Ask MetaFilter questions tagged with healthinsurance

Should I be concerned about my insurance company asking for my HIPAA Certificate?

Anonymous — Wed, 23 Dec 2009 07:20:57 -0800

I received a letter from my new health insurance company stating "they have received a claim for an illness that could be related to a pre-existing condition." What now? The letter further explains "because your plan has a pre existing condition limitation I am required to provide a HIPAA certificate."

Some backstory: I have been seeing a therapist for depression/ADD/anxiety and have been prescribed many Rx as we try and find the right combination for me. This started under my previous insurance about eight months ago.

I can provide my current insurance provider a HIPAA certificate from my previous ins. company, that's no problem. But for some reason this situation is setting off alarm bells and has me concerned. Is there anything I should be doing besides sending the HIPAA certificate?

What's the deal here?

Anonymous — Mon, 21 Dec 2009 17:02:02 -0800

I'm thinking of dismissing my therapist over some billing issues, but would like some perspective from other people. My therapist is out of network, and agreed at our initial session to permit me to sign checks from my insurance company over to her as they came in.

Stuff started getting weird in August, when a check from a July appointment never showed up. She started getting impatient, and put me on resolving it, which I did. My insurer said they had never received the claim. She said she was sure it had been submitted, and that this was the sort of thing insurance companies did to frustrate out of network therapists.

She wound up convincing me to go to paying up front, which wound up destabilizing my financial situation as the sessions are $185 each, and the checks were coming in erratically. I wound up having to cancel a session, as writing a check would have put me very close to overdrawing my checking account.

I explained this to her, and she agreed to go back onto the original plan, provided that checks come in within a month, to which I agreed.

Recently, a check for a session came in close to a month after the fact. At our last session, I reluctantly wrote her the check, at which point she said the deadline should be two weeks, and suggested that my reluctance was indicative of some sort of underlying issue, and said that she was being generous by offering to allow me any time at all to write the checks.

I responded by saying that the agreement we came up with at the first session was something she had chosen to do to compete with other in-network therapists, and that I was confused about what was happening with the billing and wanted to talk to my insurance company to figure out whether the checks would reliably come within two weeks.

What I found when talking to my insurance company is that the turnaround on their end has been remarkable, rarely going as far even as three days, and that all checks that didn't come within two weeks didn't come within two weeks because my therapist's biller has been taking her time (10-20 days) to submit the claims.

I feel like my therapist has gradually worked me into a billing situation that is very, very dissimilar to the one I envisioned when signing on with her. We didn't hammer out the details, but I expected things to run relatively smoothly, not to hear about a disputed bill until after 30 days, and that this would have a minimal impact on our therapy. This turned out not to be the case, as a lot of session time has been spent on resolving billing issues.

I believe she expected to be paid promptly, but insurance companies have up to 30 days to turn around a claim, and her biller, as I mentioned, takes awhile to submit the claims. I don't think she understood the role the insurance company and the biller played in all of this.

(In no way am I suggesting that she ever personally guaranteed that I would never have to lay money out.)

Basically, this feels like violated boundaries, because the arrangment changed after the fact. It also feels like everything that's happening that would enable us to come to an arrangment agreeable to both of us is occurring on her end. I don't think the way she attributed responsibility to the insurance company for the first disputed bill was a realistic take on the situation.

Part of the reason I'm seeing her is to work on my boundaries and where I should assert myself, and consequently, I'm feeling extremely stressed out about this. I think this situation shows she's not a good person to go to for advice, but I am open to the possibility that there is something I'm not seeing in all of this.

What I'm looking for is a reality check, to test my assumptions here. Is my therapist being unreasonable? Am I? Would this bother you if it happened to you? How much, on a scale of 1-10?

Or is this just the sort of thing where there are two individuals, both of whom are drawing a line in places they're entitled to so, resulting in an absence of middle ground that can only be described as "unfortunate?"

Tax scratch fever

ClaudiaCenter — Wed, 16 Dec 2009 00:22:51 -0800

USOpenEnrollmentFilter. Question about "health savings accounts" versus medical FSAs (flexible spending accounts). So, for years I used a medical FSA to pay for out-of-pocket medical expenses. My employer has switched to a "health savings account" program, and has phased out the medical FSA.

The problem is that the health savings account has an IRS cap of $3,050 annually for 2010. Our health coverage for 2010 has a $2,500 deductible (which the employer funds by putting the money into the health savings account, and then the employee e.g. me, I add money to hit the $3,050 cap), with the possibility of $1,500 more out-of-pocket following the meeting of the deductible.

So there's really only $550 at best for out-of-pocket costs. I have much more in out-of-pocket costs than $550 during a regular year in dental, glasses, alone. (The medical FSA does not have an IRS cap so I haven't faced this problem earlier.)

Is there anything a person can do? It seems as though a person generally cannot have a medical FSA if they already have a health savings account, so I don't think I can go out and try to get an individual medical FSA. (Which is what I really want because no limit -- some people don't like them because they are "use it or lose it," but that is not a problem for me. So if I'm wrong about that please tell me!)

Could you declare on your income tax all of your medical expenses (including those covered by the health savings account), take a tax deduction, and somehow "back out" the savings you already got through the health savings account? Would that even work?

I feel a little frustrated ...

Health Insurance reimbursement

slagerst — Mon, 14 Dec 2009 10:34:39 -0800

What examples can I cite to convince my employer to continue reimbursing my 3rd party health care? I’ve been employed for 6 years at a 12-person NYC non-profit (FWIW, 3rd longest in tenure). For the first 5 years, I had the company insurance policy, paid in full by the company. After I married, I switched insurance to my spouse’s policy, which we paid 100% (via pretax deduction from her salary paychecks). My company reimbursed me the added costs we incurred from my wife’s employer, up to the amount they would have paid had I been on their insurance.

Now, in conjunction with a merit-based salary raise, they want to stop reimbursing. I am free to rejoin the original company insurance, which I would do, meaning there is no cash savings to my company. As far as I’ve been told, it is simply a move to keep the books cleaner and more simple.

My problem is that I now have to cancel and re-instate insurance policies, and inform all my doctors, etc. Plus, the advantage of being on my spouse’s policy was (slightly) better benefits, and the simplicity of having 1 family policy for the 2 (sooner or later 3) of us.

What examples can I cite or arguments can I make to convince my employer to continue this cash-neutral situation my way? Are there companies that document their flexibility with compensation packages (salary, health ins., other)? Am I crazy for wanting this setup? "People say" that non-profits cannot offer salaries that are competitive to the private sector, but the allure is (in addition to doing good) they can offer greater flexibility to employees to keep good talent.

Should I get these tests done now, and will insurance cover treatment in the future?

Anonymous — Wed, 02 Dec 2009 11:01:50 -0800

A complicated question about a specific medical condition, insurance, and pre-existing conditions. Hello,
I'll try to explain this clearly- apologies if it's a bit long, the background is necessary!
I live in New York. Three months ago I switched jobs, and the new job told me I had to wait three months for my insurance to kick in. I did not elect to take COBRA or any interim insurance because I recently had surgery and that knocked my premiums up past what I could afford.

About three weeks after starting the new job I got the results back from a pap smear and they said they'd found HPV of the "dangerous, may possibly cause cancer" variety, and that I had to go in for a colposcopy. I explained that I was waiting for my insurance to kick in and they said it should be ok to wait the two months till this happened.
So last week I got laid off. Now there isn't going to be any insurance till I don't know when.

Planned Parenthood will do the colposcopy on a sliding scale that I can just about afford, but my concern is: if I get this test while I have no insurance, and god forbid it turns out I have cervical cancer or pre-cancer that needs to be treated... when I get a job and get insurance, will this then count as a pre-existing condition and not be covered?

I'm really worried about this. The strange thing is that I already have a condition- ulcerative colitis- but whenever I've started a new job, the employer's insurance has covered it with no problem. So that's a pre-existing condition, right? But everyone is saying that this will be different and that I absolutely should wait to get the colposcopy till I already have insurance.

So, two questions. Is there, for some reason, a difference between things like ulcerative colitis and (knock wood) cervical cancer, that would mean that the former is covered while the latter is not? Is it true that if I test positive my new insurance wouldn't cover treatment?

Second question- I know you are not my doctor, but would it be all right to wait until I do get insurance to get tested? It's already been almost three months now and I'm getting really nervous, thinking that something awful and dangerous might be growing inside me and I just have to wait. I know that the earlier you catch these things, the better, but I also know that if it IS pre-cancer, this kind tends to move slowly- is it all right to wait a bit longer?

Thanks...I'm sorry if this is a bit disjointed but the whole subject makes me incredibly stressed out and nervous and I feel a bit helpless in this situation. I want to do what's best for my health without putting myself into years of debt.

Thanks in advance to all of you....

I miss my country's healthcare system

gmarceau — Wed, 18 Nov 2009 21:44:58 -0800

I'm a grad student in Massachusetts. My school-sponsored health insurance is terrible. The maximum benefit limit is 75,000$ and covers only 80% in-network, 60% out-of-network. I'm poor, but since I'm from abroad, none of the state-supported programs will help. What are my options? If anything catastrophic happens to me, the benefits are such that the insurance will be of little help avoiding a bankruptcy. The only redeeming value of the insurance is its cost. But at 70$ a month, I'm would prefer to pay bit more for better coverage. I asked the company, but there are no extra coverage available, no "rider", as they say.

I've looked at a few private insurances. Unfortunately, coverage in my price range won't cover any activities involving motorcycles or skis, and I participate in both. Short of altering my lifestyle, being on these insurances would still leave open the possibility of a bankruptcy.

Are there any companies that sell extra coverage for people who already have some third party health insurance? How should I go about shopping for such an insurance? The staff at my school's international house were not any help. Who else should I ask? Where could I get some guidance?

Just call me Forgetful Jones.

Madamina — Sun, 15 Nov 2009 10:20:45 -0800

I missed the date to continue my state health insurance. Now my only option is to pay for the super-high-end one until 2011. Do I have any chance of fixing this? I've been working in my awesome office since 2005. I started as a "classified" (state civil service) employee doing administrative work, then transitioned into a half-time position as a graduate assistant (different union) while finishing my master's degree. In September, I transitioned back into full-time work, which is a different position but still technically "classified." During this entire time, I've only filled out one set of tax paperwork (except when my relationship status changed) and have had the same financial coordinator/boss. I've even sat at the same desk through three very different jobs.

So the other day when I went to the doctor, I got held up at the desk. They said my insurance had expired on October 31, and that they couldn't find me anywhere in the system. Eventually I just got fed up, and my clinician and I agreed to just go in and do the appointment and figure it out later.

When I got to work, I checked in with my boss, and she got in touch with the benefits people.

Turns out that when I started my "new job" on Sept. 1, I had 30 days to enroll in a plan. Then I could have done open enrollment for next year during October, but although I considered it, I didn't end up switching.

This is doubly weird because they didn't consider me a new employee for tax purposes. Or, I should add, for vacation purposes -- I only have the leftover hours from my previous stint as a classified employee, which also kinda stinks.

So all I can do now is enroll in the "standard plan." Luckily, that gives me my choice of everything, but unluckily it's the most expensive plan and has a 180-day pre-existing condition clause for everything except pregnancy. And I'm not eligible to change until next year's open enrollment, which still won't go into effect until 2011. (Geez. 2011.)

And... in looking at the cost, it's $150 more expensive for just me, and $488 for a "family plan" (adding a partner or child). So I guess we won't be doing that. I should add that this extra $150 would be reeeeeally nice to have when I start paying my loans in January. (My boyfriend has insurance, but it's way less useful than my state plan, and I may not qualify as a domestic partner.)

I'm just so royally peeved that this perfect storm of forgetfulness between me and my boss ended up like this. Apparently there was one line in my appointment letter that said I had to sign up, but that was it. No reminder from anyone, and no note saying "Oh, watch out, you're going to lose your insurance at the end of the month." I mean, it's not their responsibility to do so, but I never even got anything to say that my 30-day window was over.

Is there anything I can do? I am assuming from prior interactions that HR's rules (which are the state rules) are pretty hard and fast, but they've also treated me like a continuing employee for the whole time. Plus most situations don't involve someone who goes back and forth like this.

Yes, that's right. I AM a special snowflake.

Are there any sort of things I could say to help my case? Could I get fired and rehired? I'm in Wisconsin.

Where are the absolute cheapest places to get prescription drugs?

Anonymous — Fri, 06 Nov 2009 08:20:05 -0800

I'm thinking about switching my health insurance to a high-deductible health plan, but I need to get a handle on what all my allergy prescriptions will cost me. I think that I will be able to build up some stockpiles during this year, but I want to know how much I will actually be out of pocket when it comes time to pay for them. What is the absolute cheapest way to get the following prescriptions?

(I'm in Chicago, but assume that I am fine with mail order, will jump through a lot of hoops, and am interested in both US-based and possibly Canadian-based pharmacies, but I want them to be legal, legitimate pharmacies if they are abroad, and I want to understand how much of a risk I am taking with customs.)

Advair diskus 100/50
Singulair 10MG
Astelin 137 MCG
Veramyst 27.5 MCG
Ventolin HFA

(Anonymous just because I don't like the idea of the details of my health care being out in the wild.)

Help a Canadian travel with peace of mind!

exquisite_deluxe — Sun, 01 Nov 2009 23:29:19 -0800

I'm a Canadian abroad with expired health insurance. What options do I have for a new policy? I need private health insurance for a 6 week trip to India, departing from New Zealand. I've been out of Quebec, Canada since October 2008, and I'm returning in December 2009. My private health insurance (bought through Travel Cuts) has expired, and they will not sell me a new plan without being in Canada.

I was then going to book through World Nomads, which does allow policy purchases after leaving Canada. However, they require Canadians to confirm that they are still covered under provincial health insurance. Since I have been out of Quebec for more than 183 days this year, and did not obtain a letter of extension before departure from Canada, apparantly I am no longer covered. So I can't get the World Nomads insurance.

All the policies I have looked at require booking before the trip, or being out of Canada for less than six months. I have seen this question asking about good travel insurance in Quebec, but it doesn't seem to address what to do without having a valid extension from Quebec health.

Help!! Do I have any options?? My main concern is having coverage for major medical emergencies.

Thanks in advance!

I can never think of a good title to my questinos. Sorry.

Brandon1600 — Wed, 14 Oct 2009 20:57:11 -0800

I need help with creating a plan to diagnose a possible alignment problem with my right leg what I can do do fix it. I have always had a funny way of walking. I tend to lean forward and walk closer to the front of my feet than the back. It is not a perfect heel-to-toe movement and it makes me bounce. I am very self conscious of this and when I am in public I try to walk normally, resulting in a burning sensation on the bottoms of my feet. Think of when you were a little kid and you had to walk around the shopping mall all day and your feet hurt. My feet make an L-shape when I am standing still; my right foot clearly turns out more than the left. Another way of saying this is that my knee does not line up with my foot.

I used to run and work-out a lot. I ran the Kona Marathon about four years ago and at about mile twenty, my right knee felt like it was going to come unhinged. It was a strange kind of pain so I walked the rest of the way. I also noticed when I did squats that my right foot would turn out (heel inward) and I would have to reposition myself.

So.

I think the first thing to do is get a doctor's opinion. I don't normally deal with doctors and I can't say I really trust them. What kind of doctor should I go to? What sort of tests and procedures should I expect?

If I end up having to get surgery, what is the most effective way to pay for it? I have crappy insurance now, and I am going to be a full time student starting in January. Should I go out of country?

I am not sure what information about me would be relevant to figuring this out but:

I am 28 years old, American, employed until December with basic health coverage, well within weight standards and generally healthy, and a military veteran.

Thanks for taking the time to read this.

Should I care that my UCSF doctor is joining Hill Physicans?

otherwordlyglow — Thu, 01 Oct 2009 13:09:34 -0800

All of UC-San Francisco's physicians will shortly end their affiliation with Brown & Toland and become members of Hill Physicians Group. What will this mean for patients? I have been bombarded with news that my primary care doctor, along with all of UCSF's doctors, will, as of 1/1/10, be switching affiliations to become a member of the Hill Physicians Group. Apart from having to switch my health insurance from Healthnet/B&T to Healthnet/HPG during Open Enrollment if I want to continue to see UCSF doctors is there some reason I should care? I guess Hill is part of the Catholic Healthcare West network. Is that significant? Does this switch have any benefits to the consumer or is it just some procedural paperwork that should be somewhat transparent from a user standpoint?

Can I get individual health insurance coverage for one month?

helios410 — Tue, 29 Sep 2009 09:07:07 -0800

Can I get individual health insurance coverage for one month? Is it possible to individual health insurance for one month. My COBRA ends this month, I am going to be covered by another employer in November. In short, I am a NY resident, 27y/o, and my COBRA expires this month. I'm a freelancer who will begin coverage in November with the Freelancer's Union. What can I do in the meantime about coverage?

What can my health insurance company do with this information?

Anonymous — Mon, 24 Aug 2009 13:04:28 -0800

I want to consult a doctor about some possible health problems, but I don't want my insurance company to know about it. What do I do? For the last three months I have been insured through my very small employer's expensive plan with United Healthcare. Before joining my employer's plan I carried about seven months of short-term insurance, and previous to that I was uninsured.

In a few months I will be able to switch my health insurance to Blue Cross Blue Shield under my partner's very large employer's affordable and comprehensive group coverage. Meanwhile, United Healthcare is vigilantly documenting my medical history.

I'm suffering stomach problems, for which I've recently seen a doctor under my current plan. Because I was afraid of alerting United Healthcare to possible pre-existing conditions, I did not tell the doctor that a) I have a family history of kidney disease and b) I was told last year that I might want a screening for pre-diabetes.

It is time for my follow-up appointment, and the treatment my doctor prescribed has not done much good. In the interest of solving my stomach problem, I would like to be honest with her about my possible medical problems, but I don't want United Healthcare to have any reason to deny my claims, and I also don't want to have any problems establishing coverage with Blue Cross Blue Shield in a few months.

Should I be worried about what United Healthcare might do with this information? To clarify: I don't think either kidney disease or diabetes is an imminent health danger. However, they could be relevant to my stomach problem; I can suffer through until it's time to switch insurers, if necessary, but I'd really like to get started solving this.

Health checkup for dummies

Anonymous — Sun, 23 Aug 2009 19:10:41 -0800

Do I need health insurance to visit a G.P.? I'm 18. In all my years, I've only been to the doctor with the family, usually for injections. Now I need to see a G.P. in private and have no idea what paper-pushing is involved. I know my family has health insurance for me, but I would rather avoid having to go through all that rigmarole. Will the doctor's computer systems explode if I put it on the plastic or pay in cash and say I don't have health insurance? If I pay upfront like this, can I forget about it as soon as I walk out the door or do I need to push some papers around? I'm in South Australia if it matters. To be clear, I have absolutely no idea how the health system works. On the plus side, I've had good health for the past 17 years so I didn't need to!

carpal tunnel and tendonitis and what to do?

Anonymous — Tue, 18 Aug 2009 11:16:12 -0800

Arm/wrist problems and no health insurance: what to do? John got (diagnosed) tendonitis last summer. It was a work related injury and he received workers comp for it (including doctors visits and physical therapy). It slowly got better. In December/January John was spending too much time typing and got (diagnosed) carpal tunnel. He was in a country with public health insurance then so was able to see a doctor. He got some sort of injections in his wrists/arms (not cortisone injections), which didn't really seem to help.

Returning to the USA, John stopped having any sort of health insurance (and has a part-time job, which does not offer him health insurance but pays enough that it disqualifies him from Medicare), but went to several free clinics asking what he should do. They told him to take NSAIDs and wear wrist braces all the time. John has been doing this for the last three weeks, but the wrist braces have aggravated the previously-mentioned tendonitis in his elbows.

Right now he has weak and tingling wrists and hands, opening jars and turning on sticky faucets causes pain and tingling. In the winter (when it was really cold), his fingers were going numbish/turning white. After wearing wrist braces for over an hour, his elbows start feeling like they did back when he first got tendonitis (pain near funny bone, pain down forearm).

He doesn't know what to do. He doesn't want to make either of his arm injuries worse, he doesn't want to ruin his arms for life, he does not have savings or enough money to be in a position to negotiate a flat rate with a doctor. Right now he is doing yoga, has just started taking vitamin B-6 (thanks to advice from the internet), isn't typing or using a computer, but is at a loss as to what his other options are (other than living with weak and tingling and weird-feeling arms for the rest of his life).

What should he do? What can he do? What are his options? (Also, this is being typed by his girlfriend Jane, who would also like advice on how she can best be supportive and help John feel better during this.) If it matters, we are in the central New York area.

Health insurance only for execs' kids?

ethorson — Fri, 14 Aug 2009 06:56:16 -0800

Can a company provide health insurance for an executive's dependents (spouse, kids, etc) but not for other employees' dependents? Is it legal for a company to provide health insurance for some of its employees' dependents but not for others? For instance, can the plan specify that it covers the CEO's spouse and kids but not a web developer's or project manager's kids? (given that all three employees are eligible for insurance, etc). There was a bit of discussion of this issue in this thread, but I'd like to hear (a) whether anyone has actually experienced a policy like this and (b) what, if any, regulations (HIPAA, ERISA, etc) might prohibit it.

I'm asking for a friend who is located in Virginia and works at a company with fewer than 10 employees. This is *not* the insurance plan currently implemented at their company, but a proposed change to the existing plan.

Medicaid Discrimination?

Maias — Sun, 26 Jul 2009 10:13:29 -0800

HealthInsurance Filter: If a friend goes on Medicaid in dire financial straits, will insurers be able to discriminate against her later? A friend hit serious financial problems due to an injury. Currently has good insurance, but can't afford it much longer and is waiting to be approved for disability. If she goes on Medicaid and then recovers, will her attempts to get health insurance be forever scarred by having done so? I didn't think it was legal to discriminate based on previously having been on Medicaid (obviously, they can deny pre-existing condition coverage but that's true no matter what insurance you switch to or from). Anyone know? Is this illegal but done anyway? Any idea where to find out?

Travel insurance reccomendations for an unusual trip!

mateuslee — Thu, 23 Jul 2009 05:01:18 -0800

Any travel insurance recommendation for an unusual trip to Peru? I am an dual-citizen American/European living in the Netherlands and so I have Dutch health insurance, however, if I am abroad for more than 3 months my insurance plan is void.

In a couple of weeks I will fly to rural Peru to conduct fieldwork in some rather unpleasant conditions: high in the Andes, and also in the jungle.

I know a few people have asked about travel insurance before, but I'm looking for something more heavy-duty (mainly wrt health) should I need serious treatment.

Does anyone have any recommendation?

Thanks a lot!

How can I prevent a future health insurance co from discovering a previous dematology treatment and use it for denial of insurance?

Anonymous — Mon, 20 Jul 2009 07:45:05 -0800

I'm an American without health insurance, who needs (minor) dermatological care... how worried should I be that this will prevent me from getting private health care insurance in a year or so (denial due to prior condition)? And what can I do to prevent this from happening? After waiting for a year, I really need to have a few warts and dermatofibroma taken care of, maybe get a prescription or two. Nothing serious or particularly costly. I'm going to pay cash out of pocket, to a dermatologist or general practitioner whom I haven't seen before. I'm worried that this could be used against me in the next year or two when I will purchase private health insurance ... what should I do to prevent this? Is there a way the insurance company will discover this, etc... ?

Is this something I should worry about?

What are my options for insurance?

suncoursing — Wed, 15 Jul 2009 15:39:18 -0800

What are my options for insurance? I'm starting grad school this fall in Texas, after a few years at a startup. If I were an RA or a TA, I'd automatically be enrolled in the staff insurance plan, but I'm not eligible for that because I'm on a fellowship. I can keep my current insurance through COBRA but, at $600/month, it's a bit expensive. The plan is really nice (no co-pay for a lot of things, $200 annual deductible and maximum out of pocket, no maximum benefit for health or perscriptions, etc.), but it's way beyond anything I need.

The student insurance plan is ~ $160/month, but it has a maximum benefit of $100k. I could handle a plan with a $100k deductible, but $100k maximum benefit means it would only cover relatively minor problems that I could afford without insurance, leaving me with most of the bill for anything catastrophic. Maybe there's something I don't understand about insurance, but this plan seems completely pointless. There's an option to increase the maximum benefit to $500k for an extra fee, but that's still an order of magnitude lower than the maximum benefit for the BCBS plans I've looked at.

BlueCross BlueShield of Texas has various plans ranging from $40/month to $200/month. The $160/month plans look much better than the student insurance plan, and if I'm willing to take a $10k deductible, I can get away with only paying $40/month. If I don't have a pre-existing condition, is there any reason I should prefer group coverage to individual insurance? Are there other insurance providers I should be looking at? I found this list (http://www.tdi.state.tx.us/health/lhiah_lst_incl.html) through a previous post, but since I know absolutely nothing about any of these companies, I might as well go with BCBS if I'm just going to randomly pick a company off that list.

So my options are (roughly in order of preference):
1. BCBS insurance. Only $40/month!
2. Defer my fellowship for a semester, get an RA or a TA, and then pay $300/month to get the staff insurance through COBRA.
3. COBRA. $600/month.
4. ???. Is there something I could do that I don't know about?
5. No insurance
6. Student insurance.

Other than the large deductable, is there any reason I wouldn't want option 1?

Also, do I actually need dental insurance? It seems like insurance only ever covers half the cost anyway, and I doubt anything really horrific will happen if I skip getting a cleaning for a year.

Objective, Succinct Resources on Healthcare Around the World?

ZenMasterThis — Fri, 10 Jul 2009 06:38:30 -0800

Thoughtful, analytical, objective resources (web and book) on what works and what doesn't in healthcare / health insurance systems around the world? With the current debate going on in the US, I figure I'll get myself a little more educated on this subject. Please note IANAA (I am not an academic).

Extra points for resources that are succinct and to the point.

Health insurance for all? Is that a good thing? What can I do to help?

zeek321 — Thu, 25 Jun 2009 16:59:45 -0800

So, I saw Howard Dean on the Colbert Report last night. Please help me with some specific action steps regarding health care and the future of the USA. How can I learn more about the options on the table (and the options not on the table) and how they might affect individuals (of all levels of income and varieties of occupation) as well as the general economic health of the country? Whether or not I arrive at any personal conclusions, what can I do to help the best option prevail?

I've been vaguely aware of the situation as it's been unfolding, and I've been selfishly hoping that things will work out in my personal favor. But I've never wanted it as bad as last night. And, if I'm actually going to educate myself and take action, then I want my actions to benefit the largest number of people possible, with a long view to the future of the country.

Clarification: Please don't argue for or against different things in your answers. How can I figure out the different options and do research on them myself? Is there anything besides "write my congresspeople" that I can do to help? (Especially if I, in the most likely case, side with some sort of government health insurance?)

Gynecologists in NYC who will order a Mirena IUD

Anonymous — Fri, 19 Jun 2009 11:10:33 -0800

Gynecologists in NYC who will order a Mirena IUD for me? I'm trying to get a Mirena IUD and am encountering a frustrating loop regarding getting it paid for by my health insurance, which is United Healthcare. Here is the story:

-I am in NYC
-I have not had children
-My gynecologist is willing to implant an IUD and we have decided on the Mirena. The problem is getting it paid for.
-My insurance, United, covers the Mirena - both implantation and paying for the iud itself - 100% as a medical benefit. However.
-My gynecologist's office will not order the actual device because they have had trouble being reimbursed by United at the rate that they are charged by Bayer (who makes the Mirena). They want me to order and pay for the device myself and then seek reimbursement.
-United will not pay for the device unless the doctor's office orders it; they say I cannot just pay for it and then be reimbursed.

I've gone back and forth on this and no one is budging; they both say the alternative is to find a doctor who is willing to order the Mirena, but that they cannot suggest a doctor. This thing is $600 and it is supposed to be covered by my insurance, so I'm trying to avoid just sucking it up and paying.

So my question is, are there any NYC Mefites who have successfully acquired a Mirena and had it paid for by United Health? And if so, would you be willing to share the name of your gynecologist?

Health Insurance Reviews

philosophistry — Wed, 17 Jun 2009 16:38:13 -0800

Do you know any good health insurance review sites? Would/do you trust them? With the news coming out that more than 60% of bankruptcies in 2007 were due to medical bills, it got me hunting for an insurance company that would be less likely to stick it to me when the chips are down.

I googled "health insurance reviews" and the only one that seemed useful was insurance.freeadvice.com.

I looked up my health insurance company and I was stunned how many "very unsatisfied" votes it got!

So before I just go off and switch providers, I want your opinion. How well can I trust that site? If I can't, how do you recommend I find good health insurance?

Can my VA employer pay for individual health insurance?

88nemeth — Thu, 11 Jun 2009 15:26:06 -0800

Can my Virginia employer, a small business/sole proprietorship, pay for my individually-issued health insurance premium? I just started a new job and the owner, a sole proprietor, has offered to pay for up to $250 a month in individual premiums for me and my coworker: she doesn't want to get group coverage because, with only two employees, if one of us leaves then the other will lose insurance also.

I went through the application process for Anthem BlueCross of Virginia only to find at the end that I had to agree to the following statement: "the Anthem Blue Cross and Blue Shield policy, if issued, shall not be used as an employer-provided health care benefit plan. I certify that no employer of any person covered under the Anthem Blue Cross and Blue Shield policy may pay any premium for the Anthem Blue Cross and Blue Shield coverage, directly or indirectly, including through wage adjustment."

Some googling found examples of employers in other states paying for individual premiums, but I couldn't find any Virginia examples. My boss is offering to just give us a raise instead, but if possible I'd like to have the tax-free advantages from an employer-paid plan.

Does anyone know if any Virginia insurers are amenable to such arrangements?