Medical Coverage

Question: Medical coverage? My husbands divorcee decree states that he is to provide medical coverage for his children and any un-reimbursed medical expenses to be split 50/50. The ex does not like the medical coverage he has so takes the children to places not covered and asks him to pay for half. He believes in paying for his children but, this is absurd. We thought we would only reimburse 50% of what it would have cost if she took them to the proper clinic. Thoughts?

Answer: I dont know if this would help or not, but my divorce decree stated that I was to maintain medical coverage for my two children, but the ex paid uncovered expenses and copays at the office. I purposely kept up Blue Cross/Blue Shield for the best coverage I could get. I started getting bills and little nastygrams in the mail that the ex was taking the kids to Doctors who did not accept BC/BS ( I didnt know ANYONE didnt take that coverage, but she must have dug around to find them). I started out paying some of the bills but when it literally turned into a flood of medical bills for well child care, I photocopied our decree and mailed it to the Doctor's Offices and to the ex, explaining that if she chose NOT to use my insurance, the bills were HER responsibility in full. As soon as she got stuck with a couple of hundred dollars in these bills, she somehow miraculously found Doctors that accepted BC/BS. Problem ended. I hope this helps and you can find it useful

Question: What is the best medical coverage for a person with Epilepsy? I need medical coverage that covers prescription pills (brand name because there is no generic), possible hospitalization and ambulance. I rarely need to visit a physician, and I have already been diagnosed. I don't make a lot of money, but I am not eligible for MediCal or MSI. Blue Cross is too expensive and will not cover my pre-existing condition.

Answer: It depends on where you live. Your best bet might be to visit a local insurance agent, preferably an independent agent that sells more than one brand of insurance, and see what they can do for you. Many insurance companies, including some Blue Cross organizations have plans that exclude certain pre-existing conditions for the first year or two, but cover everything else. After the initial waiting period, the pre-existing condition is covered thereafter.

Question: What medical coverage should I get when I go to China? I'm going to Shenzhen, China to work for 4 months as an intern. I was wondering what type of medical coverage I should get, as I have asthma and I want to be fully covered incase anything happens. Thanks!

Answer: I have evacuation insurance in case something serious happens as well as regular coverage with a high deductible. Most of the time, I simply go to doctors on an as needed basis and pay out of pocket. I, too, have asthma, but I simply make sure I have enough inhalers when I come. The few times I've had to seek western medical care, I went to SOS in Beijing. You do not have to be a member but pay higher rates if you are not. Even though I was not a member, the cost of medical care was much cheaper then if I were to pay out of pocket in the States. Hong Kong is so close to Shenzhen. You'll want to make sure your coverage includes hospital stays since that's what will add up. Good luck!

Question: What is the difference between PIP and Medical Coverage? I am trying to educate myself on how car insurance works and I found these 2 "different" kinds of coverage, Personal Injury Protection (PIP) and regular Medical Coverage. The way I have seen them both defined is almost identical. What are the differences between these 2, can you get them both, and if so what benefits would having both policies have? Thanks!

Answer: Personal Injury Protection or PIP is a type of no fault coverage that is available in many states and may or may not be optional. PIP can include coverage for medical bills, loss of income, funeral expenses and other types of expenses such as to have a home aide to help you while recuperating. Medical Payments Coverage is strictly limited to coverage for medical bills and may or may not be available in some states and may or may not be optional. In some states you are allowed to have both coverages for example in Maryland with some of my better companies I will offer my clients Full PIP (in Maryland everyone must be offered PIP but they can elect to have Limited PIP which means their passengers--as long as they are not residents of the insured's household--are the only ones covered in the event of an accident) of up to $10,000 and if they don't have health insurance, I will also offer them Medical Payments up to the maximum offered by the company I am writing the insurance with. The advantage in a claim for the client is that if they have a serious claim they can collect the PIP for loss of income and the Medical for their medical bills. The other advantage in Maryland is that you are allowed to "double dip" with the PIP -- regardless if you will be reimbursed by the other party's insurance or your health insurance you can still also collect the same amount from the PIP carrier and this is totally legal. You do have to be careful with the PIP Coverage though because in some states if you collect PIP you are barred by suing the other party if the medical bills are below a certain threshold. Also in many states you only have a specific amount of time to make the PIP election--some as little as 45 to 60 days and others up to one year. For additional information you should speak with your local agent who should be able to explain the coverages that are available in your specific state and how it works. I hope this information helps. Good Luck

Question: How can a senior citizen retire to Canada and keep medical coverage? Hello. My mother in law just recently retired. Her sister lives in Canada, and she is thinking of living with her. I read that she can collect social security payments anywhere in the world, but how does she receive medical care. Here she has Medicare, but up there she wouldn't have anything. Will doctors in Canada accept Medicare, or will Medicare reimburse the Canadian medical system for any care she receives. What is the best way to approach this? The income is not a problem, but the issue of medical coverage is.

Answer: I am a senior and just posted a question about moving to Canada as a senior. I put it into the Canada Travel section and got some good answers from Canadians. I worked in Canada in the 1970s and collect social insurance from there as well as my American social security. In Canada, a senior has privileges as they do everywhere but in the USA so she would get health coverage even though she is not working. Medicare is strictly an American program and does not cover anyone in Canada but Canadian health care is much better than Medicare. You dont have to pay monthly premiums or 25% of the cost. You should go to the Canadian government website and look for the information. Does your mother in law have Canadian residency or would she be a visitor? I think she would have to be a resident. http://www.hc-sc.gc.ca/hcs-sss/index-eng…

Question: Can a foreigner obtain IMSS medical coverage on tourist status or is permanent resident status required? I am of course referring to medical coverage in the nation of Mexico. Thanks for your assistance.

Answer: To register for the IMSS insurance, you must have an FM3 ( No Immigrante) visa. You cannot get the insurance if you just have a tourist permit. Permanent resident status is a totally different thing. when you have lived in Mexico with an Fm3 for 5 years, then you may get an FM2. After 5 years, you may apply for permanent resident status...and after a couple of more years, you may apply for citizenship. it is a long process. Anyway...need to get your Fm3 before applying for IMSS.

Question: How many Obamites had medical coverage growing up? I am curious as to how many people who voted for Obama had medical coverage at home (while growing up) either due to hard working parents, or Military coverage for dependents? Please answer like this : I was insured -- Parents or I was covered by military as a dependent or We had no insurance and had to pay bills when hurt. Thanks I have asked this same question to both sides, I am not trying to "make a point" I am asking a Question. Please answer in format above or skip question, no rants please.

Answer: Medical insurance didn't exist when I was growing up. Lara, age 80

Question: Is there group medical coverage for individuals? What I mean is... Similar to employer sponsored health coverage, are there groups that any individual can join to get the benefits of a group medical plan?

Answer: There are still group plans available if you are a small business owner. You can join the Better Business Bureau or your local Chamber of Commerce. Oftentimes, these organizations offer group health insurance. http://ohioinsureplan.com/index.php/insu…

Question: Can an employee drop medical coverage on his dependent to find cheaper insurance? employee is having money issues, found cheaper medical insurance for his daughter, wants to drop her from his coverage at work to get the cheaper insurance. Is this considered a qualifying event?

Answer: Having financial problems is not automatically categorized as a qualifying event. A life event change, also called a qualifying event, is a personal change in status which may allow you to change your benefit elections. Examples of some qualifying events include, but are not limited to, the following: Change in legal marital status – marriage, divorce, legal separation, annulment, or death of a spouse Change in number of dependents – birth, death, adoption, placement for adoption, award of legal guardianship Change in employment status of the employee’s spouse or employee’s dependent – switching from part-time to full-time employment status or from full-time to part-time, termination or commencement of employment, a strike or lockout, commencement of or return from an unpaid leave of absence which results in employee/dependent becoming ineligible for coverage Dependent satisfies or ceases to satisfy eligibility requirement – marriage of a dependent or change in student status If you experience a qualifying event, you will need request a change to your benefits within 30 calendar days of the event and provide required documentation. If you do not request the change within 30 calendar days, the next opportunity you will have to make changes to your benefits will be during the next open enrollment period. If the employee failed to manage his money and is now having issues that is a personal problem, but would not be considered a qualifying event.

Question: Do the parents have to be married for baby to have dual medical coverage? My gf and I are going to have a baby next month. We're not planning to get married until next year. Does being married have anything to do with our son having dual medical coverage? Any help is appreciated. Thanks

Answer: Nope. Your GF will not have dual, but your son will. Of course that is only if your workplaces are giving you insurance. If you are both on Medicare they will not double your sons.

Question: Can a health insurance company deny emergency medical coverage based on the final diagnosis? I went to the emergency room for symptoms suggesting a life-threatening illness. It turned out I did not have a life-threatening illness and the ER doctor diagnosed something much less severe. However, now my health insurance company is refusing to pay for the emergency room fee based on that diagnosis. This seems unethical to me. My symptoms indicated an emergency, so I went to the hospital. Just because it turned out I didn't actually have a condition requiring emergency medical attention, doesn't mean my health insurance company has the right to deny me coverage.

Answer: insurance website: http://insurance6.cn

Question: Who is responsible for paying an emergency bill? The father who provides medical coverage or the mother who h? Mother has full custody. Father does not provide child support but provides medical coverage for the son. Who is responsible for paying the emergency room bill? HMSA medical plan has issued a check to reimburse some of the fee but the check was made out to the father. The mother has tried to contact the father to arrange payment for the bill but the father of the child is ignoring all her calls.

Answer: It's a side effect of this sad circumstance. It's obviously his financial responsibility, as THEY are attempting to reimburse him. My best suggestion, to get him this check, would be to have a person he trusts, or respects, inform him of this situation. They should tell him to grow-up, and behave in the best interests of his child. How he feels about his ex, needs to be secondary to the well being of his child. The child is an innocent in this mess. The child should not suffer for Dad's stupidity, and childishness.

Question: Doint a survey: How many of you don't have medical coverage @ work? I am doing a survey to find out how many of you don't have medical coverage at your place of employment or at all for that matter. You can simply answer: I do I don't Don't care to have one or...(ask any question or make any statement you would like to make)

Answer: I have medical coverage. We are given x amount of benefit dollars (cafeteria plan) & can use them to purchase a variety of benefits. Since I carry my family, the insurance is only partially paid for by my employer.

Question: What to do when you have no maternity medical coverage? My friend and her husband are having a baby. They both work, but they make $37,000 together and the Medicaid and WIC maximum income in our state is $30,000 Their employers do NOT offer medical insurance, and they currently have medical coverage that they bought on their own for $400 a month. Problem is that their medical coverage does NOT include maternity and they can't get any other medical coverage because the wife is already pregnant. They have no way of paying for OB costs, delivery, and hospital charges now! What are citizens supposed to do in this situation????? It's not for me, I need the advice for my friend ASAP. What can they do when they state says they aren't "poor" enough?

Answer: Well I am in this same boat and my husband and I have to pay for it out of our pocket. If you have them talk to whoever they are going to, an OB or midwife and even the hospital, they have different self pay contracts. Like my midwife cut the price in half if we paid the total in cash before the baby comes. Also the hospital did the same thing, cut the whole price in half if it was paid by the birth. Luckily we have everything paid off now and are just waiting for the baby. I hope this helps somewhat.

Question: In regards to common law marriage in Colorado, would medical coverage be possible? Me and my significant other have been together for 3 years. Living together for 2. When the time comes up at work to receive medical coverage, would I be able to cover her?

Answer: Just living together does not create a common law marriage. You have to present yourselves to the world as being MARRIED, file joint tax returns, have joint bank account, credit accounts, etc. Claiming to be married to get health insurance could be construed as fraudulent (according to this State of Colo. web site). Read more, and decide if your situation fits. http://www.colorado-family-law.com/color…

Question: How much would a family of 4 (mother with multiple sclerosis and 3 kids) need to pay for medical coverage? this is in the specific instance that they are ineligible for any government subsidies. I'm just trying to get a handle on the basic probable costs of medical coverage for the afore mentioned family. also, what are perhaps a few good company names to go by for these prices?

Answer: the best deal would come thru your employer.. who would usually offer matching funds to offset much of the expense. as a private person.. with pre existing conditions.. i think your beyond help insurance companys are in business to profit.. not to provide health care ..and if your not profitable risk.. they will price u out of the market. face it u have better returns in the gambling casinos than u do on for profit health insurance.. my advice is pick odd or even.. or red or black.. all on.. at least u got a 49.5% chance of winning..

Question: Has anyone given any thought to our present medical coverage or lack of? We need medical coverage in the USA desperately. Has anyone given any thought to stem cell research eliminating disease? It would greatly reduce the cost of government regulated medical insurance. Of course not to consider the pain in second place of all this. We need these cures. If at all possible. Why would any one want to stop this I don't understand.

Answer: Some people may not opt for this ( stem cell research) because they may question, Where is the line drawn or, are we playing God ?? The same situation occurred with Organ Transplants. But, now that time has moved forward, more people are willing to donate their organs. Although, Stem Cell Research will be quite time consuming, it will open doors to understanding disorders and, possible cures/treatments. As A RN, who has seen alot of suffering, to me, any research that can help ease a disorder/disease and, possible cure. I'm all for it !! Unfortunately, there are many people that are not well informed of the process and that stem cell research is ( not always) from discarded embryos. So, why not allow research ?? At least, from discarded embryos ?? What is there to lose ?? Some people store the placental blood from their newborns so that, if needed, there is blood available to be researched against certain diseases and disorders. As with you, I , also do not understand. But, hopefully, as time progresses, such research will be no different than Organ Transplants.

Question: I work for tim hortons, how soon is my medical coverage in effect? I been working at tim hortons for a little while now, and I came down with the flu. In order to go back to work, I need a doctor note stating I was sick. How soon am I coverage for medical coverage at tim hortons?

Answer: Call the hr dept and ask them. Good luck.

Question: My son has NJKIDCARE medical coverage is there an equivalent type of medical care in Delaware? My son is going to live with family in Delaware from New Jersey. His medical coverage is through NJ KID CARE is there a similar medical plan in the state of Delaware?

Answer: Yes-it's Delaware Healthy Children. Here is the link: http://www.dhss.delaware.gov/dss/dhcp.ht…

Question: Medical Uninsured Motorist Coverage not enough - what to do? I was hit in April by an uninsured motorist; he totalled both our cars. I have since seen 8 doctors to diagnose several issues caused by the accident. I've undergone xrays, physical therapy, ultrasounds, blood tests and an MRI, and am now on medication and more phys therapy. I had $5k in uninsured motorist medical coverage, which my ridiculous claim adjuster told me last week ran out over a month ago - I'm now getting bills I can't afford, and I'm not yet well. A friend said I can demand more $ from my insurance company? But he also said Colorado requires insurance companies to cover all med bills, and I've found no such statement on the CO govt sites. My regular health insurance won't cover these bills - what do I do? Was also told attornies won't take my case: the kid who hit me is likely illegal, has been unresponsive. One lawyer said even if I won the case, wouldn't necessary get $ out of it. Last thing I need are lawyer bills.

Answer: You NEED an attorney to represent you, a good one, and he/she needs to do the communicating for you. Get one that specializes in auto accidents. NEVER go it alone when fighting any auto accident case, injuries or otherwise. Claims adjusters goals are to get you to sign off on the case as quickly as possible. DON'T! It's all mind games towards you without proper legal representation. You should NOT be talking in any way with your insurance company adjuster or to the person that hit you insurance people either. That's for your attorney to do. Where injuries are involved ALWAYS have legal counsel, period. Your health insurance MUST pay your bills once your auto policy medical limits are exhausted. Eventually you should be able to get judgment ruled against this person that hit you with all the proper documentation and the will to fight to the end. Who is feeding you the information you are getting? Sounds like pure BS to me. Your auto insuance company IS responsible to take care of YOU till your policy limits are exhausted, same with your health insurance. ONLY THEN, can they deny payment of services rendered to you. GET THE FACTS YOURSELF....Quit talking to friends and neighbors. When did they become licensed personal injury attorneys?