June 06, 2011
Understanding Insurance for Health
7:55 PM | Posted by
admin |
Edit Post
Health insurance helps protect you from high medical care costs. Many people in the United States get a health insurance policy through their employers. In most cases, the employer helps pay for that insurance. Insurance through employers is often with a managed care plan. These plans contract with health care providers and medical facilities to provide care for members at reduced costs.
You can also purchase health insurance on your own. It usually costs you more than employer-based insurance. People who meet certain requirements can qualify for government health insurance, such as Medicare and Medicaid. If you do not have health insurance, you must pay your medical bills directly or rely on health care providers or organizations that donate care.
What are "covered services"?
Your health insurance policy is an agreement between you and your insurance company. The policy lists a package of medical benefits such as tests, drugs and treatment services. The insurance company agrees to cover the cost of certain benefits listed in your policy. These are called "covered services."
Your policy also lists the kinds of services that are not covered by your insurance company. You have to pay for any uncovered medical care that you receive.
What happens if my doctor recommends care that isn't covered by my insurance?
Most of the things your doctor recommends will be covered by your plan, but some may not. When you have a test or treatment that isn't covered, or you get a prescription filled for a drug that isn't covered, your insurance company won't pay the bill. This is often called "denying the claim." You can still obtain the treatment your doctor recommended, but you will have to pay for it yourself.
If your insurance company denies your claim, you have the right to appeal (challenge) the decision. Before you decide to appeal, know your insurance company's appeal process. This should be discussed in your plan handbook. Also, ask your doctor for his or her opinion. If your doctor thinks it's right to make an appeal, he or she may be able to help you through the process.
Subscribe to:
Post Comments (Atom)
0 comments:
Post a Comment