• 24
  Sep
  2009

• Filing health insurance claims - Part 4

  
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In the past three posts, we went through some important concepts and terms. Although they apply to most health insurance policies, we have been concentrating on the ones for international students in USA. Let us look further and try to understand the claims process in some more detail.

Filing a health insurance claim, getting the benefit from the policy, using the coverage, etc. all mean the same thing. What it boils down to is: You pay the premiums for the policy when you are healthy, and the insurer will take care of the expenses when you are not.

Generally, filing a health insurance claim is very simple. The claims process starts the moment you call a doctor's clinic for an appointment. It involves reaching the clinic, showing your health insurance card, filling up an application form, seeing the doctor and paying the deductible (if any). The process ends when the doctor/hospital/health center receives the payment.

The journey of that form from the clinic's reception desk to the insurance company and how the payment is taken care of will be explained in later posts. This knowledge is not just of academic interest. It is important because it helps you tackle the most dreaded term in health insurance: "denied claim". Later we will see the various precautions that one needs to take to be able to avoid getting a denied claim letter from the insurer.

• 23
  Sep
  2009

• Filing health insurance claims - Part 3

  
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In a couple of previous posts we tried to give you a better understanding of some oft used terms in connection with health insurance for international students in the USA. We continue with some more terms which are used a lot, but are sometimes not very clear to many people.

Making sense of the jargon - (contd...)

1. Deductible: This is the dollar amount you pay out of your pockets. Any expense over and above the deductible will be paid by the insurer. There are, of course, zero deductible plans too. A simple rule of thumb is: given the same features and benefits in two plans, higher the deductible, lower is your premium.


2. Pre-existing conditions: These are health problems, sicknesses, etc. that the insured suffers from or has been diagnosed for or has received treatment for before buying the insurance. Since an insurance policy is bought for coverage of events that occur after buying the policy, usually pre-existing conditions are not covered. Again, there are plans that do cover PECs after a pre-decided waiting period, albeit at a higher premium.

In further articles we look at a few pre-requisites that you need to be aware of before filing a health insurance claim.

• 22
  Sep
  2009

• Filing health insurance claims - Part 2

  
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International students who are not used to the American health insurance terminologies might find it difficult to succinctly understand some words that are used in a very matter-of-fact way on websites and by health insurance agents. Following up on a previous post, we continue our journey in understanding the claims process for health insurance, by concentrating on some terms.

Making sense of the jargon -

1. Health Insurance Claim: Simply speaking, a claim is a bill that your doctor or emergency room or some other health care facility sends to your health insurance company on your behalf. A claim is usually handled by the health care provider after you fill up a detailed form giving your insurance information.
2. Co-pay: Depending on the the kind of policy you have taken, there are two scenarios possible. Either the entire bill is sent to the insurance company, or a part of the bill (say 75%) is billed to the insurance provider and you pay the rest. The clause that deals with part payment out of your pocket is called a co-pay clause. In case your policy has a co-pay or co-insurance clause, you have to pay the percentage or dollar amount that you have agreed upon, and the rest is settled by the insurer.

In further articles, we try to clarify some more jargon; after which we move on to the actual claims process.

• 21
  Sep
  2009

• Filing health insurance claims - Part 1

  
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Having health insurance coverage is a vital part of living and studying in the USA. We all realize how costly health care can be in USA, and it makes all the more sense for an international student to stay covered. Tuitions and other living expenses are high enough, and no one needs the additional financial burden of medical bills on oneself when a health insurance policy can take care of it.

After having taken the decision of buying health insurance, one needs to be also aware of how exactly to file a claim when the need arises. It is best to know your policy well before-hand so that if you would ever need to use it in an emergency, you already know the process of filing a claim.

You need to have a clear understanding of certain things. We will try to make them simpler by explaining the most important steps and terms involved in a concise way. Over a series of articles divided into various parts, let us look at the claim process.

Part 2 deals with some terms that you need to know for a clearer understanding of the process. Read on to know more.