Health Insurance 411

Sounds like they are following the letter of the c...

2009-01-26T17:01:00.000-05:00

Sounds like they are following the letter of the contract. That is what they are supposed to do (and so are other carriers as well).

My issue with them is more along the line of general policyholder service which has room for improvement.

So far I have not encountered issues on claim adjudication. If it comes up, I can rely on my 30+ yrs in dealing with carriers on claim issues to help in fighting for my clients.

I am an Aetna insured professional w family. They ...

2009-01-26T16:49:00.000-05:00

I am an Aetna insured professional w family. They also manage our FSA accounts. Their website for managing claims is good. You can find and print EOBs and generally keep track of the claims process. The bad news is that you need to because their "error rate" is high. Like many insurance companies today they will deny your claim by default and make you followup/fight to obtain even basic benefits. My most recent experience is when they denied coverage of a basic well-care visit for my 6 year old daughter because apparently we waited only 359 days and not 365 days between appointments. I feel great sympathy for anyone truly ill and trying to get coverage from Aetna.
BWC

It's amazing how intrenched people's perceptions a...

2009-01-08T23:14:00.000-05:00

It's amazing how intrenched people's perceptions are. If a plan doesn't have first dollar coverage or low co-pays it is a bad plan. If someone sees an HSA with the high deductible the first thing they always say is what if I get really sick...under an HSA the OOP is almost always much lower then a regualar plan, they would actually be better off.

This is one of the biggest battles, getting consumers to realize a low co-pay and minimal deductible is not in their best interest nor is it insurance.

Mandate or not, nothing is free. Doesn't matter if...

2008-10-29T18:32:00.000-04:00

Mandate or not, nothing is free. Doesn't matter if it is borrowed money or health care.

There is ALWAYS a price.

Thx for you comments, Andrew.

For both loans and healtcare, people can try to de...

2008-10-29T16:09:00.000-04:00

For both loans and healtcare, people can try to demand what they want, but they aren't going to get it unless they have paid for it, or political authorities require it.

Bad loans were made because they could be sold to Fannie Mae and Freddie Mac, who bought them according to government policy. (There is more here). Now we all are paying big time for the government engineered and mandated losses.

Expensive healthcare is delivered because of political mandate. People get free care at emergency rooms without having to support or subscribe to an emergency room, or buy insurance. The obvious price distortion attempts to pay for the free care by charging whoever is available, those who are insured and those who have assets. Amazingly, this is a tax on the sick to pay for the uninsured and poor sick. When government waves its hands and says "just do it, regardless of cost", things get done with chaos and at great expense, truly regardless of cost.

I too have Crohn's and the health insurance I appl...

2008-09-23T03:15:00.000-04:00

I too have Crohn's and the health insurance I applied for recently promised me that I would be covered but, as you have stated, not for the pre-ex condition for 12 months. I filled out all the paperwork only to be DENIED by them because I had a "pre-existing" condition.

I was diagnosed 8 years ago with a back abnormalit...

2007-03-15T21:24:00.000-04:00

I was diagnosed 8 years ago with a back abnormality that the doctors described as "Spina Biffida". I have a ball like defect in my lower back that encompases 3 vertabrea and my tail bone. I also was born with something called Bi-Lateral cervical ribs. This is a genetic abnormality where I was born with 2 extra cervical ribs that come forward straight down onto my rib cage. I had one of these removed 15 years ago to to severe health risks and complications this was causing. I've been desperatly trying to get any information from any one out there that possibly has any info on these conditions. I was toild the chances of anyone having this was < less than .05% of the population in the world. So you see my dilema. I'm now 40 and am expiriencing increase lower back pain,nerve problems down to my knees,of wich I've also already had these both operated on for other problems. If you have any info I'd greatly appriciate it. email me at wpippin224@earthlink.net

This is very nice blog. do you konw Mozilla Firefo...

2007-02-13T18:17:00.000-05:00

This is very nice blog. do you konw Mozilla Firefox web browser?I really loved it,I hope you may want to download and try. thank you.

some people are just plain stupid

2006-05-04T16:59:00.000-04:00

some people are just plain stupid

Kinda gives new meaning to CDHC's "having skin in...

2006-04-21T08:52:00.000-04:00

Kinda gives new meaning to CDHC's "having skin in the game."

I understand that a certain large health insurer, ...

2006-03-29T15:32:00.000-05:00

I understand that a certain large health insurer, who shall remain unnamed, except to say that its name rhymes with "Gretna," took about 15 months to agree that it could release underwriting information so that its clients could shop their coverage. It took individual letters in each case from our compliance department attorneys (Ahem, me) to convince them that it was an permitted disclosure. Even then they insisted (rightly, unfortunately) that permitted does not mean required. I'm absolutely convinced their main concern was to avoid a violation of HIPAA not to prevent their own clients from leaving. Riiight.

Chad
Tusk & Talon

Anything more than 48 hours is too long for my pu...

2006-03-24T13:32:00.000-05:00

Anything more than 48 hours is too long for my purposes.

Boy, you are impatient!

:-)

The folks who worked for Eastern Airlines also had...

2006-03-06T21:09:00.000-05:00

The folks who worked for Eastern Airlines also had promises. Same goes for a lot of other companies.

Things change.

Sure, free health care for life is a great deal if you can get it.

So is $230 a year.

That is $0.63 a day. I will lose that much in my couch . . .

I understand where you are coming from but I get w...

2006-03-06T16:42:00.000-05:00

I understand where you are coming from but I get where he is coming from also. Military folks were promised for years that they would have free medical care for life. No office visit co-pays, no hospital fees nothing. All of it was supposed to be free.
So there is your sense of entitlement; it was promised, they expected it to be delivered. Yes what they have is cheap and most folks would fall all over themselves scrambling to get it if it were offered but it is still less than the benefit that was promised.

Say you call up a store and ask if they have any widgets in. Normally a widget cost $50. The guy says, "Sure we've got them on sale. $10 apiece." You go down to the store and there's the widgets, but they aren't $10, they are $20. Still a deal but not the deal you were expecting. Wouldn't you feel deprived and somewhat cheated?