What To Do When Health Insurance Does Not Cover Your Medical Bills
Posted on May 15, 2008 | Filed Under
Best Medical Insurance
There is no doubt that in these days of rising medical costs a good health insurance plan can save you a great deal of money over the years. There are however occasions when even the best of healthcare policies will fall short of meeting your requirements and there are many instances of individuals falling ill or meeting with an accident only to find that they are not covered. It is common of course for policies to exclude elective treatments such as cosmetic surgery, but there are many other areas of treatment that are often not covered.
So what do you do if you need some form of non-elective treatment and your insurance company is unwilling to meet the cost?
The first thing to do is to check through your policy very carefully to see whether the treatment is question is specifically excluded from cover. If it is not then you should write to your insurer and ask for a written explanation of their reasons for denying payment for the treatment in question. When their letter arrives, show it to your doctor and ask for his opinion. Very often you will find that your doctor can re-code your treatment and that re-presentation of your re-coded claim will meet with your insurance company's approval.
If your doctor feels that it is not possible to re-code your treatment then your next step should be to appeal the insurance company's decision. Every health insurance company has a clearly defined appeals procedure which will be set out in your policy document and you should follow this to the letter. Your insurance company will be looking for reasons to reject your appeal and the easiest and quickest reason will be to simply say you have failed to follow the correct appeals procedure. It is also a good idea to seek the opinion and, if necessary, assistance of your doctor or other healthcare provider is preparing your appeal.
If, despite your best efforts, you are unsuccessful in getting your health insurance company to foot the bill then there are still a few options open you.
First, see if your doctor is able to negotiate a lower payment for your treatment or to authorize a payment plan. Also, ask if your doctor is a member of a medical discount program which you may be able to join. There are a number of discount medical networks with literally thousands of participating doctors.
If you haven not yet had your treatment then shop around and see if you can find a doctor who is willing to carry out treatment at a lower price.
Finally, see if you qualify for free treatment at a public hospital or clinic. Here you will normally need to qualify on the grounds of your income or status (for example as a veteran) and is surprising how many people ignore this option simply assuming that they would not qualify when in fact they do. It is also surprising to see the number of people, particularly seniors, who are too proud to accept free treatment. If you need treatment park your pride at the hospital door while you have the treatment you need. You can always pick it up again on the way out.
Medical treatment can be very expensive but, with a little bit of persistence and some effort, you will be surprised how often you can end up with the treatment that you need at, more importantly, a price which you can afford.
For more information on all aspects of health insurance including such things as low cost family health insurance then the internet provides an excellent place to not only do your research but also get a quotation.
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