Tag Archives: claim denials

Coverage for GI specialists in New York

What is the best health insurance plan for someone living in New York City, who has Irritable Bowel Syndrome and acid reflux?  I want to be able to see gastroenterologists when I need to have specialized procedures or tests done.  My main concern is that when a doctor recommends me to someone else there’s a […]

Flu shot covered, office visit co-pay still charged?

I took my kids to the doctor’s office for their flu shots.  They told me that the flu shots were covered because of Obamacare, but I still owed the $25 co-pay.  Is that allowed? Feeling Gipped Dear Feeling Gipped, It is allowed, however if the only purpose of the visit was the flu shot, the […]

Obamacare: alternative medicine is “covered”

Why hasn’t anyone thought of a health insurance plan to cover alternative medicine?  An insurance that goes outside the current health system, a separate insurance for people looking for these complementary and alternative medicine treatments? Other Path Seeker Dear Other Path Seeker, Your current health insurance may cover it already.  The Affordable Care Act (“Obamacare”) […]

Extra lab tests likely to be covered, after deductible

Do insurance companies cover the cost of more accurate tests, such as ultrasound or blood tests, if a patient can provide evidence that he/she has one or more cancer marker genes? Informed Patient Dear Informed Patient, The insurer will pay for medically necessary tests.  So, if the doctor believes that the ultrasound or blood test […]

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 […]