Getting Over The Shame And Just Saying It: Im Uninsured Or Im Underinsured
If you have somewhat crappy insurance or no insurance, practice saying this with me: Im uninsured but smart. The next affirmation is, Im underinsured and also a great dancer. Being without insurance is just a quality someone else put on you, not something stupid you did. Money is an embarrassing thing for many people, but theres no need to feel personal shame.
Next, say this whenever you go into a doctors office : I dont have health insurance” or “my health insurance is terrible.” Then: “Are there programs to help me with the cost of medications or my care?
During my own, long bout without insurance, I quickly learned that most doctors, nurses, physician assistants, and just about everyone else in the medical field actually wants to provide health care. They are not judging you. In fact, many will be glad to help you apply to programs that get part of your meds or care covered. They know that the stress caused by underinsurance or a lack of insurance is itself a preexisting condition, one that can affect a patients mental and physical health.
How To Find Information On Your Policy
The easiest way to get information on your policy is to access your summary of benefits and coverage. All plans on federal and state marketplaces include this report. Insurance companies and employer-sponsored insurance plans must provide you with this info, too.
Every plan page includes a copy. They are easy to read and navigate. The summary lists out questions and answers. Then it explains why this information matters.
The summary includes information like:
- The coverage period
- Who the coverage is for
- Common medical events and how much each will cost you
- What happens if you need tests, schedule surgery, or visit a hospital
The summary breaks down exactly what services your plan covers. It also explains what it does not, and even provides sample scenarios with example costs.
Heres a sample of what each document looks like and the type of info it includes.
You can use the Healthcare.gov site to pull up your summary of benefits and coverage. Its right on the site if you bought your plan through a government marketplace. The site includes a search engine you can use to look up plans from private companies, too.
If you have an insurance policy from another source, contact the insurance company to ask for a copy. Or ask your HR department for help finding health insurance policy information.
Health insurance language is confusing for everyone.
Dont get frustrated and give up! Use Healthcare.govs glossary to look up terms you dont understand.
Check Your Insurance Companys Website
If you dont want to call your insurance, check the website. All major insurance and even most small insurance companies have websites that members can log into for information about their accounts. This information will include whether the health insurance plan is active or not.
Now, many people prefer to simply visit the website rather than call the insurance phone number and potentially wait on hold for a long time. Many people find that simply logging into the member portal is more convenient and can also show them other information about the account.
You May Like: How Much Is Health Insurance For A Family Of 5
Q How Do I Join A Managed Care Organization
A. After being notified that you are eligible for Medicaid , you will receive in the mail a packet of information about the different MCO plan options for receiving your Medicaid benefits. You may choose any plan described in this mailing. You probably want to choose a Managed Care Organization to which your doctor belongs. If you need help making this decision, call the Health Benefit Manager at the phone number in the mailing.
Connect For Health Colorado Marketplace
Connect for Health Colorado may also help you meet the insurance requirement. Having health insurance can help protect your health and your financial future.
- If you dont have health insurance but make too much money for Health First Colorado, Connect for Health Colorado can help you learn if you qualify for federal financial assistance to help lower the costs of your insurance.
- If you do have health insurance, you still have the option to shop for a new plan at Connect for Health Colorado.
You may also be able to qualify for financial assistance through Connect for Health Colorado outside of open enrollment if you have experienced a qualifying life event such as losing your job-based coverage, getting married, or having a baby. Visit ConnnectforHealthCO.com for more information.
Read Also: How To Extend Health Insurance
If You’re Abroad And Do Not Have Your Card With You
You can get a Provisional Replacement Certificate to prove your entitlement to medically necessary healthcare if you travel to Europe without your existing EHIC, UK GHIC or new UK EHIC and need treatment during your visit.
If you need a PRC outside opening hours, you should call as soon as possible the next working day.
The PRC will give you the same cover as an existing EHIC, UK GHIC or new UK EHIC until you return home.
When calling for a PRC, you’ll need to give:
- your National Insurance number
The EU countries are:
Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain and Sweden.
How Does Verification Of Benefits Affect The Medical Biller
Fortunately, because the front office staff actually does the verifying, medical billers rarely have to spend their time verifying patient coverage.
Unfortunately, because medical billers don’t always do the verifying, they have to rely on the front office staff to make them aware of any important changes with a patient’s insurance. This means that sometimes claims get sent to the wrong insurance company, or they are denied due to lack of coverage, because they are inactive.
This also means that a very important part of the job of a medical biller is to communicate with the front office staff, or whoever does the insurance verification, and make sure that there is an effective way to update patient insurance information, make any important changes with the patient’s insurance, and make sure all claims are sent to the right insurance carrier.
Don’t Miss: How To Get Temporary Health Insurance
Effective Date Of Coverage
Once an individual is determined eligible for Medicaid, coverage is effective either on the date of application or the first day of the month of application. Benefits also may be covered retroactively for up to three months prior to the month of application, if the individual would have been eligible during that period had he or she applied. Coverage generally stops at the end of the month in which a person no longer meets the requirements for eligibility.
Q Do I Need To Do Anything With A Deceased Person’s Health Card Or Health Coverage
The health card of a deceased person must be returned to the Ministry of Health and Long-Term Care. You will need to complete a and then mail it with the health card of the deceased person to the ministry. You should include a copy of the death certificate. Copies of this form are available by :
- Visiting your local ServiceOntario centre.
- Printing a copy of the form through
- Contact ServiceOntario INFOline at toll-free: 1-888-376-5197 or 416-314-5518
Alternately, you can send a letter to your local ServiceOntario centre providing the deceased person’s name, date of birth, sex and health number. Enclose a photocopy of the death certificate and the actual health card.
Don’t Miss: What Is Private Health Insurance
Do You Have Insurance
Right now the Affordable Care Act is still law, which means that you have to either have some form of insurance or pay a fee, unless you cant afford any of the plans offered. The budget for promoting registration for the ACA has been drastically cut by the Trump administration, but you can still register between November 1 and December 15, 2017, by going to Healthcare.gov. Under the ACA, you can also be covered under your parentss plan if youre under 26 and they are alive and insured themselves.
Still, you can have health insurance in the U.S. and still fall into overwhelming medical debt. If you have a plan that seems like it pays for nothing, what you most likely have is a high-deductible plan. These are cheaper, but you pay for everything until you reach a set amount, which can be a few thousand dollars per year or much higher. This most likely means you are underinsured.
There are also plenty of ways to be in health insurance limbo: Maybe you just quit a job, just started a job, are unemployed, are in a protracted argument with your job about whether you actually have benefits, are too poor to afford a plan, and so on. If you fall into those categories, youre uninsured.
Make Sure You’re Eligible
The Medi-Cal eligibility requirements have expanded, which means individuals and families that previously didn’t qualify, may now be approved. If you are a citizen or legal resident of the state of California and you earn less than 138 percent of the Federal Poverty Level, you probably qualify. Mybenefitscalwin.org has an online questionnaire you can fill out to quickly determine whether or not you meet the requirements for the program.
Don’t Miss: Can You Add Spouse To Health Insurance
Other Key Insurance Terms
Here are other key insurance terms to help you understand your coverage and responsibilities for costs associated with your care:
A copay is a fixed dollar amount that you pay every time you receive medical care.
For example, if you have a $20 copay, you will need to pay $20 to the providers office when you go in for your doctors appointment. Many plans have different copay amounts for different services. So your copay may be $20 for a checkup but $50 for a visit to an urgent care center.
A deductible is a fixed dollar amount that you need to pay within a defined period of time before your insurer will start to cover some of the costs for covered medical services.
Coinsurance is another way you may be required to share costs with your insurance provider. With coinsurance, instead of paying a fixed amount each time you receive medical care, you may be required to pay a percentage of the total costs. For example, your insurance company may pay 80% of the cost, and you may be responsible for to pay for the remaining 20% of the bill.
A maximum out-of-pocket expense is the most youll have to pay for your medical costs in a given time period, usually one calendar year or one plan year.
Who Is Eligible For Medicaid
You may qualify for free or low-cost care through Medicaid based on income and family size.
In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states the program covers all low-income adults below a certain income level.
- First, find out if your state is expanding Medicaid and learn what that means for you.
- If your state is expanding Medicaid, use this chart to see what you may qualify for based on your income and family size.
Even if you were told you didn’t qualify for Medicaid in the past, you may qualify under the new rules. You can see if you qualify for Medicaid 2 ways:
- Visit your state’s Medicaid website. Use the drop-down menu at the top of this page to pick your state. You can apply right now and find out if you qualify. If you qualify, coverage can begin immediately.
- Fill out an application in the Health Insurance Marketplace. When you finish the application, we’ll tell you which programs you and your family qualify for. If it looks like anyone is eligible for Medicaid and/or CHIP, we’ll let the state agency know so you can enroll.
Read Also: What Is A Good Cheap Health Insurance
I Have Insurance So Why Am I Getting A Bill
Your insurance plan is a cost-sharing agreement between you and your insurance company. Generally, many insurance companies cover the costs for preventive care throughout the year, such as check-ups, vaccinations, etc.
For other services, many insurance companies require you to cover all costs until you reach a specified amountknown as a deductible. Once you reach that specific amount, then the insurance company starts paying for covered services.
For example, if you have a $500 deductible, then every year you will have to pay your medical costs for non-preventive care until you have paid a total of $500. Once you reach that $500 limit, the insurance company will begin to cover some of your medical costs for the rest of the year.
How much they pay for each procedure and service after youve reached your deductible depends on your particular plan.
You’ll Likely Need A New Plan But Aca Provisions Apply Nationwide
If you work for a large employer that has business locations throughout the country, you may find that your coverage remains unchanged with your move. But if you buy your health insurance in the individual market, youll have to purchase a new plan.
- Health insurance & health reform authority
Since individual market coverage is regulated and marketed at the state level, a new plan is needed when you move from one state to another. But prior to 2014, health insurance was often an obstacle for people who wanted to move to a new state. In all but five states, individual market coverage was medically underwritten, so people with pre-existing conditions often found it difficult, expensive, or impossible to enroll in new coverage if they were going to need to purchase their own plan .
Many states had state-run high-risk pools, and federal pre-existing condition insurance pools were implemented in the years leading up to 2014. But high-risk pools could impose waiting periods for new arrivals to the state, and coverage through the risk pools was often prohibitively expensive and generally had benefit caps that werent always adequate.
Q What If My Baby Wasn’t Born In Hospital Or Attended At Home By A Registered Midwife
You will need to visit a ServiceOntario centre to register your child for Ontario health coverage.
If you visit a ServiceOntario centre within 90 days of the birth of your child you need to bring :
- confirmation of the baby’s birth, through either a letter from the hospital or attending physician, or a Certified Statement of Live Birth from a provincial office of the Registrar-General
- your residency document
- your identity document
If you visit a ServiceOntario centre more than 90 days after the birth of your child you need to bring :
- your child’s citizenship document
Refer to the question or to the Ontario Health Coverage Document List for a complete listing of approved documents.
Using Your Healthy Connections Plan
Q. What medical services does Medicaid cover? A. Within certain limits, Medicaid will pay for services that are medically necessary. Examples of services that may be covered include doctor visits, medications, hospital visits, and many other medical services.
If you have any questions about what is covered, to view a chart that shows each health plan and what they cover. You can also contact Healthy Connections toll-free at 1-888-549-0820.
Q. How long will my Medicaid benefits remain active? A. Eligibility for most Healthy Connections programs lasts for 1 year. After 1 year, South Carolina Health and Human Services will review your case annually.
Q. I was enrolled in S.C. Healthy Connections Choices and now am told I must choose between health plans. What should I do? A. The Healthy Connections Choices website offers comprehensive information on its health plans. Members may utilize a Quick Start Guide, search for doctors, compare plans, and more. Please visit S.C. Healthy Connections Choices for more information.
Q. Do I need to tell South Carolina Healthy Connections when I move or change jobs? A. Yes. If you have any changes to your income, resources, living arrangements, address or anything else that might affect your eligibility you must report these changes to Healthy Connections right away at 1-888-549-0820.
Q. What if my Medicaid card is lost or stolen? A. Report a lost or stolen card to Healthy Connections immediately at 1-888-549-0820.
Read Also: How To Apply For Low Cost Health Insurance
Who Pays For Medical Bills
When you have insurance, depending on your plan, your health insurance pays for at least a portion of your medical services, including doctors visits, prescription drugs, and emergency room trips. Youll pay the rest of the bills through a copayment, coinsurance or a deductible, which is the amount you pay until insurance coverage starts. Without coverage, youll be liable for the entire bill, both from the hospital or a doctor who accepts you as a patient. You can inquire about the cost of treatment ahead of time, outside of emergency situations, of course. Costs vary, often extraordinarily, so its smart to call ahead or check a hospitals website for details.
How Do I Know If My Medi Cal Is Active
Medi-cal is a Medicaid program of the state of California that was initiated in 1966. It provides medical, vision and dental healthcare services to disabled and poor people. According to the Department of Health Care Services of California state, one-third of Californias population is registered for Medi-cal. It is almost a population of 13.3 million people. There are always some people who are not sure if their Medi-cal status is active. If you are wondering how do I know if my Medi cal is active, then keep reading.
When your Medi-cal status is active, you are able to get healthcare services from doctors and hospitals. There are five ways to find out if your Medi-cal status is active:
Read Also: Can I Stop My Health Insurance Anytime