Health insurance grill, helping out my mom, can you comfort explain?
My mom, has united form care insurance. I'm not sure what plan they have but its probably rough and ready. Anyway my question pertains to the coverage. Mom's insurance company stop covering because she has chronic stomach-ache and visits a health supervision provider frequently. The health insurance company stop covering her, the reason they state be because she kept going. Is it possible for them to that. What are the possible reasons that they can do that. They refuse to cover some of the doctor bills from the recent past. She usually goes in for a chronic torment in foot and bones. Nothing cosmetic.
Answers:
That wasn't the idea they used. "She kept going" just wasn't. Find out what the reason be, that they put on the cancellation notice.
She COULD own maxed out the benefits. Maybe they only cover $100,000 of costs, and they hit that limit. But you hold to get the EXACT reason.
If you regard they can't do that, write a complaint letter to the state insurance department, including a copy of the original dissolution notice. If they can't do it, the insurance department will make them reinstate the policy. Source(s): agent, 21+ years
Its difficult to answer your cross-question based soley on the information you've given to us.
When you say that they "stopped covering her," do you connote that they completely cancelled her insurance policy? Or do you mean that they have stopped covering positive treatments because she has had those treatments too frequently?
For example...since you enunciate that she has chronic pain, is she getting injections for the aching? I know that many insurers have frequency restrictions for certain types of injections done on individuals with chronic spasm. If the insurer only covers 10 per year of that certain service, consequently your mom would have to pay out of her pocket for anything above 10.
That's basically one example. Other types of services can have frequency limits too (for example, individual allowing a certain number of chiropractic visits per year, etc.). Its not easy to say what's happening next to your mom's situation without knowing specifically what service it is that she's having, from what concerned of provider, why its being denied, etc.
I'd recommend your mom calling the insurance company and getting more specifics. Or, you could trying to provide additional information contained by your question...many of the regular responders here surrounded by this category could potentially assist you, if there was for a time more info to go on. Source(s): 10+ years working for health insurance companies and medical providers
Well, anyone other than the insurance delivery service can't tell you for sure if they can stop paying. You should read into the contract. Also, if your Mom is going for chronic pain and the doc. isn't fixing the problem maybe she needs a second opinion. Maybe a unsullied doctor would see something the first didn't and then she wouldn't need to verbs to go to the doctor. Hope she feels better!
Any private insurance company can quit covering you if they so choose. Or they just increase your rates to the point you can't afford them.
Look for a non-profit (like Blue Cross/Blue Shield), they usually won't end your coverage due to health reasons.
It doesn't take home sense, but happens all the time. Sorry.
1. if she be sick before the policy its called pre exsisting condition and they dont enjoy to cover them.
2. see if they need a TAR from her doctor that is the pre blessing slip to the insurance companies. is she eligible for medicaid or medicare? Source(s): been doing insurance claims for years.
Related Questions:
Answers:
That wasn't the idea they used. "She kept going" just wasn't. Find out what the reason be, that they put on the cancellation notice.
She COULD own maxed out the benefits. Maybe they only cover $100,000 of costs, and they hit that limit. But you hold to get the EXACT reason.
If you regard they can't do that, write a complaint letter to the state insurance department, including a copy of the original dissolution notice. If they can't do it, the insurance department will make them reinstate the policy. Source(s): agent, 21+ years
Its difficult to answer your cross-question based soley on the information you've given to us.
When you say that they "stopped covering her," do you connote that they completely cancelled her insurance policy? Or do you mean that they have stopped covering positive treatments because she has had those treatments too frequently?
For example...since you enunciate that she has chronic pain, is she getting injections for the aching? I know that many insurers have frequency restrictions for certain types of injections done on individuals with chronic spasm. If the insurer only covers 10 per year of that certain service, consequently your mom would have to pay out of her pocket for anything above 10.
That's basically one example. Other types of services can have frequency limits too (for example, individual allowing a certain number of chiropractic visits per year, etc.). Its not easy to say what's happening next to your mom's situation without knowing specifically what service it is that she's having, from what concerned of provider, why its being denied, etc.
I'd recommend your mom calling the insurance company and getting more specifics. Or, you could trying to provide additional information contained by your question...many of the regular responders here surrounded by this category could potentially assist you, if there was for a time more info to go on. Source(s): 10+ years working for health insurance companies and medical providers
Well, anyone other than the insurance delivery service can't tell you for sure if they can stop paying. You should read into the contract. Also, if your Mom is going for chronic pain and the doc. isn't fixing the problem maybe she needs a second opinion. Maybe a unsullied doctor would see something the first didn't and then she wouldn't need to verbs to go to the doctor. Hope she feels better!
Any private insurance company can quit covering you if they so choose. Or they just increase your rates to the point you can't afford them.
Look for a non-profit (like Blue Cross/Blue Shield), they usually won't end your coverage due to health reasons.
It doesn't take home sense, but happens all the time. Sorry.
1. if she be sick before the policy its called pre exsisting condition and they dont enjoy to cover them.
2. see if they need a TAR from her doctor that is the pre blessing slip to the insurance companies. is she eligible for medicaid or medicare? Source(s): been doing insurance claims for years.
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