Health insurance and elective procedures
It’s old news that medical health insurance for many people really does sucks, as they talk about in this video I found on YouTube. It’s kind of funny, kind of weird (especially the constant shot of that guy wearing a mask, not sure why that’s there), but it’s also revealing of the way many Americans feel about their medical health insurance coverage. Many people who work for large companies get great deals on group health insurance, and people who have enough money can buy plenty of good health insurance for themselves.
One of the big issues about medical health insurance, other than why so many people either don’t have it or don’t have enough of it, is about elective health care. This doesn’t always have to do with health care necessarily, and often involves elective procedures such as botox, lasik surgery, and breast augmentation. It’s up for debate about whether other people covered by a health insurance company should be made to suffer higher payments because of someone doing something that isn’t necessary for their health. However, as you can see in the video where they talk about breast reduction, sometimes it’s hard to draw the line between what is elective surgery and what is really needed.
Cheers,
Fashun Guadarrama.
Florida health insurance for non-citizen children
Reader question:
Me and my kids aren’t citizens of the United States, but we’re living here legally and I’m not able to afford health insurance for us. Am I able to provide them with health care through Florida’s KidCare child health insurance?
Emilie
Maybe so.
For people who aren’t citizens of the United States, the path to getting state sponsored health insurance for their children might be even more difficult than for other people. There are several extra requirements that determine whether or not the child fits into a certain group that makes it to where they are able to receive this help from the state. For the most part, in order to get KidCare, you have to be a citizen. But there are a few children who can still get it even if they weren’t born in the U.S. They’re called ‘qualified aliens’.
People who are legally residing in the U.S. but aren’t citizens might be eligible for Florida child health insurance if they fit the following criteria.
- Are Ameriasians.
- Come from Haiti or Cuba
- Are refugees and have received certification from the Office of Refugee Resettlement for being trafficking victims
- Are the children of someone who is in the military or is a veteran of it
- Kids who have resided legal as residents for at least five years
- People in asylum, here as refugees, or who have had their removal withheld.
Cheers,
Fashun Guadarrama.
What can a grandparent do for their grandchild without health insurance?
Reader question:
I’m a worried grandmother whose granddaughter has been getting sick a lot lately, but her parents don’t have the money for health insurance nor do they have the money to take her to the doctor. What can I, as a grandparent, do?
Millie
I’m glad you asked.
You would be surprised by how much exactly a grandparent can do, because according to state laws in Florida, they are not entirely without rights as concerns their grandchildren. It may be true that a grandparent is not allowed to apply for health insurance for a child, even when that child does not have child health insurance or any real way of getting it, but there are still some things that the grandparent can do.
According to Florida Statute Chapter 743.0645, you have the right to get health care on the behalf of your grandchild. This means that you can take your granddaughter to the emergency room or the doctor’s office, and can consent to major things. This right only comes, though, after the doctor on duty has tried many times to get in tough with the parent, and the parent has also not declared that the child can not be treated in such a way.
Cheers,
Fashun Guadarrama.
Types of family health insurance plans
Reader question:
What kinds of family health insurance are there?
Maria
Good question.
Not everybody has the good fortune to work at a job where they have extensive health insurance coverage. Some people do have medical health insurance from their job, but that insurance only covers themself. If you have medical health insurance that only applies to you, then what are you supposed to do when you need family health insurance? If you find yourself in a situation like this, then you need to begin considering taking out a family health insurance plan.
There are several types of family health insurance. One of the main ones is fee for service family health insurance. This is a traditional indemnity sort of plan. This is a very loose and allowing type of health insurance claim, because for the most part you can act first and think later. Fee for service family health insurance lets you go to a doctor of your choice, and then make a claim, the amount of which is then taken out of your total maximum coverage. Not everything is covered, so make sure you know what is before you get treated.
Another type of family health insurance is a health maintenance organization, of HMO. These are new to the family health insurance plan roster, but they’re very well liked because they are extremely cheap, unlike the fee for service family health insurance, which tends to be expensive. HMOs are more strict, though, as you have to go to a health care professional within their network. If you get treated from someone on the outside, then you’ll be paying for everything.
There are a few other family health insurance plan types available, especially considering that HMOs are so limiting and fee for service costs so much. One is PPO, which is a mix of the two, having both a network in which you must stay to get the best prices and the option for you to go outside the network for less coverage.
Cheers,
Fashun Guadarrama.
And if your health insurance claim is denied? What then?
Reader question:
My health insurance claim was denied. What do I do?
Mary
Great question.
Not being in control of your health care is a very scary thing to think about, and when you get a health insurance claim denied, it leaves you feeling as though you don’t have any options left. This is a most stressful situation, because if you want to get out if it you have to take charge and change things, and provide your health insurance company with incentive to do that, but since the consequences of having a health insurance claim denied are so overwhelming, it’s hard to get up the strength to do all that once you’re put in that situation.
The best thing to do if you get your health insurance claim denied is to ask for a face to face appeal hearing. Almost all of the health insurance plans out there will let you come to one, maybe more, of the appeal hearings over your case. If you request one of these, then your case will be looked at all over again and you’ll be able to present new evidence, and maybe get a chance of getting your health insurance claim approved this time around.
If you were following the correct steps, you should have documented everything all the way through this health insurance scare, and if you have that extra documentation you can use it in your favor. Perhaps you could even hire a lawyer. Whatever you do, go into your appeal confident that you will leave a winner, because if you don’t, you could lose the nerve.
If you really want to get your health insurance claim approved, you should try to get your doctor involved. Sometimes health insurance claims can be denied because the treatment or procedure is considered not needed. In order to fight this claim, you can get help from your own doctor, who can contact the insurance company and provide reasons for why it really was necessary and should be covered.
Cheers,
Fashun Guadarrama.