Questions tagged [health-insurance]
The health-insurance tag has no usage guidance.
42
questions
1
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2answers
56 views
Must all COVID-19 tests be fully reimbursed by health insurances in California, United States?
I read on one of the COVID-19 testing websites (https://www.sccgov.org/sites/covid19/Pages/covid19-testing.aspx but the following text can only be viewed but booking an appointment) [emphasis is mine]:...
3
votes
2answers
174 views
Can an employer ask an employee about personal health matters (HIPAA) and COBRA decision in public?
Hypothetical Scenario (in the US):
Susan's employer, MoneySavers, offers COBRA to employees who separate from the company. Susan has given her two weeks' notice (she has quit her job) and will soon ...
1
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1answer
35 views
Is it ever doctor's responsibility to ensure insurance coverage for services received? California
If patient before appointment gives explicit instructions to doctor to proceed with appointment only if patient's insurance would fully cover appointment; and then doctor in writing confirms that ...
0
votes
0answers
27 views
If (hypothetically) Congress sets a non-zero uninsured penalty, does that invalidate California v. Texas before it is even decided by SCOTUS?
Regarding the Affordable Care Act odyssey throughout the courts:
The Affordable Care Act’s (ACA) future continues to be uncertain as the law’s constitutionality will once again be considered by the U....
1
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0answers
101 views
Lab provider says I owe them money, insurance company says I don't. Who is right?
tl/dr: My doctor told me some lab work would be fully covered, but the doctor didn't do the work themselves. They sent it off to a 3rd party lab
service. Turns out that one particular test wasn't ...
8
votes
4answers
1k views
Can the law limit what heath care providers I see if I have commercial and medicaid?
There's a bit of story to this:
We had been trying to find a therapist for my son. We wanted one that we felt comfortable with. We didn't care if the provider was out of network or if we'd have to pay ...
1
vote
3answers
86 views
Are US doctors allowed to charge insured clients more than uninsured clients?
Is a U.S. doctor allowed to charge a client with insurance more than a client without insurance? I was told the cost for my visit was $40 if no insurance but $60 co-pay if I have insurance. I called ...
3
votes
0answers
55 views
Termination letter marked 1 day early
Someone I know was let go from their job on 4/1, he was using the insurance provided by his employer. In his employment contract it states insurance will remain active through the rest of the month ...
0
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0answers
116 views
Does Justice Roberts Obamacare opinion contradict itself?
Chief Justice Roberts' opinion in National Federation of Independent Business v. Sebelius upheld the ACA individual mandate as a tax. Disagreeing with the joint dissenters (Alito, Thomas, Kennedy, and ...
2
votes
1answer
115 views
Possibly a stupid question, but do insurance companies HAVE to have somebody as a customer?
Let's say Unlucky Joe is a very accident-prone young man. He keeps getting into costly accidents all the time, but it can never be proved that he does it by mistake, and it doesn't benefit him ...
1
vote
1answer
44 views
What portion of a medical bill does the insurance has to pay?
In a car accident, not at fault, what portion of a medical bill does the insurance company of the other driver has to pay?
The hospital will most probably bill my health insurance, and there is the ...
1
vote
1answer
104 views
Do I have a case to challenge a private medical invoice that wasn't covered by insurance?
I had private medical insurance as part of my employer, I rang up in October for an appointment and one was "authorised" for January.
I then left my job in December and still attended in January. (I ...
1
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0answers
26 views
Is there a legal professional who can be hired to assist with insurance for patients with complicated medical needs?
Is there a specific category of legal professional that could be hired specifically to assist with the filing of the paperwork and management of insurance claims on behalf of an individual?
I am not ...
2
votes
1answer
337 views
being forced to use Express Scripts (mail order delivery) on perscriptions
Insurance policy set up by the workplace requires us to fill prescriptions through a specific mail order vendor and denies coverage of prescriptions through other retail vendors (Walgreens, CVS, etc)
...
1
vote
1answer
56 views
Should I settle with a car insurer (Uber) and reimburse a medical insurer after car accident? (subrogation) [closed]
I was a passenger in an Uber ride, and there was an accident. I had medical treatment, paid with my medical insurance from work, and now they want to get a reimbursement (subrogation). This is totally ...
2
votes
2answers
268 views
Employer Added Wife to Insurance, Now They Retroactively Voided Her Coverage
My employer "accidentally" included my wife in my health insurance plan. (They are now saying that they don't cover spouses). They retroactively voided the plan without informing us. We thought she ...
4
votes
1answer
215 views
How much privacy about my health am I giving up if I participate in my employer's wellness screening program?
My employer is having a "Wellness Screening Fair" where you can receive free testing for things like cholesterol and insulin, and I imagine advice about how to interpret the results. Sounds good.. But ...
0
votes
1answer
47 views
Is there a fine for no health insurance 2017
I'm referring to the 2017 tax year (Jan 17-dec17 filed April 18)
My CPA for 10 years is telling me there is a fine this year for not having health coverage. Multiple other people i know who used h&...
1
vote
1answer
547 views
Are parents allowed to not pay for their children's surgery?
Through public internet group chats, I was able to meet a 16 year old girl that suffers from a medical condition on her feet. She lives in Washington, US, but in a neglectful household where her ...
0
votes
1answer
76 views
Can an employer pay less in benefits to employees on a 'Family' healthcare plan than employees on an 'Individual' healthcare plan?
I work at a community college in California. About a decade ago, my union negotiated for the district to pay 100% of all healthcare premiums for single employees, and a fixed dollar amount towards the ...
1
vote
1answer
94 views
Secular Health Care Sharing
My goal is to provide the most affordable health insurance plan or health insurance alternative for freelance workers nationwide.
The Affordable Care Act made members of Health Care Sharing ...
0
votes
1answer
53 views
What is the motivation behind the “rules for coordination of benefits”?
I am looking at a law which motivation I don't understand:
WAC 284-51-205
Rules for coordination of benefits.
(1) When a person is covered by two or more plans, the rules for determining the order of ...
1
vote
1answer
41 views
Health Insurance Usage for Employers
Do employers look at health insurance usage, and use that data to possibly lay people off for incurring too much usage?
1) Would such a practice be legal
2) Even if it were illegal, could employers ...
3
votes
2answers
203 views
Can residential/custodial parent change our kids health insurance unilaterally?
We have a parenting plan that designates all health decisions as "jointly made." The other parent previously had our child on their employer insurance plan. They just changed jobs and hence insurance ...
1
vote
1answer
214 views
What would happen to Hobby Lobby under Medicare For All?
The Hobby Lobby SCOTUS case, if I'm not mistaken, says a company can manipulate the nature of their employees' health insurance, justifying it by the idea that since they're providing it, they should ...
4
votes
0answers
188 views
What happens if I accept work contracts in two EU countries at the same time?
I am going to accept a job in Dublin, Irealnd but I also have an opportunity of getting a work contract in the Czech Republic. The latter job would be mostly remote (it would require me to visit the ...
0
votes
1answer
65 views
Interpreting an ambiguous definition in an insurance policy
My wife has a travel insurance policy where "dependent" is defined as follows:
Dependent means your spouse and your or your spouse’s
unmarried natural, adopted or step-child of the participant
...
1
vote
2answers
3k views
Is it legal for “in-network” dentist to send me a bill when insurance company denied claim?
A couple months ago I went to the dentist for a crown, he noticed my jaw clicking and he said that I would need a "occlusal adjustment" to help fix this.
Based on what I was told, I was under the ...
1
vote
1answer
213 views
Is it legal for employer to require portions of an IRS form 1040 for verification of dependent eligibility?
Is it legal (California, USA) for an employer to require an employee provide a copy of the first two pages of their most recent form 1040 as part of demonstrating the eligibility of the dependents for ...
2
votes
4answers
5k views
Can a medical practitioner legally charge health insurances a different amount from what it would charge a non-insured patient?
In the United States, can a medical practitioner legally charge health insurances a different amount from what it would charge a non-insured patient?
I am mostly interested for in the states of ...
1
vote
1answer
53 views
Pre-existing issue (medical)
I have a sub-dermal haemangioma on the side of my face, its barely visible, and its been there since I was young. We had it looked at by a professional when I was child and it was never officially ...
2
votes
1answer
4k views
What is the difference between “controlled substance” and “needing a prescription”?
I was prescribed a medication. The doctor said it was not a controlled substance. Why did he write a prescription? If it's not controlled couldn't I just go to the pharmacist and ask for the ...
3
votes
1answer
100 views
Health insurance just for a particular gender?
Can a company provide health insurance just for a particular gender? For example by giving different premiums for different genders. I think they can give different premiums for different age groups.
...
0
votes
1answer
660 views
Is an asylee applicant exempt from buying a health coverage?
According to Obamacare non residents are exempt from mandatory health coverage.
Based on the Marketplace regulation:
Applicants for asylum are eligible for Marketplace coverage only if they’ve ...
3
votes
2answers
221 views
Is what the customer service of a health insurance company tells one of their customers legally binding?
In the United States, is what the customer service tells a customer legally binding?
Example: A customer calls their health insurance company, they say X is covered, 1 month later the customer ...
5
votes
1answer
288 views
Must a health insurance in the United States provide a listing of procedure and diagnosis codes that are covered upon request?
I wonder whether a health insurance in the United States must provide a listing of procedure and diagnosis codes that are covered, if requested by a policyholder?
In my opinion, the listing of ...
2
votes
0answers
102 views
Do doctors have the legal responsibility to inform the patient of services not covered by the insurance in the USA?
I wonder whether doctors have the legal responsibility to inform the patient of services not covered by the insurance in the USA.
https://craighospital.org/resources/you-and-your-doctor-rights-and-...
2
votes
1answer
98 views
The legal value of oral claims in the US
I went to the physician in California, United States. The secretary orally told me that the appointment was covered by my US health insurance, but it was not. Can I refuse to pay on the grounds that ...
2
votes
1answer
262 views
Is it illegal for a parent to refuse to pay medical expenses with child support in the USA?
I am asking one a friend's behalf.
My friend's parents are divorced, my friend (18, F) is living with her mother and her mother's boyfriend (not married to each other). The mother receives child ...
2
votes
1answer
134 views
dental clinic - horrible service overcharged [closed]
In May this year I went to a dental clinic to put a dental crown in Anchorage Alaska USA. The dental clinic told me that the total cost for the crown would be US$2300. US$1300 would come from my ...
8
votes
2answers
3k views
Is it legal for a company to offer a different insurance rate based on spouse's employer's offerings?
Is it legal for a company to offer a different insurance rate based on the spouse's employer's offerings?
My employer wants me to indicate to them whether my spouse can have insurance under her ...
1
vote
1answer
395 views
Can you sue minors only in America?
As I was reading the story below, I thought I must be reading The Onion, only to later see that it's The Guardian instead.
http://www.theguardian.com/us-news/2015/oct/13/woman-nephew-broken-wrist-hug-...
