I am wondering what Aetna (choice position 2) covers for emergency medical outside of the United States. I believe my deductable is $2000 but I don't know how much they cover up too after that? After the deductable I know they pay 80% of the charges. I could just call them but the offices are closed for the weekend and was looking to get an answer soon before and if I get travel insurance for an upcoming trip.
Hi, I'm still a bit of a newbie when it comes to health insurance and am trying to figure out what I can do in this situation.
I got referred to physical therapy by my physician. I called the physical therapy clinic before hand to confirm that I had a copay of $35 for physical therapy, and they said "yes, you do" and booked my appointment. In fact, they made a note in my file, so it's confirmed that someone did tell me this before I went.
So I went to two appointments. I got a bill for the first one recently, for almost $300. The second one just came and it's $250.
I called the insurance company and told them I was overcharged, and after playing telephone tag with the clinic and insurance company several times, it turns out I don't have a physical therapy copay (I think I might have in previous years but threw out those old coverage booklets). My previous experience was receptionists (like at the dentist) telling me if my insurance was accepted for their specific services at their specific clinic. I was not aware one was supposed to call insurance and ask if x/y procedure was covered, because I'm not exactly sure what procedure is called or booked as. Turns out the PT was booked as some weird way, as a hospital service and not as a doctor visit or something like that, I didn't really understand -- which is why I prefer to call the clinic and ask them, since they know exactly what will be done at my appointment (and I don't, I just know it's some sort of physical therapy thing).
Anyway - Is this clinic liable for giving me the wrong information? If they weren't, were they supposed to tell me that they were not a definitive source? Otherwise, how was I supposed to know that? I definitely feel that I wasn't at fault for trusting their information...please let me know if there is something I can do about this. I know insurance companies have an appeal process (that does not apply here) -- do clinics/doctors offices do this as well?
I recently left one job and started working as an independent contractor with new company. After 2 months of this, I will be brought on as a W-2 employee and will receive insurance benefits. For this 2 month period as an independent contractor, from what I gather I have a COBRA option or marketplace options due to my "qualifying event". I rarely have medical issues but still want to be protected in case of any extreme/unforeseen major issues in this 2 month period.
However, it seems like the COBRA can be applied for retroactively until a certain date. So during this 2 month lapse of coverage, is it possible for me to avoid renewing my COBRA and save on 2 months of health insurance payments, but if something major does happen I can retroactively enroll in it and be covered from some massive expense if something does happen? Is this strategy possible? Are there legal issues to doing this? Thanks for your help everyone.
So my employer is offering me insurance that would be almost 25% of my take home pay. Since I receive a health and welfare benefit that would cover the cost of the insurance, it is not outside the parameters of Value and Cost. Looking at the insurance offered on the marketplace I can get a plan that is almost as good for about half the amount. Do I have to accept the employer insurance, or can I reject it and wait till november for marketplace open enrollment?
I have a high deductible health insurance and might need to see an ENT specialist due to my Otitis media (ear infection) since it hasn't responded to antibiotics prescribed by the urgent care facility. I have already spent $150 at the UC facility and the in-network ENT specialist visit could be as high as $400-700 (told by the front desk). My deductible is $1500. Is it better to go out of pocket for such expenses? Would my insurance have lower rates negotiated with the doctor's office if I choose them instead (and still be below my deductible)?
TLDR: Not sure how high deductible plans are of any use to a consumer.
In March, I lost my job, and lost my health insurance through my employer. I opted to not get COBRA because I’m not rich. I just got this job for a contracting company and I sent the Employer Coverage Tool to them to fill out, and they don’t offer any health insurance plans. So, on my marketplace application, I marked down that they don’t offer insurance.
I immediately got my eligibility results which tell me a mixed message:
That tells me I am eligible, but the “continue to enrollment” button is grayed our -.-
On the eligibility notice:
That tells me I am eligibility, but the next steps say to NOT enroll in marketplace plan and that I’m not eligible for a special enrollment period? Wtf is this bull shit? And to file an appeal, I have to MAIL it?! That’ll take months!
How do I fix this quicker. I’m just trying to buy health insurance (even tho health insurance shouldn’t be a thing that people have to buy, but hey, ‘MURICA, right?)
I am currently covered under my husbands insurance, but we have exhausted our life time max for fertility coverage. He is able to switch to kaiser from a PPO that has coverage during open enrollment. I was considering enrolling in a PPO through my work (no infertility coverage) to keep my current doctors. Would I be able to get full coverage for infertility treatments through kaiser if we are both listed as dependents on each plan?