Understanding how prescription drug coverage works in your health insurance plan can be a bit like solving a complex puzzle. Given the rising cost of medications, it’s crucial to comprehend this component of your healthcare coverage. This blog post aims to demystify the subject, giving you the knowledge you need to navigate prescription drug coverage […]
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In my new book that just came out, apparently different is a chapter titled Disability Does Not Define a Person. A gentleman calls me one day involving his client, Mr. Santini. Here was a situation where after serving in the military falling a hundred feet and waking up after the injury, he severely damaged his
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Health insurance can be a lifesaver in a medical emergency, but understanding the terms and conditions of your policy can feel like navigating a maze. Terms like “deductible,” “co-pay,” and “co-insurance” often pop up, creating confusion for many policyholders. In this blog post, we’ll demystify these common insurance terms so you can make informed decisions
Understanding “Deductible,” “Co-Pay,” and “Co-Insurance” Read More »
Choosing a primary care physician (PCP) is a critical decision that impacts your overall healthcare experience. However, there may be reasons you’d like to change your PCP, be it due to relocation, dissatisfaction, or a need for specialized care. The good news is that most insurance plans offer the flexibility to do so. In this
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At some point, many of us will face the frustrating situation of having an insurance claim denied or a medical service deemed “not covered” by our healthcare policy. These decisions can have a significant financial and emotional impact, leaving us wondering what to do next. The good news is that you have the right to
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I hope all is well with you today. Dental coverage is very limited. Most policies will never cover you for more than $3,500. It’s best to discuss the fees and get it in writing before procedure is performed. Many people come to me with bills over $35,000. Some dental providers are willing to reduce the
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As life changes, so do your healthcare needs. Whether you’ve just gotten married, welcomed a new baby, or have other family changes, you may find yourself wondering how to add a family member to your existing insurance policy. This blog post aims to guide you through the various options, timing, and procedures involved in expanding
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My friends, one of my clients went for surgery and they were never informed in advance that it was an out-of-network provider. The doctor was charging over a hundred thousand dollars and when I looked at the reasonable customary charges, I was able to get the bill reduced from a hundred thousand down to 11,000.
Reasonable and Customary Charges Reduce Bill from Over $100,000 to $11,000 Read More »
Good morning, everybody. I gotta tell you, I worked with a client who thought they had a PPO rather than HMO. You really need to understand your policy and realize what you are covered for and what you’re not covered for. Uh, the person was in a 24 hour psych facility and the fact that
Hopefully this will never happen to you, but your appendix burst and then you go to the emergency room, but your insurer is not paying your bill. They’re claiming it wasn’t medically necessary. Please call me and I’m sure that I can help you retrieve money for your claim. I had a client who needed
Emergency Room Expense Not Medically Necessary and Not Covered? Read More »