We are not taught about health insurance in school. As complicated as health insurance is, the schools should offer a course to our children before they have to deal with it. Health insurance is important because health care is so expensive.
If you go to the hospital with a broken arm and no insurance, you could walk out owing a few thousand dollars. If however you go to the hospital with a heart attack, you could walk out owing $80,000 if you have no insurance. Most people don’t have $80,000 sitting around in their wallet or savings account.
When this occurs, most people end up filing bankruptcy because they just have no way to pay the hospital this large sum of money. Some people have even committed suicide over debts like this. It can be a pretty depressing thing to know you owe so much and not have a way to pay the bill.
When people file bankruptcy, this causes inflation. So, for example, that $80,000 that didn’t get paid for the heart attack has to be made up somewhere. It gets added on to everyone else’s bills essentially. The hospital raises the cost of care.
People need to learn how their health insurance works and be proactive about understanding their part in the process. There are several types of insurance, and there are many people that believe once you have insurance, it pays everything. This is not true.
Medicaid, which covers nearly all of your bills if you are poor, can reject a claim and refuse to pay your medical bill. There are several reasons the state’s insurance might reject a claim. If the claim was not filed in time, they’ll reject it.
This can happen due to patient fault or medical provider fault. A medical provider might neglect to file a claim out of just pure sloppy work. The other reason they might not file a claim is if the patient failed to provide the insurance. When this happens, the state doesn’t pay the claim and if it is the provider’s fault, they are forced to eat it, so to speak. If, however, you as a patient neglected to do your part, then you owe the bill.
Medicaid has recently changed it’s way of doing business. They have begun charging hospital copays,deductibles, and other fees. Also if you take your child to the emergency room with a cold or the flu, it’s likely medicaid will reject it because you could have taken your child to a doctor’s office. Then you are liable for the entire bill.
Elderly people who have Medicare have different types of coverage. They have to pay for their Medicare coverage out of their Social Security check. If you choose not to pay for it, then you aren’t covered. Medicare has a part A and part B coverage, and you need both types to have your complete coverage. Basically part A covers hospital stays and part B covers routine care such as doctor visits. However, Medicare doesn’t pay 100%.
Many elderly people get slammed with owing the hospital a few hundred dollars or a few thousand dollars when Medicare doesn’t pay. There is an insurance you can add on called Medigap, and it’s provided through Medicare. It is supposed to cover anything Medicare doesn’t cover. Medigap will not cover pre-existing conditions at this time. It also won’t pay for long-term care. If you have Medicare and any secondary insurance, generally if Medicare rejects it, the secondary insurance will not pay it either.
Most other insurances people receive through work or pay for out of their own pocket have different levels of deductibles, copays, and coinsurance. It’s entirely up to you to know and understand your benefits.
If you don’t have insurance, doctors can refuse to accept you as a new patient. In fact. some doctors will refuse to accept you as a new patient if they don’t participate with your insurance. This happens a lot with Medicaid.
If you don’t have insurance and are lucky enough to find a doctor who will see you and then can’t pay him one month, he can refuse to see you as long as your problem is not life-threatening.
It’s important to have health insurance to keep you from ending up in bankruptcy. It’s also important to have health insurance to make sure that you have continuing care from your doctor. It’s equally important for you to understand how your insurance works.