The worst possible time to find out what your health insurance does and does not cover is when you need to claim against the policy. One of the most important parts of choosing a good health insurance policy for you and your family is to ask the right questions to discover which plan fits your needs and budget best.
The following list of topics can help you compile a list of questions to ask your health insurance provider so that you get the right policy at the right price.
1. Your health insurance policy documents
Ask for a copy of your health plan document so that you can read it through. Even if you are buying your health insurance through a group, such as your employer, you are entitled to have a copy of the complete policy for yourself. Does it explain how to get services and how to appeal coverage decisions with which you do not agree? Does it make clear what your financial responsibilities are? Make a list of questions that arise during your reading so that you can ask them of your health insurance provider.
2. Professional providers and expertise
Many health insurance policies limit you to choosing from a pool of hospitals and professional providers. Are there limitations on the professionals from whom you can seek care? Is there a list of providers that you can reference? Are there provisions for using a health care provider that is not on the approved list?
3. What limitations are on your health care providers?
Be sure that your health insurance provider has not placed contractual obligations on your health care providers that may interfere with or influence treatment decisions. Are your providers allowed to discuss all of your treatment options with you, even if they are not covered on the plan? Do they pay the provider the same amount regardless of the treatment that they prescribe? Does the plan offer rewards to the providers for keeping their costs low?
4. Can you appeal decisions?
Every health insurance company should have a formal appeal and grievance procedure to allow you to complain or request a reconsideration of decisions made about your care. Is the appeals procedure clearly defined? To whom can you complain if you are not satisfied with a decision, or an appeal? Is there a formal grievance procedure and a way to report plan physicians and providers if you have a complaint about your care?
5. Are your medical records kept confidential?
You have a right to expect your medical records and personal details to be kept confidential. Ask your insurance provider about their confidentiality policy. Will your medical records be shared with anyone without your specific permission? What information from your medical records is provided to the payer? In general, the insurance company has no right to receive anything more than diagnosis, prognosis, length of treatment, type of treatment, and cost.
6. Choice of providers?
How much choice will you have in the providers that you choose? Are your choices restricted in any way? What credentials does your insurer require of professionals associated with the plan, or for payment by the plan? Will your plan cover alternative or complementary treatments if they are prescribed?
7. Who will make treatment decisions?
Who will be involved in making your treatment decisions? If it will be anyone other than your health care provider? Do they have the appropriate training to make medical decisions?
8. Will I be covered for catastrophic illnesses?
Many health insurance policies do not cover the so-called catastrophic illnesses like cancer, stroke and heart attack. You may need other insurance cover to insure yourself against those.
Posts Tagged ‘Questions’
Key Questions When Shopping for Health Insurance UK
Wednesday, March 10th, 2010Speaker Pelosi Answers Your Questions Following Bipartisan Health Care Meeting
Sunday, February 28th, 2010
Following today’s bipartisan health insurance reform meeting at the Blair House, Speaker Pelosi answers the top five questions and ideas submitted on citizentube at www.youtube.com The questions: 1. What is the explicit reasoning behind mandating the purchase of healthcare services? – Chris, University of Florida 2. Do you believe that healthcare is a right, or that health insurance is a right? – Brian, Student 3. Thompson Reuters had performed a study in which they concluded that 40% of healthcare waste was from unnecessary care. Unnecessary care is primarily a result of a fear of being sued, aka malpractice. What is being done to address malpractice? – jatpat, Chicago, IL 4. Why not quit artificially limiting the market? Stop tying health insurance to employers and increase the market dramatically. Allow insurance providers to sell across state lines and increase it even more. The larger the market the lower the price. – crodgers1981, Lincoln, NE 5. All people voting on these bills should be required to personally read the entire bill before being allowed to vote on it. It is ridiculous that these bills are thousands of pages long. Bills should be written in clear language. – Blinn, Illinois If you missed the meeting, you can watch archived video on the White House website at: www.whitehouse.gov To learn more about health insurance reform legislation that’s being discussed, visit www.speaker.gov
Some Answers to Colon Cancer Questions
Thursday, February 25th, 20101. What is colon cancer?
Cancer is a disease which can affect cells from all organs. The colon cancer affects the cells of the colon, determining them to proliferate in an uncontrollable way. This mass of abnormal cells will form a tumor inside the colon. The cancer of the intestine is quite frequent and two thirds of this type of cancer is situated in the colon.
2. Who can develop colon cancer?
You are at risk of developing colon cancer if you drink a lot of alcohol and you are obese. Also if other members of your family had colon cancer or breast cancer you could inherit some genes that make you more sensible to cancer. If you have polyps on your intestine and you leave them untreated for a long time, they can transform into malign polyps, meaning that cancer had occurred.
3. Is my diet involved in cancer development?
Following a diet which is rich in fats and proteins could expose you to cancer. If you eat a lot of fruit, vegetables and high fiber foods you can prevent colon cancer from occurring.
4. Does colon cancer come with any symptoms?
There are some symptoms which could announce that cancer is installing, but they also appear in other diseases. Some of the symptoms are: seeing blood in your bowels, alternation of diarrhea with constipation, and low abdominal pains.
5. How does the doctor know that I have cancer?
The doctor will perform a sigmoidoscopy or a colonoscopy to examine the insides of the colon. Also x-rays of the colon will be performed. These methods will see if tumors are present inside the colon. In order to stage colon cancer CT and ultrasound will be used.
6. Can colon cancer be treated?
Generally the most indicated procedure in trying to treat colon cancer is surgery. By surgery the doctors will remove the tumor from the colon. If the cancer spread, giving metastasis, the doctors will recommend you chemotherapy and radiotherapy. These are hard bearable due to their side effects like nausea, vomiting, loss of hair, fever, and tiredness.
7. Is the treatment effective or not?
If the colon cancer was diagnosed in its early stages and it has not spread to other organs the treatment will be 90% effective and patients will survive even five years after. If the cancer has given metastasis the treatment will not be so effective any more and half of the diagnosed patients will live less that five years.
For greater resources on colon cancer or especially about colon cancer symptoms please visit this link http://www.colon-cancer-center.com/colon-cancer-symptoms.htm
Prostate Cancer Questions and Answers
Wednesday, February 24th, 2010While many illnesses and diseases are well understood, prostate cancer is one of the remaining cancerous conditions that is shrouded in misunderstanding. There are several main reasons for this, not the least of which is that men as a group, simply do not want to deal with this very common no cancerous condition.
For many men, prostate cancer affects the very core of how they define their own manhood. The prostate is a key component in the sexual performance and ability of men. Prostate cancer than strikes at the very heart of how many men view themselves. In any event here are a few of the most common questions concerning prostate cancer.
1. What really is prostate cancer?
Prostate cancer is any abnormal and malignant growth of cells in the tissues of the prostate gland and possibly all over and beyond the prostate.
2. What is advanced prostate cancer?
This is one of the stages of prostate cancer where the cancerous cells have spread outside the prostate into other parts of the victim’s body, causing damage along the way. There are four basic stages of prostate cancer.
3. What are the stages of prostate cancer?
Stage I of prostate cancer is when the cancer is only in the prostate area and hasn’t spread outside the prostate.
Stage II of prostate cancer is when the cancer is still within the prostate, but is advancing.
Stage III of prostate cancer is when the cancer has now spread beyond the outer layer of the prostate into nearby tissues.
Stage IV is the stage that all men dread. In this stage of the cancer, it has spread to other parts of the body also known as metastatic prostate cancer
4. What is metastatic prostate cancer?
It is another name for advanced prostate cancer where the cancerous cells have grown outside the prostate and is growing into other parts of the body. Metastatic prostate cancer is extremely serious.
5. What causes prostate cancer?
There is no singular factor that causes prostate cancer. Heredity is suspected to play a large role in prostate cancer as is the race of the patient. Black men are much more likely to have prostate cancer than other groups.
6. What can I do about Prostate Cancer?
If you have a prostate and are over 50 years of age, you should really consider getting a yearly prostate exam and having a simple PSA blood test done. This information will provide a baseline for future reference.
Remember that the earlier you are diagnosed with prostate cancer, the more you have to fight this deadly disease and win.