discount. The CEO does have so…
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%DETAILS% Well, I will try to keep my personal comments to myself in regards to your future husband continuing to have his ex on his policy. I would suggest you call the Department of Insurance for your state government and pose this question. They can give you all the answers. Be ready to wait a…
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I would seek legal counsel on this from someone who is familar with medical claims. In the meantime, do you have anything in writing from the hospital showing the agreed upon amounts? It is legal for a hosptial to charge different amounts because doctors and hospitals that are treating pre-authorize…
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If you are covered by your employer and you leave your job or lose your job, your employer must offer you COBRA, which is a continuation of your medical benefits. Normally, you can stay on a COBRA plan for up to 36 months. Once you are no longer employed by your company, the medical benefits contrib…
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The "In-network Doctors" heading herein has some great tips on getting your doctor enrolled. In-network doctors I actually contract with Physicians for an insurance company and quite often I get requests to go recruit a particular doctor. First of all, there are Department of Health requirements wh…
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If you and your spouse or partner are both eligible for employee health benefits, check out each company's health insurance options during open enrollment to see which may cost you less. But As you know very well that there are so many health insurance companies that are available. So it would be …
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If you are currently covered under a group health insurance plan through your employer you are eligible to get it through a new employer. However, if you leave your current employer and there is a gap between the time you left and when you start your new one (more than 3 months), the new employer do…
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Different insurance companies have different precertification requirements. Some companies only require precert for inpatient surgeries, however others require preauth for all surgical procedures. This is not a state mandated law, it is specific to each insurance company. You can not be penalized if…
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According to BCBS, if you are still under a doctor's care for a condition and have not been released, it counts as a pre-existing condition. That is what I have found out during my search. What insurance company do you go through? Most places won't cover pre-existing conditions for 12 months! M…
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As far as I know, in most states the significant other would have to legally adopt, or become the legal gardian of the child in question in order for that child to be classified as "dependant" on the significant other. Your significant other cannot approve medical procedures for the child, thus they…
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no, no employer can force you to sign up for medical benefits. If you are covered by a spouse, for example, there may be no need for you to sign up for your company's insurance program.It may be required for you to sign a waiver stating you are refusing the insurance offered by your employer. This i…
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Cosmetic Surgery and Insurance Typically, Cosmetic surgery and all other "elective" surgery is NOT covered under Medical Insurance policies unless the procedure is of a medical necessity.  Corrective Cosmetic Surgery In general, for an insurance company to cover a plastic surgery, the surgery…
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It depends on how the Summary Plan Descriptions (SPDs) of the insurance plans are worded. Although there are several methods, in most cases, it depends on the birthdate (excluding the year) of the parents. The parent whose birthdate falls earlier in the year would be primary.However, be sure to read…
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Yes, but if you work with an agent, he/she can usually take care of that for you.
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Yes,The way this was explained to me by my companies H.R. Dept. was the fear the company has of being sued. Say you get a nasty divorce, separation or some thing along them lines and out of spite your husband or wife drops the family plan, then you or your child get injured and goes to the hospital …
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Insurance companies negotiate rates for services at the best advantage to them. Companies with larger groups get the best rates becaues they have more economic leverage. Medicare is the 900 pound gorilla in the insurance world. So the short answer is no, it is not fraudulent. The reason is each insu…
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No, I'm checking on the CA State Law, but haven't found it yet. Here's the research I found so far.From Blue Cross Administrators ManualMedicare is the primary payor for employees age 65 or older in employer groups with less than 20 employeesWhen a group has fewer than 20 employees, Blue Cross is co…
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  Pregnancy is not a pre-existing condition when enrolling in a group (employee benefits) plan. That is not the whole answer to the question. It needs to be determined if your question is about group or individual insurance?It is true that pregnancy is not considered a pre-existing condition i…
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Usually when you turn 23, 24 or 25, depending on what the contract says.   If you are on your parent's insurance and are going to college full time then you will be covered until you graduate. Once you graduate check with a local insurance agent to see about obtaining insurance for yourself t…
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Yes, but check into them carefully first. Both me & my husband both have insurance coverage on us and our kids. I did not realize it but it is hurting us more than helping us at the moment. My insurance is not as good as my husbands and my birthdate falls earlier in the year. My husbands insuran…
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If you're in Washington State, if you're declined by the insurance company, you can enroll in the State's insurance pool plan. Depending on what state you live in. In the state of Georgia, yes. If you live in Georgia and apply for individual health insurance, you can be denied if you or a member of…
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If you have insurance through your employer, and you are the policy holder,(the insurance is in your name) this insurance will be primary for you, and your spouses insurance policy will be secondary.The insurance policy thru your spouse's employer, (your spouse is the policy holder, or the insurance…
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It appears the Federal Law would require them to - "Simlarly Situated Individuals"The group of covered employees, their spouses or dependent children who are covered under a group health plan maintained by the employer or employee organization. This group is receiving their benefits under the group …
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No. According to the Department of Labor' HIPAA Act of 1996, "... HIPAA prohibits plans from applying a preexisting condition exclusion to pregnancy, genetic information, and certain children". Info from Dept. of Labor website: www.dol.gov/ebsa/faqs/faq_consumer_hipaa.HTML yes. the laws that gov…
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I don't know specifics about N Dakota, but look into state benefits. If this isn't an option, then talk to different doctors or hosipitals about payment plans. There are plenty of hospitals that will work with you.
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They can try and say that, but as far as I know the burden of proof is on them. If you told the truth on the application - they will have to pay.You might have a condition that the insurance company thinks a reasonalble person would have known that they had.
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to my knowledge, most states only permit residents to buy medical supplements that pay expenses not covered by primary health plan, as opposed to two major medical plans. reasons have something to do with problem designating which is responsible for paying what expenses.supplements or extra PIP (per…
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little unclear on who received funds they didn't post or cash, (doc's office has an ins. co. check?) but i believe the answer is this:if you signed forms in a doctor's office that said you accepted responsibility for any expenses not covered by your health plan, you may be in a rock and a hard place…
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You may want to check on your search engine for health insurance for pregnant women. There is no individual or group insurance that will take you now, but I have seen some banners and pop ups for this type of insurance. I don't know what type it is or what it costs, but it can't hurt to check them o…
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The Affordable Care Act, if it is upheld by the courts, makes certain changes in the ability for insurers to exclude applicants from coverage based upon certain preexisting conditions.Normally, there are preexisting condition exclusions in private health insurance policies. These exist so as to allo…
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Yes. All you have to do is send in a cancellation letter or send it to your insurance agent and have them send to the HMO company. Once they receive it, they will then have medicare reinstated as your primary health care. Maybe get in contact with your agent and see about a medicare supplement polic…
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In CA:If you're with an employer group - no problem - groups of 2 or more are guaranteed issue and the time you spent on one plan counts towards any waiting periods on a new plan.If an individual plan writes you - they have to count the prior time too.
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If Long Term Disabilty is denying you because on the date of the claim you were in the pre-x period then it would be forever. When the pre-x time is over - then it would cover a NEW claim. Not a pending one. Check YOUR actual policy for exact details. For more information www.SteveShorr.com/disabili…
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Yes and no. There are supplemental insurance programs available - do an internet search for "supplemental insurance."Programs such as these will help pay that remaining percentage - in most cases, a large portion of it at least.   Adding supplemental coverage can be a good option. I have an a…
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Yes. It's a "special enrollment" - "Qualifying Event"For MORE details see http://www.steveshorr.com/dictionary.htm#Special_Enrollment
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%DETAILS% Answer When did your old plan end? When does your new plan start? Do you have the SAME plan with the Insurance Company. That is, one might be HMO the other PPO, etc. If you were given a prescription with a years worth of refills while you were covered by Aetna through y…
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It depends on the divorce agreement. If they have filed for divorce and it is pending, this has probably been addressed in a temporary or interlocutory order. Some states also include a mutual restraining order when the divorce is filed, saying that neither can change the status quo (such as ending …
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Medical insurance should cover any injuries substained no matter how they were caused.   Health insurance is only responsible (in most cases) for what your car insurance and the third party involved's insurance does not pay. Legally, car insurance is primary over health insurance.
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Just file and when the question asks about other coverage - answer it honestly. I see so many questions on this site about primary - secondary and don't understand all the confusion. Just fill out the forms and wait for payment. I've search all over the Insurance Code http://www.leginfo.ca.gov/cgi-…
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If you as a non-custodial parent are having to pay half of the medical expenses and you know he/she has secondary medical insurance, I suggest with the primary and secondary insurance, you require a copy of the Explanation of Benefits (EOB) that insurance companies provide when they process a claim…
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Try contacting a full time professional health Insurance Agent and a member of the National AssociationClick here to find one Sign up for PCIP.
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Answer Yes, try a employer group plan or Mr. Mip. Answer Some carriers will offer individual coverage to an insulin dependent Type 2 diabetic. The rules are fairly stringent and it will generally be at a higher rate but it is not always an automatic decline. Talk to a local agent who speciali…
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You would have to sign a waiver on your insurance stating that you have prior coverage. Your application that your employer gives you should have that on it. The above answer assumes that you have the right to opt out. Here in CA if your employer pays 100% of the premium you can not opt out even …
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Both.   The primary decision maker in this process is the doctor. The Managing Networks have two objectives in this process. Offering a large network to their insured and keeping their costs low. They try to find doctors who will accept the payments amounts they determine appropriate and have…
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Answer It probably depends upon the medical insurance company you are with and what coverage you have with them. Answer I have never seen a medical insurance policy that does not cover teeth knocked out in an accident - even with no dental insurance. I once was reimbursed by Blue Cross …
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It's illegal to join a group only/primarily just for health insurance. Sure there are Alumni Groups that may offer it... but the pricing reflects who in the group is actually buying it. Check out pricing in CA at www.SteveShorr.com If you want the legal citation - email me directly and I'll get it f…
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No. The employer cannot force you not to take the coverage. However, if you don't want you may have to sign a waiver.
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A husband is not legally responsible to have health insurance for his wife. Many employees opt not to have health insurance for themselves. Health insurance is a voluntary election and no law exists making it otherwise. However, do be aware that any medical-related debts incurred by one spouse are …
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Employers usually change their insurance on their renewal date which is anytime of the year. Yours may just have happened to be in the middle of the year. They do not have to give you notice, but even less than two weeks, that's still plenty of time for them to give you information regarding the new…
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Yes. but you will have to fill out an application and be subjected to underwriting guidelines.   You are probably also eligible for COBRA or HIPAA if you can't get an Individual Plan.
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Although we cannot recommend specific insurance companies, we recommend you contact your state's insurance commission to learn of approved companies. The fallout of the current Congressional action on Health Reform program may change the makeup of current insurers also.
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Probably not. Is this a divorce case? Who is paying the premium? Spouse would still have Cobra rights.Who wants to drop the coverage?What about alimony? Medical Support orders?   A person can certainly choose to drop a spouse from their coverage with one exception. If the employer is paying 1…
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The most well known alcohol help group (Alcoholic Anonymous) is available everyday in large cities and costs nothing. If the alcoholic is motivated to recover it is an excellent resource. I know because it worked for me. I have not had a drink in over 13 years old.
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Answer Yes, you can have insurance coverage from multiple carriers.
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Yes, you should be since you were already covered prior to this. Although each state varies with this type of coverage. Even if he has a waiting period before he can enroll, he should get a letter from his prior insurance company showing that he had creditable coverage.
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No. Keep in mind that insurance coverage is very expensive and the employer, as a rule bears the largest amount.
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No. But companies can usually get better rates and coverage in group insurance, than can an individual.  A Different Opinion I am sorry but I disagree with both points in the answer above as absolutes. First, if the employer is paying 100% of the employees� coverage then the company is leg…
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Generally insurance coverage should be offered to an employees spouse. It does not matter if they are offered coverage from their employer whereas it provides an additional option in case 1 plan is more affordable than the other.
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Hep C and Insurance Hepatitis C exclusions are rare. If you have coverage, then the company should pay. Was it a pre-x? Was it admitted on the application? Is this employer group or individual coverage? Do you have copies of the EOB's? These could all be relevant. All you can do is approach each…
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%DETAILS% Depends on the doctors office billing procedures.For more details visit www.SteveShorr.com   yes, your secondary insurance should cover this amount if you have reached your deductible with them. Normally, if the primary insurance applies a deductible or co-insurance/co-pay and yo…
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Don't see any reason why not. Have you read your policy, any "funny" provisions? Just turn in the claim and let them process it.If you need a more techical answer try steveshorr/research tools
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Your doctor gave you services based on YOU paying. His deal is with you, not the Insurance Company. Did the MD PROMISE that you would only have to pay if Insurance Covered it?for more details see www.SteveShorr.com
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If your first plans are through your employer you can try two options. First see if the company offers any voluntary supplemental plans. These are group plans that you have the option of purchasing or not. The advantage to buying these from your employer is that they may be eligible for payroll dedu…
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AFLAC, Conseco, and Allstate provide supplemental medical insurance. There may be more. I do know that AFLAC and Allstate make their plans available to individuals (versus work groups) Look in your phone book under AFLAC or Allstate to find local agencies. There are several sources of supplementa…
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Yes. If you are working are you STILL eligible to be on your dads coverage?For more info. see http://www.steveshorr.com/dependent.definitions.htm
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%DETAILS% Answer Official documentation is not relevant. Check out steveshorr.com
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Did you have the surgery on the same plan you have now?Did you admit to this surgery on the application?How long is the pre-x clause?Does your state require that your present coverage count the time on a prior plan towards the pre x?for more details visit www.SteveShorr.com
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%DETAILS% Answer This is a confusing question... The answer is at steveshorr.com
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Your MD's office probably has a sign up that says your responsible.Show them how the error was made and a copy of the letter you sent to the insurance company pointing this out.For more information visit www.SteveShorr.comNo since it would take about two seconds to fix that over the phone with the i…
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Take all your information to an attorney, ask for a free consultation and ask him if he thinks he can help you.try steveshorr.comProbably not, most inquiries from attorneys are treated the same as any other. It may not seem like it but you can usually get the situation fixed yourself.
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That's really a question for a family law attorney. Rather than worry about it - why not just purchase coverage for him. If you are talking about expenses incurred after the marriage has taken place, then YES, your assets are at risk. Medical expenses are considered a "common" debt of the marriage, …
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Traditionally, medical benefits are offered on a "take it or leave it" basis, meaning that you have the option to waive the insurance - but will not receive increased pay because of it.Increasing your salary because you waived benefits is a newer, more progressive concept that some businesses (typic…
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YesYou only need to disclose it if they ask you. Which I'm sure they will on a claim form. You can't collect twice. Just up to the amount of the total bill. There are "supplemental" plans or individual plans that would pay twice.for more info. visit www.steveshorr.com
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They would start with the defintion Medically Necessary Services or supplies provided by a licensed health facility or health professional, which are determined by the health plan company and its contracting or employed Physician Group to be: Not Experimental or Investigational. Appropriate and ne…
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