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Medical Insurance
Refusal To Pay For
Emergency Treatment
- Have your physician write a letter. Your MD should be able to
provide justification for having the treatment in the hospital --
you were too ill to be sent home; the treatments had to be started
without delay to begin to reverse the effects of the crisis, etc.,
etc. It may take 3 months or so, but they generally pay up.
Your Right to
Experimental Treatment
- Have your benefits manager intervene with the insurer, when the
insurance company considers treatment "experimental." Have your MD
send the insurance company the information they need to make their
decision. It may take 3 months and numerous contacts by phone and
letter to get reimbursed.
Your Right To See
Physician
- If your insurer
(HMO) denies your request to continue seeing a specialist, here are
some thoughts. The insurance companies have to let you go to your
hospital if it is in your best interests. Have your MDs call, fax
and mail, all information. Insist! Let the company (HMO) know that
you know your rights and should something (God forbid) happen to
you, you have kept a record of everything, every conversation
documented and you and/or your family will pursue this to the
fullest. The HMO will usually capitulate.
Medical Insurance Coverage (US)
- You
may be interested in a couple of Federal provisions regarding your
medical benefits after you leave your employer:
Waiver Of Waiting Period
-
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
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