Friday, December 28, 2012

Could someone explain the walmart health insurance clause to pay them back in case a suit is won

Could someone explain the walmart health insurance clause to pay them back in case a suit is won?
Is it health insurance or is it not? If its health insurance, there is a contractual obligation to pay for the cost of health care. Why should someone have to pay them back money from a lawsuit to reimburse them?...that would make it not be insurance...if you have to pay back the benefits. If its not insurance, what is it? but the coverage should have nothing to do with how I can sick. they should simply cover because you are sick. If she was in some sort of accident where no one was liable or was just seriously ill from some degenerative disease, they would still have to pay. It seems like a clause insurance carriers put in there to make money. If the lady had insurance coverage, they owe her benefits because she paid premiums for those. Knowing all this, its like the lady and her family ..should not have even bothered suing the trucking company. why bother and do all of that so that walmart can swoop in and reap the benefits?
Law & Ethics - 3 Answers
Random Answers, Critics, Comments, Opinions :
1 :
This is called "subrogation", and it exists in ALL insurance policies, not just health insurance. The legal principal is that whoever is responsible for the injury or damage should pay for it. Health insurance (or car insurance, or home insurance) will pay your damages up front, but they will then recover from the party at fault. Richard
2 :
Consider this: when people are hurt and sue they just don't sue "because yes". They sue because they want their costs covered. Imagine this; you are in a 2 car accident that wasnt your fault. You are going to want the other party to cover it. In essence it shouldnt even go to your carrier because the "wrong" party should pay for everything. Same concept. To have an insurance pay and then to sue for medical expenses you didnt pay yourself is wrong and the carrier has every right to request it back..
3 :
You only get one bite at the apple. Insurance exists to make sure you do get one bite in case that bite is not otherwise forthcoming, but it doesn't mean you might also get lucky and get a second bite.

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Monday, December 24, 2012

How do i go about getting a health insurance plan

How do i go about getting a health insurance plan?
I want to purchase health insurance on my own.

What is a good place to start? How do I find out what kind of mental health coverage I can get? I am really inexperienced with this...any help will be much appreciated!
Insurance - 5 Answers
Random Answers, Critics, Comments, Opinions :
1 :
I work for an insurance company. Depending where you live, the insurance cost may very from state to state. If are employed with a company who offers health insureance, you may have no to some premium payments to make to have the benefits. If you are purchasing the benefits or getting them through an employer, you often have on to two choices of health coverage: 1) a PPO, which stands for Prefered Provider's Office (like blue cross or anthem). With this type of insurance you can usually fing a vast lits of providing doctors who will be contrated with the insurance company who you have contracted. This providers have to obey the regulated rates at which the company will pay for procedures and no more. The difference in what they charge and what the contrated rate is can not be balanced billed to the insured. You also may have somthing that is called a "deductable" and an "out of pocket expence" which is kind of like your share to pay for your medical expenses. There is no "head" doctor to see and you can choose your specialis without referal. 2) an HMO (like pacificare and ethna), is a group of physicians who are contracted under the HMO. Most of the time, you medical expenses will be paid for in full after you pay you office co-payment. MOst of the time there is no "deductable" and or "out of pocket." Most of the time you have to select a head doctor who will be your primary health care physician, he will be in charged of refering you to a specialist if he sees it fit, if he/she does not, you are out of luck. Mental health agencies like HMC/CAPS will be a group of contracted mental health physicians who will run, usually, as you health physician would. * in addition, find out if your plan includes dental coverage, Rx coverage, vision, death benefit, ortho, chiro, etc. Purchasing on your own most often will not be cheaper then 400-600 dollars per month. If you have an employer, it could range from 0-120 dollars a month. Hope this helps. Cheers!
2 :
online inssurance help from expert http://insuranceshelp.info/
3 :
The bets thing to do is make a full research first and start to compare all the prices and benefits. Or if you want the easy way you can simply get a consultancy from professionals. Here is my source: http://www.myhealth-forum.com/
4 :
you are supposed to collect as much as resource as you can by searching the relevant keyword in search engine,if you have good luck there,then your problem solved.however,if you could not find the fitful answer by doing that,here http://www.HealthInsuranceFreeTips.info is the resource i prefered.
5 :
You need a trusted adviser to help you through the process of purchasing health insurance so that you understand what you are purchasing. Some may suggest going on line to get a quote but you probably already know that there is much more to health insurance than price. Some might even suggest a discount plan which is not insurance at all. That adviser can answer questions as to what is and is not covered by the policy, explain deductibles and copays and show you the hospitals and doctors that participate in the network. Check with the agent that writes your home or auto insurance he/she can generally provide you a health insurance proposal that takes into account your budget and health situation. Ultimately, you are the one who determines the affordability of your health insurance plan by deciding how much you will participate in sharing the cost of your health care with your insurance company. If you choose a plan that covers everything i.e. doctors office visits, prescription drugs, preventative health benefits, maternity coverage as well as low deductibles and low copays your monthly premiums will be significant. On the other hand if you are young and healthy and rarely use the health care system you could consider a plan that covers only the major health catastrophe which will result in a relatively low monthly premium. You then can use the monthly premium savings to pay for the occasional doctor visit and still come out ahead. Use the Internet to educate yourself but use an agent to purchase the coverage.
6 :
Try this one - http://healthplans.my-age.net - my family have their health insurance - it is affordable and has good coverage for dental issues.

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Thursday, December 20, 2012

Is human health insurance is necessary for me

Is human health insurance is necessary for me?
I want to tale a humana health insurance policy. How I can get a profitable health insurance? Please help me.
Insurance - 4 Answers
Random Answers, Critics, Comments, Opinions :
1 :
See, insurance isn't MEANT to be "profitable". That's not how it works. How it works, is you and 100 other people pool your money, and pay ALL of your claims out of it. You pay 1/100 of ALL of your claims. It probably won't be you, but if it is, you'll be glad you have it.
2 :
What is a "profitable" health insurance policy?
3 :
health-quotes.talk4fun.net - I switched to this health insurance from them, cause it gives much cheaper rates for mÐµ.
4 :
are you a human? than "human health insurance" is necessary for you. lol Are you trying to "profit" from your health insurance? Don't understand what is your question.

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Sunday, December 16, 2012

Why do health insurance companies deny life ins coverage to people who have a history of malignant melanoma's

Why do health insurance companies deny life ins coverage to people who have a history of malignant melanoma's?
I was just denied life insurance coverage due to a health history of malignant melanoma = 10 years ago, 2 squamous cell carcinoma's = 5 years ago, and 3 displastic nevi removed 6 months ago by my dermatologist.

I get skin exams whenever I see anything suspicious. I take all the necessary precasions. I am almost 45 years old; fair complected, and a female.
Insurance - 5 Answers
Random Answers, Critics, Comments, Opinions :
1 :
Watch "Sicko"......
2 :
because insurance companies do not have a soul!
3 :
melanoma can be related to a skin cancer. that is why. the main advise: never try to buy life insurance on the top of health insurance. ask life insurance specialist and he will be able to get you a life policy with melanoma history. you will be rated at the higher risk level, but you can get it. Best of luck to you www.absinsurance.com
4 :
Well, there are two answers. You're looking for standard rates. Once you have a malignant melanoma, you no longer QUALIFY for standard rates - the odds are just MUCH higher that you won't live as long as someone who hasn't had any melanoma. The second answer is, if price is no object, you CAN buy life insurance. You need to talk to a high risk life agent in your area. You're just going to pay through the nose for it - maybe even close to payout value.
5 :
The reason is because life insurance companies think that your future risk of malignant skin cancer is higher than that of the average population. The best offer you could get with your history as you mentioned it is standard. You should work with an independent insurance broker with experience handling life insurance cases like yours. Not all companies view the same risk the same way. Placing your policy with the right company is important.

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Wednesday, December 12, 2012

What questions do I need to ask when buying health insurance

What questions do I need to ask when buying health insurance?
I am 36, female. For those of you who have experience on health insurance. What items do I need to make sure covered? And any conditions I need to check? Thank you!
Insurance - 4 Answers
Random Answers, Critics, Comments, Opinions :
1 :
you have to buy a Health insurance. There are many company offering health insurance ICICI Loamabrt ,Baja Alianz , Appolo , Star Health , Relinace , New India , Oriental all Company have many plan for single or family as per your requirement you can by a health insurance . mostly all co are giving cash less card , basic document required are your identity proof and age proof , contact any agent for detail or also compare product in in wb sit like policybazzar or i will suggest to u to visit www.insurancepandit.com/index.php and then click on Health All the Best.
2 :
Hi! let me tell you that most of the companies have almost same product. However few companies are also offering OPD expenses also, but their premium is much higher. if you are below 45 the best option which you should check is Reliance healthwise policy, premium is half than any other company. However you should do your own research before buying any policy.... afterall its your hard earned money.
3 :
You need to talk to an insurance agent directly for this. If you go online and get quotes, you will not know if the policy you buy is right for you. An agent will ask you questions regarding your health, types of treatment, any problems finding a specific policy for your needs and what costs you can afford to spend. Also if you have problems later with filing claims or other questions, you can call the agent for advice. good luck
4 :
Its always good in taking health insurance.. First inquire about about the coverage of your policy you are going to take.. Find whetherIs your policy current and in good standing?.. You can also get the insurance broker help.. find a reputable broker, check credentials with either the National Association of Insurance Underwriter..

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Saturday, December 8, 2012

Is there health insurance available for someone whose company does not offer its employees health insurance

Is there health insurance available for someone whose company does not offer its employees health insurance?
My son works for a construction company that is family owned & does not offer health insurance to its employees.

Is there a group he can join to obtain some type of coverage?
Insurance - 2 Answers
Random Answers, Critics, Comments, Opinions :
1 :
He can start calling different insurance companies for quotes. They offer insurance to individuals.
2 :
There are many different places where your son can purchase individual health insurance coverage. In fact, many people do not realize that in the absence of an employer actually paying the premiums for them that individual health insurance is much cheaper than a similar group health insurance plan. The catch is that with an individual plan one must be fairly healthy in order to be accepted onto the plan. Shop around and compare quotes from a number of companies to find the best deal. Here is some more information on how individual health insurance works:

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Tuesday, December 4, 2012

Can a health insurance company deny emergency medical coverage based on the final diagnosis

Can a health insurance company deny emergency medical coverage based on the final diagnosis?
I went to the emergency room for symptoms suggesting a life-threatening illness. It turned out I did not have a life-threatening illness and the ER doctor diagnosed something much less severe. However, now my health insurance company is refusing to pay for the emergency room fee based on that diagnosis. This seems unethical to me. My symptoms indicated an emergency, so I went to the hospital. Just because it turned out I didn't actually have a condition requiring emergency medical attention, doesn't mean my health insurance company has the right to deny me coverage.
Insurance - 7 Answers
Random Answers, Critics, Comments, Opinions :
1 :
Your insurance company should pay as long as you have emergency room coverage. There shouldn't be a problem with that, call your insurance company again and maybe your agent can help you.
2 :
Yes. They cover what they cover. Most of the time, if you don't get admitted, you pay a way lot more for your overreaction. They aren't denying you coverage - if you look to your policy, it will say, "emergency room visits only covered if you are admitted" or some such. Blame the doctor, or blame yourself, for not having a life threatening condition. The policy is what it is - the coverage is clearly worded. Read it over, so NEXT time you don't have any surprises.
3 :
Most state insurance laws use "prudent layperson" criteria. Meaning...if a "prudent layperson" (i.e. - a reasonable ordinary citizen) would consider the circumstances as an emergency, then the insurance company should process the claim as an emergency. By the way...hospital claims specify the diagnosis you presented to the ER with, in addition to your final diagnosis. So, the insurance company should be aware of the symptoms you presented to the ER with, in addition to your final diagnosis. Its hard to say what happened in your situation, without knowing what symptoms you had that made you feel like it was an emergency. But you should at least be able to appeal with an explanation of why you felt it was necessary to seek emergency care. But insurance companies can have tiered benefits ("emergency" use of the ER, and "non-emergency" use of the ER...based on whether or not a reasonable person would consider your situation an emergency). You can either have a reduced benefit for non-emergency situations, or no benefit at all.
4 :
Read your insurance under emergency room expenses covered. You'll find you're covered. Insurance companies are dogs; they'll tell you it's denied and if you swallow it, they saved the money. If you prove them wrong, they'll shrug and say "sorry, honest mistake" and pay up.
5 :
~~You can try and have the doctor who gave the billing diagnoses code, write a letter to the insurance company stating that the symptoms while not a serious diagnose, appeared to need emergency treatment. This may help them reverse the decision. Otherwise, they can hold you responsible if your policy had strict guidelines on ER visits.~~
6 :
Potentially. Insurance companies are trying to keep people out of emergency rooms that don't belong there. I would be surprised if they've denied the whole claim. Usually they'll just make you responsible for more of the bill. In other words it wouldn't be odd to have a $250 copay for an emergency room that is waived if you're admitted -- accident being treated different than illness of course.
7 :
I'm not an expert on this, however I would suggest you take a tour here http://www.HealthInsuranceIdeas.info/free-online-health-insurance.htm ,there are expert's tips there.

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Saturday, December 1, 2012

Why should major corporations have the burden of supplying health insurance in America

Why should major corporations have the burden of supplying health insurance in America?
They don't need this extremely expensive burden in other countries and shouldn't have to provide it in America.

Isn't it time to make America more competitive with other countries by not expecting companies to provide money toward health insurance benefits?
Politics - 6 Answers
Random Answers, Critics, Comments, Opinions :
1 :
Why stop at healthcare insurance ? Why do we have to pay them at all ?
2 :
I don't think we should force any burden on anyone too weak to carry it. We'd just cause a lot of collateral damage by doing so. Should corporations have to shoulder the burden? Probably not, but that's what we're going to do, because we have to be competitive in the global marketplace, and an unhealthy workforce doesn't lead to a superior product.
3 :
Actually, the major corporations are the ones that started offering insurance to their workers in the first place. So they have nobody to blame but themselves. I'm not making this up. They started offering it because they they thought it would br cheaper for them in the long run.
4 :
Those other countries that don't have expensive employer based health plans usually have universal health insurance. Which way do you want it?
5 :
It's an incentive to attract talented employees.
6 :
That, or maybe we could just stop sitting around talking about how to compete with other countries and go do something of productive value.

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