Health Insurance Secrets You Need to Know

  • The Truth About Your Health Care

    After months of debating, the House of Representatives recently released the text of its official health care bill online, which generated “unprecedented” traffic to its Web site. Meanwhile, the public and political debate rages on. Whichever side you’re on, one thing is clear: This is an issue that everyone is invested in, and rightly so. With that in mind, we thought we’d point out 10 facts you may not know about your existing health care coverage. Not all of these  points are negative, but a lot of them are. We do include some pieces of advice, too. Ultimately, before we argue for health care reforms, we need to understand what exactly needs to be fixed. Photo Credit: Getty
    Health Care Companies Don't Have to Tell You What You Paid
  • Health Care Companies Don't Have to Tell You What You Paid

    As of right now, your health care provider is not required to divulge how much your procedures cost in advance. Assuming you’re covered at all, you won’t find out what you owe until you get a statement in the mail weeks or months later. Unfortunately, because pricing happens in a black box, there is room for tampering. Earlier this year, Ingenix, a division of UnitedHealthcare, was caught tampering with these charges, so that customers were  shortchanged on their reimbursements. Many Americans, including President Obama, believe this practice needs to be changed so that consumers can shop around for the best prices on their procedures in advance. In the meantime, some Web sites do exist that help provide estimates for these costs. They aren’t perfect, but they help. Photo Credit: Getty
    Beware Your Anesthesiologist
  • Beware Your Anesthesiologist

    Normally, when you go to a hospital, your main concern is getting a good surgeon or physician, but it’s the anesthesiologist who  should be your key consideration. You don't get to vet them in advance and they may bill you separately.  Plus, hospitals often bring in anasthesiologists from outside, so not only are they more difficult to evaluate, but they may also qualify as out-of-network coverage, forcing you to pay more out of pocket. (The same can be true of radiologists and pathologists.) DailyFinance.com recommends interviewing them before surgery when possible to see if they meet all your qualifications. Photo Credit: Getty
    Some States Offer Better Coverage Than Others
  • Some States Offer Better Coverage Than Others

    The quality of coverage varies widely by state. For a breakdown of how all 50 states rank across a range of categories like access to coverage and overall prevention and treatment quality, check here. Most importantly, individual states have different laws on coverage. For example, in Mississippi, only one of every three adult diabetics gets preventative care. By comparison, two thirds receive preventative care in Minnesota. And in Massachussets, every cancer patient is entitled to get coverage for a wig or toupee. Be sure to research your state to guarantee that your health care provider is abiding by your local regulations. Photo Credit: Getty
    Pre-existing Conditions Can Include Almost Anthing
  • Pre-existing Conditions Can Include Almost Anthing

    As the debate over health care reform has dragged on in the past few months, more stories have surfaced about coverage being  canceled due to pre-existing conditions. As it turns out, most anything can qualify as a pre-existing condition if your health care provider deems it appropriate. Minor health problems like acne and hemorrhoids have been cited as pre-existing conditions in the past.  Pregnancy is a frequent reason for cancelling coverage, and recently one woman was denied coverage because she had once been raped. (It was particularly ironic as the woman had previously worked as a health insurance underwriter herself.) To make matters more confusing, now babies are being denied coverage for these conditions. A 2-year old girl was denied because  she was considered “too skinny,” and an infant boy was denied for being “too fat.” The best way to appeal these decisions is to get your doctor to write a note to your provider. It may not always work, but it’s better than you trying to fight through the bureaucracy alone. Photo Credit: Getty
    There Are A Lot More Health Insurance Employees Out There than You Think
  • There Are A Lot More Health Insurance Employees Out There than You Think

    Here’s a startling fact: For every two doctors in this country, there is currently one health insurance employee. This adds up to a grand total of close to half a million employees. This may mean there are more people who can respond to your phone calls (though as you’ll read in the next post, that’s not always good). But it is also a symptom of how bloated the health care system has become, and the costs that come with it. Photo Credit: Getty
    Don't Interact With Your Provider Over the Phone
  • Don't Interact With Your Provider Over the Phone

    Yes, interacting with a health insurance representative over the phone can be less than pleasant, but that’s not the only reason we make this suggestion. If any of your claims are later contested, you will want to have a written record of previous exchanges with your health care provider. Photo Credit: Getty
    Rescission
  • Rescission

    No that’s not a typo for recession, but it happens because of clumsy mistakes like typos. Rescission is the technical term for health care companies cancelling coverage retroactively, claiming they have been "misled." Basically, if you seek coverage for an especially expensive procedure, your health care provider may choose to scrutinize all your paperwork and questionnaires over the previous years. If they find even the smallest mistake, they will use it as a reason to cancel coverage for that procedure, sticking you with the bill. Photo Credit: troismarteaux
    Health Care is the Leading Cause of Bankruptcy
  • Health Care is the Leading Cause of Bankruptcy

    The leading cause of bankruptcy in the United States is medical bills. More than 60%of all bankruptcies filed in 2007 were from medical costs, according to one study. Yet 80% of those who filed for bankruptcy for this reason were actually insured. According to the authors of the study, working families "frequently collapse under the strain of the health care system that treats  physical wounds, but inflicts fiscal ones." A more recent study puts it even more starkly: “Someone files for bankruptcy every 30 seconds because of health concerns. And every year, 1.5 million families lose their homes to foreclosure due to unaffordable medical costs.” Photo Credit: Getty
    Tax Payers Pick Up the Tab for the Uninsured
  • Tax Payers Pick Up the Tab for the Uninsured

    One of every five people who go to the emergency room are uninsured, according to a recent government report. By law, hospitals can’t turn anyone away from emergency treatment, but who picks up the tab? You guessed it: American tax payers. And it's a pretty big bill. A recent estimate put the annual cost of emergency room visists at a whopping $14 billion. Photo Credit: Getty
    Your Coverage Can Be Cancelled Without You Knowing It
  • Your Coverage Can Be Cancelled Without You Knowing It

    In many states, your health care provider has no responsibility to notify you if your coverage has been terminated. Instead, the  obligation falls on your employer, who often times may forget or choose not to let you know. Even in states where providers must notify you, there can be a significant lag time between termination of coverage and when you find out. For example, if you are covered under COBRA, your employer has a month to notify your health provider if your coverage is being terminated, and your provider has another two weeks to inform you. This leaves you in limbo for a full six weeks. And unfortunately, if you make appointments during this time, you will not be covered. Photo Credit: The Consumerist
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