| Subject | Date Asked |
|
| Insurance refuses to pay | 5/13/2008 |
Q: I had an accident while vacationing and had to get stitches. We ended up in ER but due to a long ...
A: See if the health insurer has an ombudsman you can talk to. They should be able to straighten this ...
|
| Humana HMO pre-authorization | 5/5/2008 |
Q: I am having a horrible time trying to get anything pre-authorized. It doesn't appear that anyone at ...
A: WOW. That sounds frustrating. Unfortunately there is no standardized way in which this works. ...
|
| Breast Reduction | 4/23/2008 |
Q: i have cigna health insurance through my employer and i got denied due to the amount of grams they ...
A: I'm guessing that your plan provisions only consider it medically necessary if they take 496 grams ...
|
| insuance denying coverage on something they once covered | 4/18/2008 |
Q: I had Great West Insurance last year. They were supposed to clean up the mess that the previous ...
A: Yes - as far as I am aware, they are two very different items. So the insurance company you are ...
|
| insuance denying coverage on something they once covered | 4/18/2008 |
Q: I had Great West Insurance last year. They were supposed to clean up the mess that the previous ...
A: It sounds like orthotics are an EXCLUSION on your plan. Unfortunately, plans can exclude anything ...
|
| insuance denying coverage on something they once covered | 4/18/2008 |
Q: I had Great West Insurance last year. They were supposed to clean up the mess that the previous ...
A: If you have not done so already you should ask your surgeon to write a letter of medical necessity ...
|
| Pre-medical condition | 4/15/2008 |
Q: We are moving from MA to CT or NY, depending where we will get an health insurance. I had cancer ...
A: You should be able to purchase health insurance from any number of plans in MA or CT, including Blue ...
|
| Breast reduction coverage | 3/25/2008 |
Q: I currently have an HMO with Cigna through my employer. I received letters from two doctors stating ...
A: If your carrier (in this case Cigna) doesn't cover the procedure and it is listed as an exclusion in ...
|
| Out of Network Coverage | 3/25/2008 |
Q: My mother wants to have an operation done by a surgeon who accepts her insurance (UPMC); however, ...
A: She may simply try contacting the insurance company and explaining the situation. Its possible that ...
|
| insurance covered cell phone | 3/21/2008 |
Q: i have a son with TBI. i was told that medicaid would cover payment for a cell phone for him. i was ...
A: My recommendation would be for you to contact Medicaid yourself and ask them if there is a specific ...
|
| clinical trials | 3/14/2008 |
Q: Is the provider required to inform the patient's insurance company that the patient is enrolled in a ...
A: That's a very good (and interesting) question that I'm afraid isn't in my area of expertise. My ...
|
| Gastric Bypass Surgery | 3/6/2008 |
Q: I am on SSI with medicaid insurance. I feel that if I was to get the surgery and loose the weight, ...
A: Rosalee... Generally speaking, if a health insurer (or Medicaid) has a procedure listed as an ...
|
| private insurance | 2/28/2008 |
Q: A family member is ESRD. She has medicare and NC teachers insurance. It medically necessary that she ...
A: There are a couple of things you can try. First ask the folks at Davita if they have a case ...
|
| who's at fault with aetna | 2/7/2008 |
Q: i have Aetna managed choice ppo. my PCP wanted me to have a CT based on abdominal pain. his office ...
A: Since your PCPs office made the appointment for you at the local hospital, ask the referral people ...
|
| health provider bills | 1/30/2008 |
Q: I received a bill from a provider today that was addressed to my 21 year old daughter and me. When I ...
A: I doubt they would waste their time to tell you the truth. It sounds like it is just a "scare ...
|
| lap band appeal | 1/29/2008 |
Q: I was denied the lap band procedure. Obviously Aetna didn't read what was sent in the first place ...
A: It appears as though Aetna holds itself out to be URAC Accredited and as such (since Georgia doesn't ...
|
| insurance coverage for barriatric surgery | 1/23/2008 |
Q: I am significantly overweight and qualify for barriatric surgery however, my husband and I both ...
A: Generally speaking, if a health insurer has something listed as an exclusion on their plan there ...
|
| BCBS of GA and Mayo clinic | 1/8/2008 |
Q: We have BCBS of GA PPO. Would my husband be covered if we went to the Mayo Clinic in Jacksonville, ...
A: I apologize for my late response, I was on vacation last week and forgot to change my status to "on ...
|
| change health insurance | 12/17/2007 |
Q: I currently purchase my own health insurance and insure myself, my spouse and my daughter for $385 a ...
A: The "discounted" rate is something you'd have to work out with the doctor in advance, or at least I ...
|
| change health insurance | 12/17/2007 |
Q: I currently purchase my own health insurance and insure myself, my spouse and my daughter for $385 ...
A: Here are the answers to your questions.... 1. Yes, generally that is correct. 2. I'm not sure ...
|
| medical bill | 12/12/2007 |
Q: so know the collection agency it is calling me and telling me that they are going take me to court i ...
A: Here is what I would recommend. Contact the hospital and work out a payment plan. Even if it is ...
|
| health ins | 12/4/2007 |
Q: I currently have Anthem-Matthew Thorton Blue through the company that I work for. I've been at the ...
A: Sounds like you have done your homework! You are correct - COBRA is VERY expensive - but it may make ...
|
| Hospital Bill | 11/28/2007 |
Q: I am writing for my mother in law. She has received a hospital bill that see got when she had eye ...
A: Can you answer the following questions for me? ** Does your mother-in-law have health insurance ...
|
| cobra | 11/28/2007 |
Q: I quit one company last month and got into this new company and subscribed to their Health ...
A: I belive you probably can. However, for a definitive answer, you should contact the US Department ...
|
| Harvard Pilgrim HMO | 11/24/2007 |
Q: I am trying to find out what criteria are used to determine medical necessity for breast reduction ...
A: Typically the HMO will not provide you in advance with the medical necessity criteria upon which ...
|
| Pre -existing condition? | 11/21/2007 |
Q: I am pregnant and my family is covered through my companies health insurance. I am thinking of ...
A: LTD and STD are not my areas of expertise, but I can tell you what I know about it. Bear in mind I ...
|
| Pre -existing condition? | 11/20/2007 |
Q: I am pregnant and my family is covered through my companies health insurance. I am thinking of ...
A: I am not an attorney, so please do not take this as legal advice. However, Per Title 31 (Maryland ...
|
