Medical Insurance claims and you

Medical Insurance claims and you:
Okay in this article I will provide you with tips on making claims and completing the paperwork that is involved. The process begins when you first apply so let's begin there.
Depending on your age, health condition and whether or not you are employed, you have several options to choose, all of which my come into play for any medical insurance claims and how they are processed and paid. Due to the Patient Protection and Affordable Care Act, "Obamacare" many dynamics have changed in respect this. For instance:
1. Insurance companies are no longer able deny claims from people with preexisting medical conditions. How this relates to you is that if you have a preexisting condition and are enrolled in a health insurance plan, the insurance cannot deny you any medical insurance claims. Now please note, that this Act that was signed in March 2010 will not be fully enforceable for all Americans until 2014. Currently, only children under the age of 19 are protected.
I will address "Obamacare" in future articles, but now more specifics about general filing of medical insurance claims.
2. If you are employed, you are given the health insurance options your employers offers and then you choose from those options. Now specifically, as it relates to medical insurance claims, before one is filed you must meet the following criteria:
A. Eligible Employee: Depending on state law, you have to be an employee that is covered by the policy. In other words, if the state law says that you must be at least a part-time employee, of a company with 10-50 employees, who has met the minimum waiting period, then you are an eligible employee. You employers benefits coordinator will provide you with specifics concerning this.
B. Waiting Period: Depending on the policy and the state law the waiting period may be from 30-90 days.
C. Special Enrollment: Allows for special circumstances due to a change in an employee's family situation; for example death of covered person, baby added to the family.
There are a few more points concerning employer medical insurance but those are the basics. Now for those who are covered by Medicare and Medicaid, as far medical insurance claims are concern this is dependent strictly upon the insurance company that you are being insured through under those programs.
Generally, your doctor will file the claim for you and if there are any disputes from your insurance company you can:
1. Have your doctor check to be sure all to information was submitted properly through their medical billing and coding system. This will address instances when your claim is denied do to filing error.
2. You have the option of appealing the insurance company's decision with them.
3. Contact your state's insurance board if you feel you were wrongly denied concerning any medical insurance claims and follow up with them.
So there, you have a short article on dealing with medical insurance claims. More articles to follow concerning all areas of insurance claims.


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