The Confusing World of Health Insurance


If you’ve got ever caught a political and wherein a baby-kisser is speaking with someone and that individual is claiming that after having fitness coverage for decades, their insurance agency canceled their coverage once they became unwell. During one election duration, a few baby-kisser added out a lady who was smoking for 40 years and were instructed she had degree 4 lung most cancers. She stated to the audience that her insurance organization had denied treatment for her, however, greater than possibly it was too overdue to deal with level 4 most cancers correctly. This type of misinformation is to nobody’s benefit besides perhaps the baby-kisser strolling for office.


Over a twenty yr career working inside the health insurance area, I’ve heard many, and sundry, stories approximately troubles getting their health claims paid – in reality, I doubt that there is a story I have not heard. And it in no way fails – these situations often arise because of the lack of awareness, confusion, and misconceptions that those maximum insured individuals have approximately their health insurance coverage.

The medical insurance topic has many sun shades of gray, due to the different sorts of insurance and plan designs and the complex troubles which have a completely unique effect on the insurance. No, remember whether or not I activate the TV or radio, talk with individuals or study approximately the problems, it’s clear that many human beings are stumped about how health insurance works. After years of looking the fitness care debate rage within the halls of Congress, it’s clear that even politicians who are working at the hassle might not absolutely realize the strategies, troubles and the implications of this massive business known as health insurance. Even those who prepare your scientific payments as well as the coverage representatives who deal with your claims bills, won’t have a clean expertise of the billing process or your plan.


First, a quick rationalization on more than one very fundamental issues – the difference between institution and person health insurance coverage and while, and beneath what circumstances, insured consumers may also lose their coverage. Both of these subjects display up within the media and are constantly bandied through people and politicians. The remarks I listen indicate that people who have medical health insurance, and bring the insurance for years, are dropped through the insurance agency (or positive treatment or approaches are denied) after they end up unwell. In a few instances, this is authentic however it’s vital to recognize how and why this could arise and the exclusive varieties of health insurance that impacts a lack of insurance. So…We could’ speak turkey!

* If upon the receipt of a claim or inquiry for coverage, it’s miles decided that the treatment is related to a pre-current situation, that turned into now not revealed at the pre-current questionnaire, the insurance organisation can cancel insurance or refuse to pay for the treatment, even though the man or woman has been insured and paying charges for some time.


As you can see, cancellation of health insurance coverage isn’t always a black and white problem. There are many variables and blanket statements by politicians and others who lack an expertise in health insurance tactics and nuances aren’t continually correct and purpose loads of confusion. Those who make those broad assertions should recognize what they’re pointing out. But greater importantly, insured people should be dedicated to knowing how their fitness coverage works as opposed to counting on the statements of others.


Take the time to read your insurance coverage. “Oh certain,” you assert, “I’ll don’t forget all of it if I even apprehend it inside the first place.” And it really is genuine but after studying that file, you’ll have a concept of what to do or who to name when you have a clinical/dental state of affairs that happens. Instead of being saddled with greater out-of-pocket costs that vital, you may apprehend sufficient to know who to call, what to invite and when to interfere. So pricey readers…..Take that first step and study – then touch your coverage employer and ask for clarifications on factors that you’re no longer certain about. You will then discover your self inside the motive force’s seat, in preference to the opposite manner round.

Lynne Lucio, The Insurance Decoder – copyright 2010

Author and medical insurance professional, Lynne Lucio has been interpreting the medical claims labyrinth for over two decades supporting them in any other case helpless in the pursuit of blanketed approaches and correct and timely declare bills. She is the writer of The Insurance Decoder (self-published) that’s the culmination of her career in the enterprise supplying the depth and breadth of know-how of the medical claims system and what it takes to get claims paid correctly.