Category Archives: Weird Words

Easy-to-understand description of those strange words that health insurers use.

Who is watching the bills?

Whose responsibility is it to monitor accurate procedure coding for a patient’s billing and account? Can the patient reasonably be expected to audit and enforce correct coding?  Is there a source of transparent codes/procedures (along with what is covered by an individual’s policy) that consumers can access? Watchful Wonderer Dear Watchful Wonderer, The patient cannot […]

Affordable Care Act: How to find good info about options

“I am a self-employed person. How can I make the most informed decision about medical insurance policies?  Are there any no-bullshit resources I can use to educate myself?” Just The Facts Ma’am  Dear Just The Facts Ma’am, In theory, the exchanges should be showing you apples-to-apples comparisons of the various plan options. There is a […]

Emergency room cannot refuse you

Can a hospital refuse to remove a bug from my ear just because I have no health insurance? Uninsured and Bugged Dear Uninsured and Bugged, A hospital cannot turn you away from the emergency room, without first determining what is wrong with you. Under federal rules called Emergency Medical Treatment and Active Labor Act (EMTALA), the […]

Pre-existing conditions — what’s the big deal

I don’t understand why health insurers won’t take pre-existing conditions.  I have diabetes but otherwise I’m healthy as a horse.  I haven’t been in a hospital or emergency room in years.  Why is it such a big deal? Diabetes No Biggie Dear Diabetes No Biggie, Kudos to you for managing your diabetes successfully. Health insurers […]

Should employer pay when you leave their health plan?

I’ll be getting married in 37 days and 14 hours (but who’s counting?).  I’m planning to go onto my husband’s health plan.  I told HR this, and they said, “Oh, we’ll save some money on you then!”  I didn’t say anything, but aren’t they supposed to pay me the money they would have paid for […]

Crone’s disease treatment is done — is it a pre-existing condition?

Is Crone’s Disease a pre-existing condition if I have been discharged from further treatment? I’m worried that I won’t be able to get health insurance, even though I’m perfectly fine! Crone Free Dear Crone Free, The pre-existing condition problem only arises when you change health plans.  And it’s only a problem until January 2014, when […]