How do I review, audit, question, and negotiate this stack of medical bills? Employer-based insurance that is a PPO. It's decent. But the hospital's billing department, not so much... Lots and lots of individual bills. Most valid, but some may not be. [more inside]
Today the US Department of Health and Human Services (HHS) issued a final rule prohibiting denial of coverage based on gender identity. I am trying to figure out exactly what this means in my situation. [more inside]
My understanding was that a "qualifying life event" - new job for you or spouse, you or spouse divorce/die, you or spouse give birth to or adopt a child - opened a free open enrollment period for you, spouse, and child, wherein you could do things such as decline insurance from one spouse's plan and both enroll on the other plan, and generally make whatever health insurance changes you wanted to. My HR rep told me that this is not always the case for birth/adoption of a child specifically - more inside. [more inside]
My friend has been seeing a psychologist, but not submitting the bills to insurance. Can they use their HSA funds to pay the bills? [more inside]
Demographic info: Male, 31, Oregon Complications: Semi chronic joint problems, somewhat unstable employment [more inside]
I'm in Washington State with a Premera Blue Cross HSA HDHP. I'm maybe, finally, in a position to start funding an actual health savings account, not just pay my household's premiums (~$400/mo for two people) and treat my insurance as a lame catastrophic plan. I'm having trouble finding a good account provider, though, and would like some recommendations. [more inside]
I recently lost my healthcare coverage and would like to explore scenarios for obtaining coverage for my estranged wife and the rest of my family. [more inside]
My partner was recently in a life-threatening accident, and he went to the closest hospital - which happens to be the only hospital in a 100 mile radius that is out of network for our insurance company. Do we have any recourse? [more inside]
What does it mean when medical insurance applies a negative exclusion amount to a charge? [more inside]
I have breast cancer. My health insurance company, which has paid out tens of thousand of dollars in the past two months with not a peep of protest, has now denied the $6000 genetic testing to determine whether I have the BRCA (and other) mutations. I am not really surprised, but I don't want to pay $6000 out of my pocket, either. [more inside]
USA insurance-filter: is it possible to be covered by 2 private insurance plans at once? We like my wife’s employer’s insurance, but it doesn't cover the expensive fertility treatments that we’ll be receiving soon. My work’s insurance does cover those treatments. Can we pay for both insurance plans and be covered by both? [more inside]
I have an appointment with a psychiatric nurse tomorrow, I have two insurance policies that overlap until the end of the month, and I don't know which policy would be the smartest to use. [more inside]
I am using my high deductible health insurance for the first time. "Preventive" services are completely free. Help me understand how to stay within preventive services. [more inside]
USA insurance-filter: we can't have kids naturally and need either surgery or IVF. We are on my wife’s insurance, which does not cover either of these. My employer's insurance says it does, but before we switch I want to be very sure these things are covered and understand any limitations. Can I just ask the insurer directly? [more inside]
Asking for a friend: "I have TMJ & I'm looking for new insurance. I've noticed that Health Choice Insurance doesn't exclude TMJ, but you have to be authorized for it. The company seems small, and to partner with a handful of clinics. Does anyone have experience with this company, or with a different company who would cover an occlusional splint specifically made for the treatment of TMJ?" [more inside]
The BlueCross BlueShield plan I've had for a few years "allows" only $78 of the $180 that my out-of-network therapist charges. Other companies can't/won't tell me what their allowed amount would be. Does your plan "allow" more than mine does? I just don't understand how they can say that the "reasonable, usual and customary charge" for a therapy appointment with a Ph.D. therapist is $78, because that's just ridiculous. Am I missing something here? Or is this just the insurance companies being $&%#?!*@.
What do I need to do and where do I need to go to have my adult brother receive a professional assessment stating he has autism and will need lifelong health insurance through my father? [more inside]
Under my current health insurance, I am being forced to switch to a more expensive ACA compliant health insurance plan ... [more inside]
My dear friend is resigning from her job in the near future. She will move to another state in 2-3 months and plans to go without health insurance until she can find a job there. Is this as bad an idea as I think? How can I help? [more inside]
I'm moving to Texas for a new job in a few weeks. I have a health insurance question. [more inside]
We just found out the baby we're having any day now is probably not eligible for medical care at birth on her mother's insurance plan. Help! [more inside]
I'm trying to lower my car insurance rates and the rep with my insurance company suggested I drop stacked uninsured motorist coverage because I already have health insurance. I understand how the stacked coverage works but it seems redundant to carry it if I have heath insurance coverage. Am I misunderstanding how UIM coverage works?
Please help me mitigate/cope with my feelings about doctors/insurance and have the best visit with a general practitioner that I can after 10 years of being uninsured. This way lies snowflakes. [more inside]
My last job had health insurance through a certain company I'll call WORST COMPANY, and they capriciously decided to be assholes about pre-certifying a surgery that my husband needs, as per my husband's surgeon (the surgeon is ready to go, he's been treating my husband for this condition for years now, and he says this is what's required. We've done all the conservative measures and they didn't help). We were fighting with them for almost a year and it was a whole big thing including trying to appeal to the state (which didn't work because then we found out my then-employer had a self-insured plan). It's a long story but please take my word for it that it was capricious and not our fault. I just got a new job and thought "Thank god, we'll start over with someone else." Except my two options are a high-deductible plan through OKAY COMPANY and a regular PPO through...........WORST COMPANY. [more inside]
I am trying to pick between two health plans. The higher deductible plan makes more sense for me except for one thing – there is no out-of-pocket limit for out-of-network treatment. This seems like a big flashing warning sign to me, but I’m not sure how avoidable out-of-network care is. For example, would being taken to an out-of-network hospital after a car accident start triggering unlimited expenses that I would be entirely responsible for? Is this a plan I should stay away from?
I work at my local County Hospital and for the last two weeks we've had a very low census. I hear rumors that the local Giant HMO and local For Profit Hospital Chain are packed right now. I also know one Local For Profit but Independent and Unaffiliated Hospital is at risk of closing right now because of extremely low census. So for folks who actually work in hospitals (and clinics?) are you seeing a change in number of patients since Obamacare started? [more inside]
We need to pick ACA insurance in NYC and after some research are most likely going with the Gold Health Republic PrimarySelect plan (which uses MagnaCare's network.) Is there a very good reason to not go with Health Republic or PrimarySelect, considering what the other NY options are? We're not eligible for PrimarySelect EPO or else we would have gone with that. thanks so much.
Hello all, I was laid off from my job in July and went to Europe for a few months. Now that I am back in USA, I tried to sign up for affordable care act via www.mahealthconnector.org/ only to find out this site is the reincarnation of the devil. I cannot finish my application for this health insurance because I get stuck on a page that requires me to put in my employer info. Now since I am unemployed I obviously do not have an employer. This site literally will not let me complete the rest of the application without entering a whole bunch of information on my current employer which does not exist! How on earth do people without jobs apply for this?? Does anyone else run into this frustrating issue? Is there any other health insurance I can sign up for?
Does anyone have any experience with purchasing health insurance through the Freelancer's Union? Any feedback on the process and level of satisfaction with coverage would be appreciated. [more inside]
My friend Stan (very) recently moved to the USA, and has already had a run-in with his health insurance that we are not sure how to deal with. Stan's new boss Joe invited Stan's family over for an afternoon, and at some point Stan's five year old fell and cut his arm on a rock in the garden. [more inside]
I'm looking for good resources for information about the upcoming exchanges, especially concerning eligibility restrictions, specifically in Colorado. [more inside]
I need group health insurance, but I don't know what my options are with the new potential changes in the law. I am in the East Bay, in California. Help? [more inside]
I just received a notification from my insurance company that as of July 1 they're no longer covering the brand-name version of a necessary medication I take daily. If I want to keep taking it I have to pay the full price (many hundreds of dollars per month)—or switch to the generic, which I've taken before and found that for me it is basically crap. It doesn't work as well, and has pretty unpleasant side effects, and I have documentation to that effect from my doctor of many years. Is there anything I can do to create a happy ending here?
I'm self employed. I need health insurance. My main concern is a random ER visit that will put me in debt for the rest of my life, so I told my wife not to worry about deductible prices, since I only need to go in once every few years anyway. She found something with a $4,000 deductible. And that was like $80/mo. The other ones were even more expensive. Is this price range right? Is this the only way to protect myself from crippling debt?
My partner and I are considering going into couples counselling. The insurance plan we share does not cover this type of counselling "except when rendered in connection with services provided for a treatable mental disorder." One of us is in treatment for a mental disorder, so this seems worth investigating. Can you offer us any experience or advice about dealing with therapists and/or insurance companies in this situation? [more inside]
I am an ABD grad student dealing with significant situational depression. My therapist has recommended I seek out a prescription for an SSRI (antidepressant). My insurance situation is a bit complex -- I'm on the university's faculty EPO plan, but don't have a primary care physician relationship established. Trying to sort out the right order of operations for making sure I get coverage, and get timely access to care. [more inside]
How do I figure out the details on a tricky health insurance situation so I am not doing anything shady, but also don't accidentally end up many thousand of dollars in debt? [more inside]
I'm talking the absolute BEST, at any price. [more inside]
My wife's mom is a widow of advancing age. She lives alone in Eastern Europe, in a country with universal health care. (More or less... thanks, austerity!) As she is getting older, we're starting to worry about her living over there, both because of quality of care and because the day that she's no longer suited to live by herself seems approaching. We live in the US and would like to bring her over here permanently. Putting aside immigration questions, how do we get health insurance for her? [more inside]
My husband got a new job and it looks like his health insurance will be better and cheaper for us than what we have through my employer. Problem is, my office is tiny and if we drop off our insurance, only one person in the office will remain on the group plan and a group of one is not eligible for a group plan. If we drop off the plan, I want to ensure she doesn't get screwed over. Can you help me figure out what questions she and I need to ask the owners and our insurance broker and/or come up with creative solutions to pose to the owners of the company? (I realize that this is really the coworker's issue but we're a very tight-knit office and my coworker wants this help.) [more inside]
I have mental health issues and I need to see a therapist, a psychiatrist, and have my medications prescribed/refilled regularly. I'm moving next month to be with my significant other (not married), but I'll lose my health insurance which is through my current state. Where do I get these mental health services at a reduced cost as an uninsured person in Tucson, AZ? [more inside]
Should I live without health insurance for the next year or so? [more inside]
I need to buy health insurance in Portland, Oregon and I'm wondering if there are any professional guilds or Freelancer's Union-type groups that sell health insurance. [more inside]
So this was me commenting a bit ago about how some views toward health care actually damage the lives of real people. And now I need advice, because the situation has grown so far out of my control and I think I’ll go out of my mind with worry. [more inside]
Where does one go for reliable information about any risks of using your health insurance policy? [more inside]
Which address should I give when I go to the Emergency Room? This is turning out to be a surprisingly stressful and complicated question. [more inside]
It's open enrollment time, and given the changes in all the policies, it's now a lot harder for a clear cut decision. [more inside]
Health insurance question: I got laid off from a small company a few months ago, and have been paying over $400 monthly for COBRA. This eats up a ton of my unemployment money. I'm wondering if I should switch to an individual plan. [more inside]
I have recently lost my health insurance. While it is possible I will be reinstated to the plan I lost, which is provided in conjunction with my school, I need to be insured again ASAP, and I don't mind the possibility of doubling up on insurance for a short period of time. New Yorkers, do you know of any affordable (<$500 or so per month) plans I might be eligible for? I am a full time college student. [more inside]
Please help me understand COBRA and my family's options after it runs out. [more inside]