A Question on Getting Health Insurance (part 3)
I’ve had a serious health condition that appears to be stabilized. Can I buy individual health coverage?
Depending on what your condition is and when it was diagnosed and treated, you can probably buy health coverage. However, the insurer may do one of three things:
- provide full protection but with a higher premium, as might be the case with a chronic disease, such as diabetes;
- modify the benefits to increase the deductible;
- exclude the specific medical problem from coverage, if it is a clearly defined condition, as long as the insurer abides by state and federal laws on exclusions.
One of my medical bills was turned down by the insurance company (or health plan). Is there anything I can do?
Ask the insurance company why the claim was rejected. If the answer is that the service isn’t covered under your policy, and you’re sure that it is covered, check to see that the provider entered the correct diagnosis or procedure code on the insurance claim form. Also check that your deductible was correctly calculated.