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Health Coinsurance benefits are a provision under which the insurer and the insured share costs incurred after the co-pays and deductibles are met, according to a specific formula or schedule. You can learn all about how coinsurance works and how it fits with other healthcare insurance policies here.
→ Read MoreThere are many qualifications and limitations regarding what health insurance covers and to what extent. A co-pay or co-payment is the contractual amount you must pay for your use of a specific medical service covered by your health insurance policy. Pre-certification is a requirement, but not a guarantee of payment of benefits.
→ Read MorePre-existing medical condition under your health insurance policy is discussed.
→ Read MoreIncurred medical expenses or fees which are not covered under your health insurance policy and not medically necessary are discussed. If you have been denied coverage because the company has deemed it not medically necessary, with your physician’s help, you have a chance of persuading your insurer otherwise by appealing their denial.
→ Read MoreYour policy is likely to have separate pages describing the benefits for Participating Provider Services and Non-Participating Provider Services. As previously explained, participating provider services are subject to a calendar year deductible and non-participating provider services are subject to a Separate Deductible for Non-Participating Providers. Though the deductibles that apply are different, the description of the covered expenses themselves are nearly identical.
→ Read MoreCertain medical treatment must be pre-certified by your health medical insurance company in advance of treatment.
→ Read MoreAn insurance policy lapse is a termination of coverage that occurs when a policyholder fails to make the required premium payments. After a policy lapses, no benefits are payable because the coverage has terminated. Sometimes, however, there are circumstances when, even though you are late or delinquent on the payment of premium for your individual health insurance policy, your coverage may still be extended. We will discuss these situations so that you know and understand your rights.
→ Read MoreFind the right lawyer for your legal issue.
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