Category Archives: Health Insurance
Looking for Transparency in the Cost of Medical Services and Insurance Coverage? Just Be PATIENT.
Transparency is a modern buzzword gaining traction in many areas of public life. It’s been a part of the healthcare arena since at least 2010 and seems to have kicked into high gear starting in 2020. Yet even today, consumers struggle to find out what health services will cost upfront, and healthcare providers and insurers continue to strive to keep that information secret and hidden from patients until the bill comes after the fact.
Medicare Insurance Denials – What Can You Do?
Medicare Advantage policyholders have their claims denied at an outrageous rate, according to the federal government’s own reporting. On the bright side (sort of), claimants who appeal their denials are by and large successful in eventually getting their claims approved. If you’ve had your legitimate Medicare Advantage insurance claim denied, there are steps you can take to get the coverage you need and are entitled to, and you might also have a right to monetary damages based on your insurer’s violation of the law.
How to Fight a Health Insurance Claim Denial
We’ve previously discussed some of the many reasons insurance companies give for turning down claims. Insurance companies are often wrong when they make these determinations, but how do you go about convincing them of their mistake? You have a right under state and federal law to appeal a health insurance claim denial, but you must follow certain steps in a certain order under defined time frames. We talk about those steps below.
Is Cosmetic Surgery Ever Medically Necessary?
Surgeries and other treatments and procedures can cost thousands of dollars, so it’s no surprise that health insurance companies only want to cover procedures that are deemed medically necessary. So-called elective surgeries, procedures that people choose to enhance their looks or for other reasons unrelated to treating a medical condition, are not covered.
Why Some Health Insurance Claims Are Denied
Without health insurance, a visit to the doctor can set you back several hundred dollars. If you need surgery, a name-brand medication, or if God forbid you get a life-threatening illness, medical care can run into the thousands and quickly become unaffordable. Health insurance can literally be a lifesaver, but what happens if the insurance company refuses to cover the services or treatment you need?
What Do Insurance Companies Do With Consumer Complaints? Hide Them From Investors, of Course!
On July 20, the Securities and Exchange Commission (SEC) announced that it had filed charges against a health insurance company for hiding a long list of consumer complaints from the company’s investors.
Eligibility to Buy a Marketplace Plan
The Health Insurance Marketplace® is a service that helps people shop for and enroll in health insurance. The Marketplace is run by the federal government under the auspices of the Affordable Care Act, also known as Obamacare, which brought health insurance to millions of Americans who were previously uninsured.
Health Insurance and Federal Taxes: The Government Giveth and the Government Taketh Away
Tax season has come and gone for most of us (did somebody say extension?), but even if you already filed, if you didn’t get it all right, you can expect to hear back from the IRS telling you to try again. One particularly confusing area involves the premium tax credit offered as part of the Affordable Care Act (ACA), aka Obamacare. The tax credit is a signature piece of the ACA, providing access to health insurance for millions of Americans who otherwise wouldn’t be able to afford it.
What Does an Insurance Agent Do?
The way people buy insurance is changing. More and more, people do their own research online and make purchasing decisions without consulting a professional. This is happening in every area of life, and the insurance industry is no exception. For many people, however, insurance remains a complex and complicated area, and they want guidance when it comes to understanding insurance terminology and learning which companies and which plans offer the best fit for their needs.
What Is a Catastrophic Plan, and How Do I Get One?
The way people buy insurance is changing. More and more, people do their own research online and make purchasing decisions without consulting a professional. This is happening in every area of life, and the insurance industry is no exception. For many people, however, insurance remains a complex and complicated area, and they want guidance when it comes to understanding insurance terminology and learning which companies and which plans offer the best fit for their needs.
