Quantcast

Subscribe to:
POZ magazine
E-newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr MySpace
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
July 29, 2014, 06:27:32 AM

Login with username, password and session length


Members
  • Total Members: 23066
  • Latest: MikeDH
Stats
  • Total Posts: 632188
  • Total Topics: 47870
  • Online Today: 227
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online
Users: 4
Guests: 168
Total: 172

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: Question on Letter from Health Insurance  (Read 12839 times)

0 Members and 2 Guests are viewing this topic.

Offline tommyga

  • Member
  • Posts: 12
Question on Letter from Health Insurance
« on: December 17, 2009, 12:09:21 PM »
I got a letter from United Healthcare today, and it said:

"Dear Member or Provider,

We received your request for appeal in the United Healthcare Central Escalation unit.

We want to make adecisions about out customers' request based on complete information. If you, a reporesentative or a physician has information that might help us in our review, please fax it to blah blah blah blah."

Any thoughts on this? I'm guessing my health insurance is about to discover my diagnosis? Should I expect and increase in what I pay for health insurance?

We just had an open enrollment at work, and it didn't ask me any questions about a recent diagnosis, or anything like that. I didn't change my coverage at all.

Sorry for all the questions, I hadn't had much reason to be an expert on health insurance until now. I guess it is possible that it only covers a certain portion of my lab work expenses per year?

Thanks,
~Insurance Idiot

Offline tommyga

  • Member
  • Posts: 12
Re: Question on Letter from Health Insurance
« Reply #1 on: December 17, 2009, 12:10:07 PM »
Oh, and I didn't exactly pick up the phone to inform my insurance either of my diagnosis. Obviously there is a lot of other stuff going on.

Is that an issue?

Offline madbrain

  • Member
  • Posts: 1,208
  • No longer an active member
    • My personal site
Re: Question on Letter from Health Insurance
« Reply #2 on: December 17, 2009, 12:21:19 PM »
I got a letter from United Healthcare today, and it said:

"Dear Member or Provider,

We received your request for appeal in the United Healthcare Central Escalation unit.

We want to make adecisions about out customers' request based on complete information. If you, a reporesentative or a physician has information that might help us in our review, please fax it to blah blah blah blah."

Any thoughts on this? I'm guessing my health insurance is about to discover my diagnosis? Should I expect and increase in what I pay for health insurance?

We just had an open enrollment at work, and it didn't ask me any questions about a recent diagnosis, or anything like that. I didn't change my coverage at all.

Sorry for all the questions, I hadn't had much reason to be an expert on health insurance until now. I guess it is possible that it only covers a certain portion of my lab work expenses per year?

Thanks,
~Insurance Idiot

It sounds like you are covered through your work health insurance.
How long were you covered by work health insurance prior to your diagnosis ? If it is at least 12 months, you will probably be fine, because the insurance company isn't allowed to deny you coverage for any pre-existing medical condition if you had insurance for at least 12 months.
In order to deny you any coverage now, the insurance company would have to prove that you had HIV before they first covered you, and that you sought treatment for it. They may try to do that, but they can't succeed since you didn't know about your HIV yourself.
Since you are covered by group insurance, any premium increase related to your condition would be passed on to your employer and spread among all the employees of the company. Depending on the size of the company, yes, there may be a premium increase the next year, more likely if it's a small company than a large one.

Offline tommyga

  • Member
  • Posts: 12
Re: Question on Letter from Health Insurance
« Reply #3 on: December 17, 2009, 01:43:02 PM »
Yessir, I am covered through work. I've been working at the same place for the last 5 years. It's a big company, so maybe ther won't be an increase. I hope not!

Thanks for the reply madbrain! You da man.

Offline hotpuppy

  • Member
  • Posts: 555
Re: Question on Letter from Health Insurance
« Reply #4 on: December 27, 2009, 10:40:38 PM »
Very unlikely you will see a premium increase......

in a small company the company would get socked with a premium increase.... which is why most small companies don't offer insurance.

They might be about to challenge you on the pre-existing side... but if you have creditable coverage they are sunk.  Best thing to do is let your HR benefits person fight with the insurance company. 
Don't obsess over the wrong things.  Life isn't about your numbers, it isn't about this forum, it isn't about someone's opinion.  It's about getting out there and enjoying it.   I am a person with HIV - not the other way around.

Offline azprince

  • Member
  • Posts: 153
Re: Question on Letter from Health Insurance
« Reply #5 on: January 02, 2010, 04:19:54 PM »
Since you guys are discussing insuarnce, I iwant to ask you to advice on my situation !
I have insurance through work , it covered me for the last 2 years but it will end oon since I am going to school again, at school they offer me Aetna, but i noticed that it says in the benefits explanation for the pharmacy limits  :
7500 per member for plan year 09/10 through 09/09.
So it means that I will only be able to buy Atripla twice :-\
In this case what should I do? do you think they can increase the limit for me ? is there anyway that I am understanding the pharmacy limit in the wrong way...after all it doesnt make any sense that we must be covered in school because its a full time program then they put a limit ...
I would appreciate any clarification and guidance
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.