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Doctors go insurance-free for several reasons, such as decreased reimbursement rates from health insurance companies, and excessive paperwork. In many cases, doctors who do not accept insurance have flat rates, or income-based sliding fee schedules, to keep care affordable. Other providers have monthly, quarterly, or annual fees, where their patients pay in advance, in exchange for a certain number of services or visits. Some may require payment at the time service is rendered each visit.
If your doctor goes insurance-free, talk to the billing office to determine how much care will cost. In some cases, it may not be much more than you would pay with health insurance coverage. Caution here, you may mistakenly feel that insurance is no longer important or necessary. Nothing could be further from the truth! The true cost of health care totally out of your own pocket could devastate you financially. Tests, lab work, prescription coverage, and hospitalization or emergency care can be thousands of dollars. In all cases, if you are determined to stay with your doctor no matter what, until you have a new “enrollment period” so you can switch health insurance options, it is best to pay your doctor, sometimes referred to “cash pay” and keep your insurance for all other necessary reasons. One unforeseen emergency without insurance is why you’ll want to keep insurance. One bout of cancer, an embolism, a heart attack, a strange infection, an accident, so many things that could happen that your 1 specific doctor cannot take care of is why you’d want to keep that insurance plan in place.
If your doctor rejects your health insurance plan, it is a good idea to call the health insurance company and state your case. In some cases, your health insurance provider may honor your appeal. Obviously, this does not happen often, but if your provider is providing a service that no one in your city/county provides, your insurance company may make exceptions for you to continue seeing your provider. You can also ask if your doctor’s office will submit an out-of-network claim on your behalf or provide you with necessary paperwork to file it yourself. You may also inquire about what you would pay out-of-pocket as a cash pay client.
If you find yourself losing your health insurance plan and your new plan does not have your doctor in their network, now what do you do? There are some cases in which you are entitled to continue receiving care from your current medical provider, even if they are no longer within your plan’s network.
In Nevada, if you are actively undergoing medically necessary treatment, many insurance companies will work with their new members on transition of care. Depending on the patient’s need, there are times the insurance company may negotiate with the existing provider to complete their care.
At Nevada Insurance Enrollment, health insurance agents can help you find your plan’s list of in-network providers and understand your coverage for primary and specialty care. If you do not currently have health insurance coverage, we can also help you find a plan that your preferred health care provider accepts.
Today’s Health Insurance plans may offer benefits above and beyond just doctors and hospitals, such as free preventive services, fitness programs, teledoc/telehealth, and so much more!
If your health insurance company refuses to cover a claim, you have the right to appeal the decision and have it reviewed by a third party. Your policy should outline how to appeal a denial.
Guaranteed issue means that the health insurance coverage is guaranteed to be issued to applicants, regardless of their medical history, their age, their gender, or any other factors that might increase their likelihood of using health services.
By page visits (this month)
By page visits (this month)
A deductible is an amount you pay before the Insurance Company starts paying. Health insurance plans will have different deductibles. You’ll be expected to pay the whole medical bill out of your own pocket until you’ve paid your deductible.
During the Medicare Annual Election Period (AEP), which is from October 15th through December 7th each year, many people may ask the question, “Do I want a Medicare Advantage Plan or a Medicare Supplement Plan (Medigap)?”
The Affordable Care Act / Obamacare, put specific enrollment periods in place to prevent people from only enrolling in health insurance when they were sick or needed surgery.
Even if you live in a state that requires health insurance coverage for fertility treatments, there may be certain requirements that you have to meet to have services covered. For example, if you have unexplained infertility, you might only qualify for in vitro fertilization after a period of time or a specified number of in-vitro cycles.