Health Insurance

Recently Answered

  • 2 Answers
    A
    A , Internal Medicine, answered

    Your health insurance may have some exclusions and limitations. Plans vary so much that it’s hard to say exactly what limits and exclusions might be in yours. To make sure you know the ins and outs of your policy, you need to read that entire insufferably boring booklet (summary plan description (SPD)) with all the policy rules and limits and bylaws and heretofores and therewiths. You can get it from your HR department or the insurer. If it makes it more enjoyable, read it aloud and set it to song.

    In general, though, health insurance plans can limit coverage for a pre-existing condition only for a certain period of time, usually no more than 12 months. Many plans have a three-month waiting period before all benefits kick in. However, it’s important to note that under the Affordable Care Act of 2010, health insurers can no longer place dollar limits on health care they cover in your lifetime.
    See All 2 Answers
  • 2 Answers
    A
    A , Internal Medicine, answered
    Most people under retirement age get their health insurance through their employer. Some get their insurance from a union or organization. You can also buy individual health insurance to cover you and your family. If you can’t get insurance through your work and can’t afford to buy it yourself, you may qualify for coverage under federal or state plans that offer insurance at lower rates.
    See All 2 Answers
  • 1 Answer
    A
    A answered
    Group health plans provide coverage for qualified group members and sometimes their dependents. Insurers make group health insurance plans available to membership groups, such as employers, credit unions, labor unions and trade associations. 

    The premium that you have to pay for coverage through a group health plan is usually much less than through an individual health plan. An employer may pay a portion of the premium cost.

    If you are self-employed and have no insurance benefits, check with your state insurance commission to find out whether you are entitled to "group of one" coverage. This type of coverage provides the protections of group coverage.
  • 1 Answer
    A
    According to the Consumer Health Information Bill of Rights, you have the right to expect that organizations will hold staff responsible for any improper access, use or release of your health information. You have the right to expect that a breach of your health information will be investigated as required by law. You can further expect to be notified of harmful breaches and assisted accordingly. 
  • 1 Answer
    A
    According to the Consumer Health Information Bill of Rights, you have a right to request a limit on the medical information released to others involved in your care or the payment of your care. Your provider has the right to deny the request, but must provide you with a reason if it cannot be met. However, a request to keep information from your healthcare insurer must be granted if you pay for the service in full at time of delivery. 
  • 1 Answer
    A
    According to the Consumer Health Information Bill of Rights, you have the right to read and review the information used by healthcare professionals to make decisions about your care. Access can be requested at any time, including while you are receiving care. You have the right to obtain a copy of your health information in a timely manner in accordance with state and/or federal laws. 
  • 1 Answer
    A
    According to the health care law, if you are planning for long-term care, you have more information about the quality of care in nursing homes. Specifically, the law: 
    • Provides better information and accountability for nursing home care: It is now easier to file complaints about the quality of care in a nursing home. You also have access to more information on nursing home quality and resident rights.
    • Extends financial protections to spouses of people on Medicaid: If you are married to someone on Medicaid who is receiving care services at home, you will have the same protections for your income and other resources as do spouses of those on Medicaid who live in a nursing home. This provision takes effect in 2014.
    • Promotes independent living: Your state may receive financial incentives to provide greater access to the services and supports you need to live independently in your own home and community.
  • 1 Answer
    A
    In the past, young adults frequently were forced off their parents’ policies once they reached 18 or 21 or graduated from college. Now they can stay on or be added to your family policy even if they have left home or are no longer a student. 

    If you currently include your children on your health insurance, the Affordable Care Act allows you to keep them on your family policy until they reach age 26. This means you can make sure they have health insurance even if they no longer live with you, are married, or are no longer in school. You do not have to claim them as a dependent on your tax return. You will not be able to include their spouse or their children on your policy.
  • 2 Answers
    A
    To make sure that your health information privacy is protected without interfering with your health care, the HIPAA Privacy Rule allows your information to be used and shared in the following ways:
    • For your treatment and care coordination. For example, your doctors can see what tests you have had and their results, so tests do not have to be repeated.
    • With doctors and hospitals that provide you care, to provide payment for their services
    • To make sure doctors and other health care professionals give good care
    • For protection of the public's health, such as to report when the flu is in your area
    Your health care provider or health plan does not have to ask you whether they can use or share your health information for these purposes.

     
    See All 2 Answers
  • 2 Answers
    A
    A Notice of Privacy Practice tells you how your information is used or disclosed and explains who has access to your information. You receive the notice the first time you visit a new healthcare provider, pharmacy or hospital. You are asked to read and sign an acknowledgement that you received the notice. The law does not say that you have to sign it, but if you do, it helps the provider to document that you got the information. 

    Health insurance plans must also provide you with a Notice of Privacy Practice; if you have health insurance, you probably received the notice in the mail. Insurance plans don’t ask for your signature.

    See more at: http://myphr.com/resources/faqs.aspx
    See All 2 Answers