Posts Tagged ‘Paperwork’

Don’t Leave For School Without Health Insurance For Students

January 30th, 2010



Going off to college is one of the most exciting and important moments of your life. It is a time for learning, growing, and training for your life’s work. Going off to college can be scary too. It’s often your first time away from the comfort and protection of home.

Smart students should plan carefully in order to bring with them all the possessions they need everyday, but careful planning cannot ignore a very important, less tangible thing, their health. Health insurance for students is one of the most important things to bring with you to the dorm.

With the costs of medical care spiraling out of control, a good health insurance plan is more important than ever. If you are fortunate enough to have continuing coverage on your parent’s health insurance plan then consider yourself lucky. In all likelihood, your current coverage will exceed your other options in both cost and quality of coverage.

However, many new students are not as fortunate, and they are reaching the age where they are no longer covered under their parent’s health insurance plan. If you are among those students whose parent’s plan no longer covers them, then you should waste no time before investigating the available health insurance for students.

Your research will quickly reveal that you have two basic options from which to choose: 1) enroll in a college sponsored plan or 2) purchase coverage from a commercial student health insurance provider. Each has its own set of advantages and disadvantages.

Enrolling in your college sponsored health plan is very easy and convenient to do. The paperwork and applications can be completed before you unpack your first box of things in your new dorm room. The price is often right too, and the billing can often be included with your tuition and fees. Further, students with a college sponsored plan will enjoy easy access to on campus health facilities, and they will have minimal – if any – out of pocket expenses for routine visits. Also, dental and eye coverage is frequently included in a college plan.

However, while college sponsored health insurance for students is more than sufficient when dealing with minor illness or injury, it is likely to fall short in the event of a more serious condition. Typically, college sponsored health insurance for students provides primary coverage for treatment at the medical facilities of the college or university, therefore students may have very limited options when pursuing treatment at an outside facility, and such treatment is likely to require a referral.

Also worth noting is that most college plans provide no coverage to students who are traveling abroad. Perhaps the most important negative aspect of a college sponsored plan is that they typically have a relatively low threshold of maximum coverage, so a catastrophic injury could leave the student with significant medical expenses that must be covered out of pocket.

Many of the disadvantages of a college sponsored plan are addressed when health insurance for students is purchased from a commercial provider. Commercial providers will typically provide coverage domestically or internationally. Additionally, a commercial provider allows flexibility when choosing a medical provider as well as provides international coverage.

Another advantage is that the student can continue their coverage after graduation, so there will not be a lapse of coverage during the time between graduation and starting their careers. It should come as no surprise, however, that the great advantages of a commercial plan come at a price. Not only are premiums more expensive than the college plan, out of pocket expenses and deductibles are more costly as well. And the dental and eye coverage that is rolled into a college plan is likely to be absent in commercial health insurance for students.

No matter which direction you go, the important thing is that you make sure you are covered. Recent graduates often find themselves with debts from student loans and the like; health insurance for students can prevent medical bills from adding to that debt.

By: Sammy Kay

Avoiding Health Insurance Claims Denials on Group or Private Health Insurance Policies – Part 1

November 17th, 2009



These days a patient must be vigilant about his or her own health care in terms of researching treatment, securing pre-authorizations, and knowing what to do if their group or private health insurance policy denies a claim. After all, a health insurance claim denial is the last thing you want to have to worry about in the middle of a health crisis. A denied claim feels like a knife in the back placed there by the very company that’s supposed to be watching your back. Luckily, some claim denials can be easily avoided.

According to one lawyer at the Texas State Department of Insurance, “The most common basis for a claim denial in the health insurance industry is that the procedure, preparation, or pharmaceutical is not covered by the policy. So, the easiest and most important way to avoid a claim denial is to read through the most recent and most inclusive version of your health insurance policy and get a picture of the kinds of things that are covered, and those that aren’t.” This is a great starting point. Make sure your policy is the most up-to-date. In the past few years most policies have changed to put more financial burden on patients covered.

It’s also a good idea to contact your health insurance provider and ask to talk to someone who specializes in the area of treatment you’re receiving. After all, he or she might be the very person reviewing your claim, so feel free to ask specific questions about what might or might not be covered under your particular policy. For future reference, write down his or her name and telephone number at the beginning of the conversation. Keep detailed notes on exactly what happens every step of the way, and retain all related paperwork, even if you’re unsure whether it’s relevant. Include in your notes:

* When the required treatment pre-authorization was requested, and received, and from whom

* Date of the treatment

* What was discussed with the doctor, what actions were taken, and what follow-up will be required

Unfortunately, mistakes are common in claims processing. Consider a 2002 study by America’s Health Insurance Plans, which reported that 14 percent of claims submitted to insurance providers are denied. The same survey found that one out of every seven claims had to be re-submitted and re-processed due to errors in the original claims, a costly process for everyone involved.

Other things that you might consider include:

* Research your state’s laws regarding what should be covered in a claim, and what the law considers “arbitrary.” This would influence an insurance company’s definition of “medical necessity” and billable needs.

* Make sure your insurance provider and doctor’s office have been in contact with each other, and that all the necessary paperwork has been forwarded from one to the other.

* If your coverage is fully or partially paid by your company, make sure you keep your human resources department fully informed of the situation so that they can help with any paperwork that might come up that you can’t manage.

By: Ryan Patterson