Category Archives: When Insurers Say No

Health coverage different for employee than for dependent

Is anyone else aware that the benefits of a health plan can be different for the enrolled employee versus the dependent?  How is this even legal in any state?  And disclosure is not required either.  This was a work-related injury. Fuming and Hurt Dear Fuming and Hurt, I  think what you have found is that […]

Obamacare: can specialists refuse to treat me?

Do uniquely qualified specialists have the right to refuse to treat a patient who has name brand private sector insurance, just because the policy was purchased on the health insurance exchange? Special Case Dear Special Case, If the specialist accepts patients with insurance from that insurer, he or she would not be able to reject […]

Employer missed health insurance payments – what to do

I just found out that my employer has not been paying for my health insurance for the past seven months.  Should I try to get the $1,400 they “saved” or just be glad that they put me back on the plan? Unpleasantly Surprised Dear Unpleasantly Surprised, If you think this was a simple clerical error, […]

Test for toxins might be covered

What toxins can I get a blood test for, that health insurance will cover?  I know that lead is usually covered, but what else? Chem-Free Dear Chem-Free, As long as the test is medically necessary, it would generally be covered by health insurance.  The test would need to be related to symptoms you were having, […]

Obamacare: DNA tests not required

Should insurance companies be allowed to use DNA tests to decide how much to charge someone?  Insurance companies currently use such information as sex, age, preexisting medical conditions, BMI, smoking, and other factors to set rates for individuals on the basis that these factors effect the likelihood of payouts. DNA information can show genetic likelihood […]

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: Not all colonoscopies are “preventive”

I would like to see you do research and topic of colonoscopy on patients that have been diagnosed with ulcerative colitis previously.  Getting insurances to cover for these people is not good.  They have to pay their high deductibles,(mine is $2500)therefore really is not affordable for most. Insurances feel that colonoscopies are diagnostic not preventive […]

Medical tourism — getting surgery cheaper elsewhere

Which health insurance providers have provisions that allow for medical tourism?  I’ve heard that hip surgery is much cheaper in other countries, and I’m going to need it soon. Have Hip, Will Travel Dear Have Hip, Will Travel,  Medical tourism is going to another country for medical care.  It is popular for cosmetic procedures or […]