Questions tagged [health-insurance]

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What happens if Reed O'Connor's ruling on the Affordable Care Act (Texas case 4:18-CV-167) is ultimately upheld?

Currently the 5th Circuit is entertaining an appeal to Judge Reed O'Connor's ruling that the entirety of Patient Protection and Affordable Care Act (PPACA or Obamacare) is unconstitutional. If the ...
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1answer
110 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) ...
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1answer
55 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 ...
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2answers
230 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 ...
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1answer
154 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 ...
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1answer
45 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&...
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1answer
384 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 ...
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1answer
68 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 ...
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1answer
73 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 ...
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1answer
46 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 ...
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1answer
38 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 ...
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2answers
113 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 ...
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1answer
176 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 ...
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0answers
145 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 ...
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1answer
63 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 ...
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1answer
900 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 ...
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1answer
162 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 ...
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2answers
2k 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 ...
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1answer
44 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 ...
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1answer
3k 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 ...
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1answer
90 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. ...
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0answers
118 views

Can an employer charge employees more than 100% of group health insurance premiums?

Assume Company A is charged $100 per month from Health Insurer B for its group health plan offered to A's employees, can A charge it's employees $110 per month to enroll in this coverage, but still ...
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1answer
580 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 ...
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2answers
178 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 ...
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1answer
240 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 ...
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0answers
92 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-...
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1answer
84 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 ...
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1answer
180 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
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1answer
130 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 ...
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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 ...
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1answer
357 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-...