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Small group laws vary from state to state, so you really need an agent who is familiar with AZ laws to provide something definitive.
In general, HIPAA "guarantees" coverage without restriction to individuals who have had at least 18 months of continuous coverage with a prior carrier. It does...
Now that she is pregnant . . . no.
She can't get insurance. Her husband can't get insurance.
Has nothing to do with foreign nationals, although that is an issue for some carriers. It has everything to do with buying the coverage before you need it.
His condition IS pre-existing, despite what you believe.
The coverage you are inquiring about (international travel medical) is (to the best of my knowledge) only issued on an individual (not group) basis. As such, HIPAA restrictions on pre-ex do not apply. That being said, each state has the...
If the carrier denies the claim I would certainly contest it, especially if her medical notes dispute a diagnosis relating to heart disease. Keep in mind you may have difficulty accessing her records. HIPAA privacy issues extend even beyond death.
Ablessin -
I certainly was not trying to pick a fight, or play one-up. Just addressing a "missing piece" in that many insured plans (group or invididual) will not extend coverage to a dependent that does not reside in the household of the covered participant and/or where the covered participant...
I suspect the Unum policy benefits would have terminated at age 65 regardless of your life expectancy. I do find it curious they are giving you an 8 year "warning" and (apparently) cutting off before your 65th birthday. Makes me wonder if they have your DOB incorrect in their system.
I also...
Not necessarily . . .
I gather this was one of those "simplified" underwriting plans like those pitched on TV by Art Linkletter. Answer a few questions, no physical exam, accept/reject based on your answers, low face amount, policy issued in about a week.
Anyone who passes away in the first 2...
So, are you saying a diabetic just can't get insurance? At all?
Not 100% of the time . . . maybe 99%.
Varies from state to state. Some states have "no health question" underwriting where they have to accept almost everyone . . . and the prices are sky high. Most states allow individual...
get coverage that just won't pay for the diabetes
Nope.
Problem is, diabetes is a complicated and multi-faceted disease. To exclude diabetes is to also say the carrier wont pay for circulatory problems, eye disease, kidney problems, . . . in other words almost every major organ in the body can...
Few carriers will cover diabetics stateside. I am not aware of any carriers offering inernational coverage that will extend coverage to a diabetic, no matter how well they have managed their illness.
Birthday rules and court orders aside, some group plans refuse to cover dependents of a non-custodial parent, especially if they do not live in the home of the covered plan participant.
The carrier is obligated by contract to pay the designated beneficiary, regardless of whatever changes may have been intended. If you can prove he was mentally incapable of making proper choices when he named the ex as beneficiary, you may have reason to challenge the policy provisions.
When...
There are privacy issues that will prevent the doc from sharing most (all?) of the information about your wife's medical history. Yes, both of you should go and settle this in person if possible.
I can understand why they want the amount paid in full . . . payments on a $220 bill are more of a...
I would suggest going back to the provider and letting them know you want them to refile the claim with proper coding.
So . . . your wife tried to pay the $220 to the provider and the provider REFUSED to accept her money, AND refused to refile????
File a complaint with the carrier, and with...
I find it odd that the clinic will not refile the claim. How much money is involved?
Someone will have to pay. As indicated earlier, if the carrier denies the claim, and your wife refuses to pay, your joint funds can come in to play.
A non-qual annuity simply means it was funded with after tax dollars, not part of an IRA or other retirement vehicle.
Without seeing the policy, going only on what you have posted, it would appear the carrier acted appropriately. The annuitant died and proceeds were payable to his children...
Yes, and no.
When treatment is rendered SOMEONE signs a financial responsibility form. Presumably it is the one who is receiving treatment. So if your wife is treated (and is the one who signed the financial forms) and there is an outstanding balance after third party payments, then she is...
Sounds like it was a deferred annuity as opposed to an immediate annuity. Your original post made it seems as if it were an immediate annuity and payments had been made to her husband on a regular basis . . . or maybe that was my misinterpretation.
If payments to her husband had not begun, then...
Seems to me the carrier was simply following the contract. Your mothers husband was the beneficiary (annuitant) with a contractual line of distribution upon his death. Your mother as the owner had the right to change the beneficiary as long has her husband was alive, but upon his death...
I am not completely sure I understand your question, but it would appear your area of concern deals more with your financial arrangement with the carrier/TPA than with laws governing health insurance.
What does your agreement with the third party payor say with regard to compensation? Do you...
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