Questions tagged [health-insurance]

For questions about health insurance policies, including relevant terminology, types of policies, how to evaluate a health insurance policy, etc. Questions should be tagged with a country-specific tag in most cases, e.g. "united-states" or "canada".

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132 views

Lab repeatedly submitted bill to wrong insurance. How do I resolve the issue?

I am handling the estate of my late step-father. In November 2021 he was in the hospital and had lab work done. The lab company sent the claim to the wrong insurance. My mother & insurance company ...
0 votes
1 answer
51 views

Does my spouse's income count the income calculation for the Affordable Care Act? (See details)

Scenario: I plan to retire before I am eligible for Medicare My wife is eligible for and plans to sign up for Medicare when I retire My wife has income from social security We file our taxes as ...
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2 votes
1 answer
177 views

Health insurance company went out of business; what am I on the hook for?

In June 2020, I had a biopsy (negative). At the time, I was “covered” by ACA-compliant insurance that was paid in full, in good standing, etc. I paid the required co-pay on the day of the procedure. ...
1 vote
2 answers
190 views

Paying too much for health insurance - is there a crisis-only policy avaialble?

Say there's a family of four living on one income. The income level is moderate, say in the $80-100k per year range, they live simply and budget carefully, and have a relatively comfortable, debt-...
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1 vote
2 answers
79 views

Are there any tax/general implications to adding my fiance on employer sponsored insurance?

I recently started a new position and am working on declaring/electing benefits with my employer. To my surprise this employer allows "domestic partners" to be insured for various forms of ...
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0 votes
2 answers
110 views

Pre-existing conditions on short-term health insurance

Despite the many answers on this site saying pre-existing conditions are a thing of the past, there are non-marketplace US insurance plans that exclude pre-existing conditions on a 12 month or 24 ...
  • 797
11 votes
3 answers
3k views

Can you just cancel a health insurance plan and buy a new one at any time?

So I need to buy insurance for myself. I picked one of those plans where you pay a huge premium monthly and also get to pay for all the healthcare too. My question is, can I just cancel my plan and ...
1 vote
1 answer
152 views

What does a negative plan discount mean on a medical insurance claim in the United States?

I saw the following medical insurance (Aetna) claim in the United States: What does the negative plan discount mean?
24 votes
8 answers
8k views

Dental insurance isn't really a type of insurance?

The central tenet of insurance is to pay slightly more on average while getting protected from paying very large amounts of money should disaster strike. In essence it's paying a premium to lower risk....
3 votes
1 answer
126 views

Is the hospital illegally using "balance billing" of primary and secondary health insurance to charge us too much?

My wife and I live in New York City and recently we had a baby and my wife stayed in the hospital for two nights. She has insurance through her employer, which is her primary insurance, and she is ...
3 votes
1 answer
132 views

Private health insurance in Germany

I moved to Germany as a university professor two months ago. This month, I discovered that I am partially issured through the so called 'Beihilfe,' and that I have the option of choosing between ...
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2 votes
0 answers
50 views

Dual citizenship. Live 1m in Florida, 1m in Buenos Aires, 1 month in Florida, and so on. I'm covered in Argentina. What should I do while in the US?

Dual citizenship: American and Argentinian. I'm covered in Argentina, but does not have health insurance in the US. I would like a catastrophic plan, but they aren't offered to 46 years old. Do I have ...
5 votes
1 answer
1k views

From a customer standpoint, does it make any financial difference to go to a non-profit hospital or a for-profit hospital? [closed]

From a customer standpoint in the US, does it make any financial difference to go to a non-profit hospital or a for-profit hospital?
2 votes
1 answer
34 views

Are COBRA plans subject to the same special enrollment rules as non-COBRA group plans?

I recently elected COBRA coverage, and a few weeks later my wife left her job. She has access to her own COBRA coverage from her job, but we'd prefer her to be on my plan rather than hers. My COBRA ...
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-3 votes
3 answers
201 views

Why do some medical insurances only allow their insurees to buy 30 days worth of some pharmaceutical drugs (not a narcotic) at once?

I have a 90-day prescription for a pharmaceutical drug (which isn't a narcotic) in the US. By default, my medical insurance only allows me to buy for 30 days, i.e. I'll have to go 3 times to the ...
0 votes
1 answer
79 views

Can an Orthodontist charge you more later on due to over calculating?

I went to the dentist for a cleaning March 2020. I had said while there that my mouth hurt as well as my jaw. The dentist recommended I see the orthodontist and asked if I had time that day for a ...
2 votes
1 answer
119 views

Did the Hospital Mis-Bill My Insurance Plans?

Some months ago, I received treatment at a hospital in New York City. While I was there, I provided them with the insurance information for two plans under which I was covered. Company A sent me an ...
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0 votes
1 answer
134 views

Do you qualify for Medi-Cal if you are wealthy and just don't work?

If I'm reading the descriptions of Medi-Cal correctly, low income alone is enough to qualify you for free medical coverage. So, if you are taking a sabbatical, working on your own startup (that isn't ...
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1 vote
0 answers
211 views

If I meet my Out-Of-Pocket Maximum, but not my deductible then what happens to my medical bills?

Out-Of-Pocket Maximum is the amount you pay including any cost sharing payments such as coinsurance, copayments and deductible amounts. Usually copayments don't get counted toward deductibles and ...
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0 votes
1 answer
42 views

What are the minimum financial benefits a long-term care insurance must have to allow a Washington tax resident to opt out from the long-term care tax

Revised Code of Washington (RCW) 48.83.020 (mirror) states: "Long-term care insurance" means an insurance policy, contract, or rider that is advertised, marketed, offered, or designed to ...
4 votes
2 answers
122 views

Which insurance is primary when you have coverage through two employers?

If someone has health insurance coverage in the U.S. through two separate employers, which is considered primary for the coordination of benefits? How is this determined?
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-1 votes
1 answer
82 views

Is it allowed to change one's qualifying long-term-care insurance after opting out from the long-term care payroll tax in Washington?

After opting out from the long-term care payroll tax in Washington by purchasing a qualifying long-term-care insurance, one has to keep a qualifying long-term-care insurance, other one may get in ...
0 votes
1 answer
59 views

To opt out from the long-term-care payroll tax in WA, does the LTC insurance have to be active by Nov 1, 2021, or simply be purchased by Nov 1, 2021?

To be allowed to opt out from the long-term-care payroll tax in Washington state, does the long-term care insurance have to be active by November 1, 2021, or simply be purchased by November 1, 2021? ...
1 vote
0 answers
46 views

Should retiree take insurance from employer or should he/she take from external insurance organization?

My dad is retired bank official in India. I want to know if he should go for health insurance provided by his employer or he should go for other insurance organizations, given say the cover is exactly ...
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22 votes
7 answers
6k views

Are the HSA and FSA bad deals?

As I understand it, the HSA and FSA accounts are intended to provide individuals with a way of not paying tax on money they spent on healthcare. The individual sets up the account to receive a portion ...
57 votes
7 answers
14k views

Is US health insurance just a terrible deal overall for a healthy young adult?

Since it is open enrollment period, it is once again time for me and my family to review our decisions about our healthcare insurance. These days, there are quite a few nuances to healthcare insurance ...
2 votes
1 answer
148 views

After opting out from the long-term care payroll tax in Washington by purchasing a qualifying long-term-care insurance, can one drop the insurance?

After opting out from the newly established long-term care payroll tax in Washington state by purchasing a qualifying long-term-care insurance, can one terminate the contract with the insurance? Or ...
1 vote
3 answers
287 views

Is 0% coinsurance better than a lower deductible?

I have two options for my healthcare provided through work. My employer covers 100% of the monthly premiums for both, and the premiums would be essentially identical anyway (within $2/month), so that ...
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2 votes
1 answer
57 views

Employer changing Healthcare provider during COBRA eligibility period -

I am currently on COBRA and my eligibility runs for several more months. My employer (who covers my COBRA) is changing healthcare providers. I assume they must let me continue under the new provider ...
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2 votes
2 answers
154 views

Can you keep on COBRA for medical and elect only dental and vision coverage from new employer?

Long story short, I am changing jobs and my new employer offers medical, dental, and vision. However, I've had a rough year and have finished paying all of my medical insurance's deductible and am ...
18 votes
6 answers
7k views

Why is the monthly premium of one medical insurance plan over TWENTY times of another?

After many years of school, I recently started work. I learned about the different categories of health insurance: for an HMO I have to contact my PCP, PPO gives more flexibility, and POS is somewhere ...
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1 vote
1 answer
85 views

How to respond to CA 2020 tax penalty notice? I forgot to indicate I had health coverage

I received this mail yesterday: PICTURE OF MAIL I am a student with F1 visa status and filed both federal and state taxes for 2019 and 2020. I do have an external scholarship that includes a very good ...
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2 votes
1 answer
113 views

Is a layoff a QLE allowing one to elect different health plan offered by employer?

If one is laid off, one is allowed under Cobra to continue group based health insurance thru employer. Does the layoff count as a QLE allowing one to change health coverage if an employer offers ...
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2 votes
1 answer
73 views

Reimbursement from insurance after FSA reimbursement received

A couple months ago, I had a dental appointment and, since my dentist is not in-network, I had a substantial bill. I submitted this expense to my flex spending account (FSA) for reimbursement, and I ...
0 votes
0 answers
54 views

Hedging Costly And Unlikely Events With More Than Conventional Insurance

The selling proposition of something like an inflation-adjusted annuity is that the purchaser trades uncertainty for certainty. Even though some simple calculations will show that fixed and regular ...
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2 votes
1 answer
107 views

Is the employee-paid premium on a health insurance plan that is shared with a non-dependent tax deductible?

My health insurance premium for just me is $0. If I add my domestic partner, however, the premium goes up to $190. I know I have to account for imputed income, on the basis of the additional employer-...
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0 votes
1 answer
81 views

Claim money from unused health insurance (set by employer)

Is it possible to claim unused health insurance money after you leave a company? It is basically unused group health in the United Kingdom (England). The health insurance was set by the employer where ...
33 votes
2 answers
5k views

Do I have to pay a medical bill when the ER never submitted it for an insurance claim?

My husband went into cardiac failure while we were traveling. He was taken by ambulance to the nearest hospital ER. I gave his insurance information at the time of service. About a month later, I ...
6 votes
1 answer
97 views

Does a qualifying life event require changing retroactively to the date of the event?

My employer offers several insurance plans, including both a low-deductible plan and a high-deductible HSA plan. Suppose my family was planning to have a baby in the middle of next year. Would it be ...
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3 votes
1 answer
88 views

Health Insurance Premium deduction for Husband/Wife LLC

Assume the following situation: My wife and I own a LLC in a community property state. (50/50) We are self-employed and have no employees. Under this arrangrement, business income flows through to ...
2 votes
0 answers
62 views

Cobra or catastrophic insurance

I'm about to leave a job and go on a long bikepacking trip. At the end of the trip I will be going to grad school and getting student health insurance. This is all in the United States. I have decent ...
30 votes
2 answers
6k views

Insuring body parts

In the past few months I have injured my hands 4 times since I started playing basketball. One break was particularly bad and I wasn't able to use that hand for programming. This slowed down my work ...
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1 vote
0 answers
53 views

Mandatory retroactive insurance coverage due to QLE in USA

My wife and I have a QLE (Qualifying Life Event) for new insurance: a job change. The document is dated April 12. We apparently have 30 days to enroll in new insurance now. When we spoke to Health ...
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1 vote
1 answer
72 views

Will my surgery bill be covered by Medicaid if I just started a new job?

I had a knee surgery while i was on medicaid. The hospital hasn't billed me for the surgery yet. I will start a new job soon. Will Medicaid still pay for that surgery?
0 votes
2 answers
392 views

Accidently forgot to cancel insurance Kaiser, refund possible?

I had a personal health insurance plan from Kaiser, but I forgot to cancel it when my workplace health insurance coverage (also from Kaiser) started, so for 2 months I was charged for 2 plans. Is it ...
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2 votes
0 answers
43 views

Do we have to pay deductibles on medicare and medicaid separately?

My fiancé has been seeing a PTSD therapist for about five weeks, paying out of pocket for the sessions until her medicare deductible was met so she would be covered. We just got a call from the ...
2 votes
1 answer
80 views

Self-funded & fully-funded health insurance plans for small businesses

Imagine that a hypothetical small business in the U.S., MoneySavers, is setting up a health insurance plan that it will offer to its employees. I'm looking for clarification on any misunderstanding ...
-5 votes
1 answer
171 views

Can a lab collection requisition be used in two different labs and still be covered by the health insurance?

For example, let's assume that a lab collection requisition lists two tests: test A and test B (e.g., test A and test B can be some blood tests). Can the patient do test A in one lab and test B in ...
4 votes
1 answer
84 views

If I get covered by a new healthcare plan in the middle of a month that is already covered by COBRA, will I get double coverage or a prorated refund?

I've been unemployed and have paid into the COBRA dental, vision, and healthcare plan of my previous employer, ever since being laid off from that job. I submitted my last COBRA payment on February 1, ...
1 vote
1 answer
65 views

If a health insurance considers a physician with a given NPI as in-network, does this mean that any physician with the same NPI is also in-network?

If a health insurance plan in the United States considers a physician with a given National Provider Identifier (NPI) in-network, does this mean that any physician billing via the same NPI is also ...

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