What to Do When Your
Health Insurance Won't Cover Your Medical Care
It is becoming increasingly expensive
to get a health insurance coverage nowadays. However, health
insurance is a long term investment that would save you money in
the long run.
If you have looked at the various health
insurance plans, you would have noticed that there is no health
insurance plan that will cover every kind of medical treatment you
will need during your lifetime.
Regardless of how good your health insurance is,
you may someday need to be treated for a health condition that is
not covered by your health insurance policy. Elective treatments
like cosmetic surgery and liposuction are typically not covered by
health insurance plans but there are other health conditions and
medical procedures that may not be covered.
If you ever need to undergo a treatment or
procedure that your insurance policy does not cover but the
treatment or procedure is not specifically mentioned in the
“excluded treatments” section, inquire with your insurance
company. Request a written explanation that states their reasons
for not covering the treatment or procedure that you need to have.
Show this letter to your doctor. Most of the time, a treatment or
procedure simply needs to be re-stated and then presented to the
insurance company, have it approved and get your treatment or
procedure covered.
However, you could land in a situation where the
treatment or procedure cannot be re-phrased, or the treatment has
already been given to you and now the company denies you the
coverage. The fact is, you do not have much options left. You
might need to spend your own money for the treatment or procedure.
If your health insurance company denies your
claim for coverage, you can make an appeal. Insurance companies
have procedures for appealing a claim so you would need to follow
the procedure of your insurance company. Insurance companies would
generally reject an appeal based on technicality rather than use
their resources to investigate the claim. Thus, if you decide to
go with this route, make sure you follow all the steps. Check with
your policy handbook as the proces to appeal would be in there. It
is also good if you seek advice from your doctor before filing an
appeal.
If, after going through all the process and
following the steps for appealing a claim, you still lose, don't
give up. The other options you can follow and which can save you
from bearing the entire expense are:
1. Negotiate with your doctor for lower payment
or if he can approve a payment plan.
2. Is your doctor a member of a medical discount
program? Check with your doctor because many doctors do join such
networks and groups.
3. If you have not started treatment or
undergone a procedure yet, do a little research and find another
doctor who can give you the same but at a lower cost.
4. Check if you are eligible for free treatment
at a public hospital or clinic based on your income level, veteran
status or some other socio-economic reason.
Be persistent and you will surely find a
treatment or procedure, the price of which is affordable for you.
Timothy Gorman is a successful Webmaster and publisher of
Easy Health Insurance Guide. A website that specializes in
providing health insurance advice to include easy ways to find
cheaper
COBRA insurance that you can research in your pajamas from the
comfort of your own home.
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