Denied Health Insurance - What to do Next
Denied Health Insurance - What to do Next
Denied Health Insurance - What to do Next
Thousands of people in the US are denied health insurance each year and end up facing huge medical bills due to pre-existing conditions. This is because so many insurance companies will refuse or charge exorbitantly high premiums for people who suffer from such things as high blood pressure, asthma, heart disease, diabetes or cancer, and the result is that these people may face significant financial problems. However, despite the difficulty of being in this position, there are options available. Many health insurance providers allow people to appeal their decisions, and there are plenty of alternatives that can be considered.
Making an appeal
If for any reason you have been denied health insurance, step one is to appeal against that decision. It will be necessary to research laws regarding the reason for your denial, and records should be kept of everything if the company should require documentation. If your chosen insurance provider still refuses coverage after an appeal, the next step is to contact an insurance broker that specializes in health insurance. In most cases, health insurance brokers will know the system extremely well and can work through it and find a good policy for almost anyone. However, it might be required that the policy you are offered contains a clause that excludes treatment for your pre-existing condition. Such a scenario is often not the best solution, but it is an option to be considered for some people.
Other options to consider
Even though private health insurance is the most desirable coverage, there are other options to consider. Anyone who has been denied medial insurance is eligible to apply for their state's high risk health insurance program, if there is one. These programs are currently available in 34 states. The downside is that they do not cover certain conditions, and you are relying on the fact that state legislation will not change later on and affect your coverage.
Alternatively, married individuals whose partner has company health insurance can usually get themselves included in the same plan. Many of these employer-based insurance plans do not require health checks before enrollment.
The Patient Protection and Affordable Care Act
It is now only necessary for anyone denied health insurance to find a temporary solution to their problems, thanks to the law change in March 2010. This new law, part of the health care reform bill, is designed to prevent health insurance providers from discriminating against anyone who sufferers from a pre-existing medical condition. This act already covers children, and from January 2014 will cover adults as well.
Summary: There are manyoptions available to anyone suffering from a pre-existing condition and has been denied medical insurance. Some advice includes: possible appeals, alternative coverage and future changes to the law surrounding such circumstances.
Health Care Reform Bill Windfall for Retiree Insurers
The recent health care reform bill contains a largely ignored clause that is hoped will provide a lot of relief to health plan sponsors who are struggling with retiree healthcare costs. Known as the Reinsurance Program', this provision creates a subsidy for sponsors of health plans for retirees that offer coverage to anyone aged over 55 years old.
This new program provides a similar incentive to employers that is offered by the 2003 Medicare Modernization Act. Employer groups that are willing to maintain medical insurance plans for retirees will be eligible for a significant windfall. The Reinsurance Program offers clear benefits to industries and employers that are dominated by unions and lumbered with expensive medical plans for retirees.
The potential savings
The proposal is that the new program will establish a temporary Reinsurance Program for employers that provide medical insurance to their retirees who are aged 55 or above, but currently is not available for Medicaid. Employers and insurers will be reimbursed for up to 80% of claims between $15,000 and $90,000 made by retirees.
Taking the example of an employer group that has 700 employees and 500 retirees on its program and spends $10 million per year on its health insurance program, the subsidy could total up to $725,000 annually, which amounts to a reduction of 14.4% of its retiree plan costs.
Will it work?
It is likely that there will no doubt be a group of people in the government who will attempt to dilute and limit the category of providers who are able to make claims, as we have learned from the lesson of the RDS (Retiree Drug Subsidy) program. In this case, the drug subsidy was initially supposed to be calculated with all prescription drug costs that were incurred by plan sponsors. However, this relatively simple formula was complicated by a decision made by bureaucrats to exclude certain classes of drugs from this subsidy. The worry is that there might be a similar rationale in this case, with certain medical expenses being excluded later on, in order to align eligibility with only approved medical procedures that are within the government's basic plans as is defined by the final reform bill.
The language contained within the bill makes it unclear as to which party will actually receive the subsidy. The bill in the Senate states that: "The program will reimburse insurers or employers", while the bill in the House only gives reference to "employers". This vague wording leaves us with the question, will the employer be eligible for the subsidy or not? This remains to be seen, but it is hoped by many that it happens, as it will only serve to benefit both employers and retirees. Who Doesn't Need Health Insurance? The Benefits Of Having An International Travel Health Insurance Womens Health Care: Crucial Improvements In The Treatment Of The Issues by:Andy Guides Jr Compare Health Insurance Plans - Why You Should Discover It Healthcare Insurance Coverage For Those Traveling To The United States Private Health Insurance Uk - What Things Helps Make One Handy Purchasing Affordable Health Coverage How California Health Insurance Companies Fight Rate Review Health Insurance Benefits Pregnant Women Private Health Insurance In Australia As Compared To Other Health Insurance What Is Total And Permanent Disability On A Critical Illness Insurance Policy? Hospitalization And Health Insurance Health Insurance For The Healthy