Thursday, March 31, 2011

Can someone explain how deductable works on health insurance?

I need to choose an insurance plan but I don't know what deductable means, or how it works. A simple explanation will help Thank you
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A deductible is the amount of money you have to pay a year towards your bill before your insurance starts paying. Every insurance company is different so call them for specifics. Deductibles usually do not apply for regular doctor visits. They have a copay or coinsurance and the money you pay does not go towards the deductible. Diagnostic tests, outpatient procedures and hospitalization is where you will see deductibles. Insurance company keeps a running total for the year, meaning that once you meet the deductible you do not have to pay it again until in resets at the end of the year. If you have a $300 deductible and your medical bills are $2000 for the year, you pay the first 300 of the bill then the insurance company will pay most of the rest of the outstanding $1700. Hope that helps
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Is there a website I can go to that has testimonials of people denied health insurance?

I need a few examples of people who have recently been denied insurance because of a pre-existing condition or similar circumstance, is there a website I can go to that has some?
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You can try a search on ripoffreport. This country has the best healthcare system. But it is not perfect and neither is any other health care system in any other country either.
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Why is it that only those employed by companies, full time and the wealthy can have health insurance.?

A friend of mine works six hours a day, five days a week and of course this company does not provide health insurance for 'part time' workers. She has spent innumerable hours trying to find health insurance she can afford but her income is so limited she's been unable to secure this. She is 52 years old and does her very best to provide for herself. Are there any answers to this dilema. It seems so unfair that some can get care when they have money but the others lives seem to be rated less valuable.
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Employer sponsored health care started out as a small perk about the time of WWII, and morphed into this highly inconsistent & unbelievable complex system we have. It seems profoundly illogical for our country (the US of A) to give lip service to promoting business & especially small business, then saddle the poor entrepreneur with health care expenses for the employees And if some employee is chronically ill the small business is punished de facto for carrying that person. And if a person has a chronic illness, they can't change jobs or will loose their insurance. Then if they loose their insurance, they can't get reinsured as now have a prior condition. A Pro-Business stance would be universal health care! All the other civilized countries of the world have it.
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why do doctors treat you badly if you don't have health insurance?

i went to a dermatologist and she didn't seem to care about the problem i had. she didn't even prescribe me medicine for it. she let the nurse do everything and i was charged a lot of money. she acted as if she didn't have time for me but she spent time on other patients. could it be b/c i don't have health insurance and she thinks i can't afford to pay for medicine?
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I don't think that the lack of insurance is the problem, In fact it is to the doctors advantage that you do not have insurance. Most doctors charge a patient more money who don't have insurance than they receive for those who do have insurance. I think that you just ran into a bad doctor, the doctor having a bad day, or a doctor who was jsut so busy that she had her nerses do most of the work. Next time choose another doctor.
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Why did my Health Insurance Premiums go from $250 a month to $950 a month under Bush?

When I have never been hospitalized and hardley ever used the Insurance.
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because you are high risk with mental illness? I really can't say. Ask God. I concede to Epic beard man ! LMFAO
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What would the cost of a physical exam be without health insurance?

About to start a new job and dont have medical insurance
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It depends on where you live and the type of tests they want to run. It could be anywhere from $75 to $1000s. This isn't like getting your car repaired, where you can ask for an estimate, but they should give you a ball park figure. A doctors office call is one price, where as blood tests are sent out to a lab and they bill separately.
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Can people with ALS (Lou Gehrig's disease) join a Medicare Advantage plan for 2008 health insurance?

Medicare Advantage (MA) health plans offer more value to Seniors because they usually fill insurance gaps that original Medicare has like hospital stay and physician care deductibles and copays. Can all Seniors who are eligible for Medicare in the US join a MA plan or are some conditions, specifically Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig's) disease excluded?
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Yes, they can. You must have Medicare parts A & B to qualify for a plan. The only health issue that will keep you from getting on a Medicare Advantage plan is End Stage Renal Disease. Open enrollment is November 15 to December 31. You'll want to visit a local independent agent that works with senior policies to find the best plan for your situation. Many MA plans will also include Part D. Prescription co-pays are one of the biggest difference in plans. There can be several thousand dollars difference in your co-pay between plans so it is imperative that you do an analysis of your medication.
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Have you had a Rhinoplasty/Septoplasty through private health insurance and medicare?

I need this procedure done and have been informed that medicare will cover some costs for the septoplasty component. The total costs including anaesthesia and hospital is $13000. I have been advised by my surgeon to join a private health fund but am wondering if they will cover more than medicare would. Would be really helpful if I could get some advice from someone who has been through it. Thanks.
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healthquotes.awardspace.info - here is my health insurance plan. As I remember they can provide such a service.
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do you get mailed letters about health insurance?

ok me n my bf have been going out for while and we want to have sex n i am going to go to planned parenthood for birth control i was wondering if i used my health insurance card if my parents would be mailed something about the coverage of my birth control.
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They might be, yes. Many insurance companies send out statements every month showing how much coverage has been used and what amounts have been paid to which providers. Talk to the Planned Parenthood people about this. Many of their services are available free or at a very reasonable cost. They won't bill your insurance company if you ask them not to. (And PLEASE don't decide not to use birth control because of this!)
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Dems pass a bill that forces me to buy health insurance from an insurance company?

so explain to me how that makes Republicans in the pocket of major insurance companies again? Liberal logic is a massive fail.
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42! Nope that doesn't work. It's Bush's fault! Nope again. Ummmm.......
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Why does the govt passed laws protecting Health Insurance Companies from Anti-Trust Monopoly Laws?

Why is it? I know you may say that there are thousands of insurance companies, however, they are mostly owned by 4 companies. Insurance companies had a lot to do with how the cars manufacturers in the US were affected. Toyota, nor Honda pay insurance to their employees, the govt of Japan does. That way they saved millions a year to invest in their cars. Why do we protect these companies from anti trust law? Lobby? Bribery? Thanks for your answers.
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Because they make more money that way. It's kind of like that famous bank robber who when asked, "Why do you rob banks?" responded, "Because that's where they keep the money."
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Can I get my health insurance to pay for my gynecomastia/mastectomy surgery?

I developed breast tissue after taking several different prescribed antidepressants years (which didn't work, by the way). I went to a endocrinologist and he said I may be able to get the insurance to pay for it. I want to get it taken care of because I feel self conscious.
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You will have to check with them, but if there is a medical necessaity for it and it is not mere cosmetic surgery, they will cover.
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What do you tell someone who can't afford health insurance?

What do you tell someone who's working at a place like Wal-Mart or construction when he needs health care? If someone only makes $12.00 an hour, he's not going to be able to afford to take a lot of money out of his check for insurance. (I made less than that for 3 years, I was lucky I never had a health problem) So he's not going to be able to go to the doctor, which costs about $100-150 a visit (it was $120 the last time I went, not counting the prescription). But there are still a lot of people that don't think we should have a national health care system. The Wall Street Journal's answer was tax breaks and health savings accounts. Geniuses...if you make little money, how can you save any? When I made $9 an hour, I generally had less than $200 a month left over after bills were paid. I used that for food. What use is the best health care in the world, if only the rich can afford it? So what do you tell the millions who aren't fortunate enough to be insured?
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I hope you all never have to find out what it's like to work all your life, pay your insurance, pay your taxes, do all the responsible things you're supposed to do, and then lose your job, possibly due to age discrimination (very hard to prove). Run out your Cobra, and no one will insure you due to a pre-existing surgery or condition. At the age of 60 it's not easy to find a job that you've done for 40 years, when they can get a 30 year old for much less money, with a college degree. No one expects to find themselves in this position, but s..t happens all the time. All you need is the right set of circumstances to happen just a certain way, and you could be broke and on the street. Everything you worked for gone, no savings left. I hope you all realize that it really can happen to you, and quit being so smug. You're young and think you have the world by the tail, but it can turn around and bite you at any time!
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Does your employer have to tell you if they make changes to your health insurance?

So I found our new insurance cards in the mail and noticed our copay went from $20 to $25. I'm wondering what else changed on our insurance without being told about it. Can your employer legally make changes like that without telling you? I'm wondering if our deductible is still the same.
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No, they don't. Absolutely, they can make changes without telling you - or they can cancel the coverage without telling you, too. You'll have to ask someone, if the deductible is the same.
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Pres Obama now wants to put limits on our health insurance premiums, do you want the gov control care we get?

If the government controls the insurance premiums, that will automatically control the amount of care those insurance companies pay for; basic cause and effect. Didn't the Message from Massachusetts tell this Administration the voters did not want more Government control of anything?
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Cost controls at the same time the government wants to dictate standards of care are not going to work. It is meant to fabricate a crisis whereby the government will be put in a position to come to the rescue with universal care. Private insurance will either be forced to cut care or move out of health care. I think people who are old enough remember when the government tried to cap oil prices will reject this idea.
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How much will we save on health insurance once Obama & the for profit insurance companies figure out?

a scheme to stick us with? Does anyone really think that the overall cost of health care will go down?
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The cost skyrocketed because the American people were convinced that they needed insurance. As soon a pencil pushing geek is put in charge of deciding who gets care and who doesn't, that is when the system failed. When I blew my knee out last November, I went to the hospital, and breezed through the check in and received great care. I had X-Rays, and was scheduled for an MRI and a specialist. And then, they found out it was work-mans comp, and the government got involved. It took 3 days to sort through the paper work just to get a MRI, and then another 2 days to get surgery scheduled. If I had a medical savings account or catastrophic insurance, everything would have been better. Because of my experience with single payer health care, you will never convince me that it better then our current system.
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Is it legal for a company to refuse to put a spouse on health insurance?

Is it legal for a company that you work for to refuse to put your spouse on your insurance if they are able to get their own insurance at the company they work for?
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A company can require the spouse to take their employers insurance if the company self funds their own insurance. They can even charge a surcharge if your spouse elects your coverage when they can get their own coverage through their own employer. If however it is a fully insured plan then it is not legal. Self funded insurance does not have to follow the same guidelines as fully insured groups.
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Do all full times jobs give you health insurance?

I just got a full time job. The guy really didnt say anything about health insurance or any kind of insurance since its full time i was wondering if i get it? its about $9.00 an hours. not sure if that helps any tho
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Offering health insurance or any other type of employee benefits such as 401k plans, profit sharing, life insurance, disability, etc. is entirely optional for the employer unless they are a "union shop". The companies that usually offer these benefits do so to increase retention (a high turnover rate can lead to poor profits), increase morale among employees, increased production and an overall better work environment because employees feel more valued and respected which is worth more to them than say an extra 25 cents per hour. While most companies that offer the benefits do so only for full time employees, some companies do offer the benefits to part time employees. In addition some companies do have a waiting period (which can vary from 30 days to ......) after your initial hire date before you become eligible for the benefits. In addition the amount the companies expect the employees to contribute to the plans varies widely among clients which means to get coverage under group health insurance you might have to contribute anywhere from 10 to 50% of the cost. You should probably ask someone in the Human Resources Department or the Office Manager or look in the Employee Manual if you were given one since many times it is listed there. If they do not offer health insurance, you will need to either purchase your own or try to find another job that offers it. I do wish you the best of luck at this new job.
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When you join the Army, do they talk to your current health insurance company about bills and stuff?

I got hurt when I was 13 but it doesn't have anything to do with me now I'm 100% healthy. My parents are still making payments on the bills but I'm wondering if they will know about this? Will they talk to the insurance company I'm currently insured under at all?
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Let's be honest, if the military spent time investigating peoples medical history it would be one never ending episode of CSI. The Privacy Act ensures your medical records aren't for the public eyes. The Army does run a credit check to make sure you don't suffer from indebtedness. If your name pops up on a credit check and the bills are from a medical institution it would be a dead give away that you aren't 100% healthy and honest. Don't lie to the recruiters, seriously. The military has it's own health care system called TRICARE. They are an independent agency that deals with active duty soldiers, dependents, retirees etc. They have no business talking with your current health care insurer. ps Just because you think you are healthy doesn't mean you are fit 2 fight. Good luck
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With health insurance, what if the provider does not submit the claim before the window for doing so closes?

For example, on a date the provider provided a service, but failed to properly submit the claim for insurance before the window for doing so closes. Does the person who received the service then have to pay the provider, or does the provider forfeit payment for not properly submitting the claim?
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It depends on the provider's contract with the insurer. Most contracts, with an IN NETWORK provider, say that the provider has to "eat" the bill - and can't charge the patient. But if it's not in network, or that provision isn't in the contract, then the patient is on the hook for the full amount.
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Can an employer terminate health insurance while you're still in the hospital?

A friend of mine was in a catastrophic accident (not at fault) and has been hospitalized for 3 weeks. The company he works for knows that he is injured and believes he MAY not be able to work again. The company has told his family that they will be terminating his insurance after April. Is this legal? This seems to be discriminatory to me, but I'm not sure of the law.
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The employer is obligated to follow the benefit rules of the plan. If your friend becomes ineligible under the rules of the plan, then they have to terminate his coverage. So the question is not whether, in general, a person's health insurance can be terminated while they are hospitalized. (It can.) The question is why specifically your friend's insurance is being terminated. Are they terminating his job? Are they stating that he's no longer eligible because he's not actively working the minimum number of required hours per week? These could be valid reasons for terminating a person's group health insurance benefits IF those are the eligibility requirements under the plan. If the injury was not work related and your friend has not been at work for 3 weeks/will not be returning any time soon, its possible that your friend's coverage could be canceled. He should speak with his human resources representative, if he's able to do so. (If he's unable to communicate, whomever is his legal representative should do so for him.) He or his legal representative could also check with his state's Department of Labor, if they feel that he is being wrongfully terminated. He should also find out whether he's protected under the Family Medical Leave Act (small employers are exempt from that law), and whether or not he will be eligible for COBRA continuation coverage. They could also contact an attorney to assist them.
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Double up on individual health insurance?

Can you have more than one Health Insurance Plan for your self? I have to buy my own insurance, but even the best individual insurance is crappy and I wanted to now if people ever buy two insurance plans? The insurance i have now only lets me see the doctor twice a year. If I got another insurance plan would it pick up where the other left off?
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Hi, Generally it is not a good idea to have more than one health insurance plan because only one will be your primary coverage. You need to be careful if you want secondary coverage. Many policies will not allow you to get a policy if you already have a policy. Having said that, there are supplemental plans that pay YOU instead of the doctor or hospital. They are with companies such as Aflac and are supplemental plans. They are set up so that you get a certain dollar amount for each doctors visit, emergency room visit, hospital stay, or surgery. While I represent individual insurance companies I don't generally recommend these supplemental type plans unless you go with an HSA where you don't have co payments and you have a high hospital deductible. But you get what you pay for with insurance. If you want low co payments and deductibles then your premium will be high. I would recommend getting a primary plan that is good enough and saving money to pay co payments and deductibles. Try this site http://free-health-quote.blogspot.com/ Here you can get quotes from different health insurance companies in your area, its the best way to find an individual health insurance with a reliable company. Best Wishes,
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Double up on individual health insurance?

Can you have more than one Health Insurance Plan for your self? I have to buy my own insurance, but even the best individual insurance is crappy and I wanted to now if people ever buy two insurance plans? The insurance i have now only lets me see the doctor twice a year. If I got another insurance plan would it pick up where the other left off?
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Hi, Generally it is not a good idea to have more than one health insurance plan because only one will be your primary coverage. You need to be careful if you want secondary coverage. Many policies will not allow you to get a policy if you already have a policy. Having said that, there are supplemental plans that pay YOU instead of the doctor or hospital. They are with companies such as Aflac and are supplemental plans. They are set up so that you get a certain dollar amount for each doctors visit, emergency room visit, hospital stay, or surgery. While I represent individual insurance companies I don't generally recommend these supplemental type plans unless you go with an HSA where you don't have co payments and you have a high hospital deductible. But you get what you pay for with insurance. If you want low co payments and deductibles then your premium will be high. I would recommend getting a primary plan that is good enough and saving money to pay co payments and deductibles. I hope this helps.
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Does a person on Medicaid need to continue with a secondary health insurance like Blue Cross?

I can't get a straight answer from either agency. Naturally Blue Cross wants their monthly payments to continue -- as Medicaid wants their percentage of health costs to be at a minimum. Can someone out there give me a definative answer?
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Medicaid or Medicare? Where I live, you can't get Medicaid if you have insurance. Medicaid is based on income and ability to get medical care. With Medicare, secondary health insurance is really a necessity these days.
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