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Transplants and Insurance

May 14th, 2010

Image taken from Wallae.com

Image taken from Wallae.com

Most people are not very concerned when it comes to considering a transplant, because the percentage of the population who do receive them is small in comparison. The health insurance industry on the other hand is very aware of what is going on and why. They are also very concerned over the rising costs and the procedure of the waiting lists.

Individuals who have insurance through their employer in general never get to see what is written on the annual health insurance policy. Unfortunately, the only method the individual has in finding out if they are covered for a specific procedure or transplant surgery is after they receive a statement from the medical physicians involved and ultimately when they receive a copy of their hospital bill.

The health insurance they are covered through may or may not send them a duplicate copy of what they are receiving and will break down each independent health insurance expense by medical physician and by lab expenses. This is not the way you want to be assured if you are covered for a surgical procedure. However, health care through a health insurance policy held by the employer is well guarded and especially secretive.

This seems to be a bit one sided considering the employee is also paying a sizeable sum through a payroll deduction with every paycheck. However, for other individuals who are able to receive a copy of their annual affordable health insurance policy there is few things to consider and look for.

1.    Check with the human resources department if this is possible and for those who actually have a copy of their health insurance policy make the time to try to read it and then understand.

2.    If at no avail, try setting up an appointment with your medical physician and surgeon and try to ascertain the answers you are concerned.

3.    Be advised through your health insurance advisor of those necessary services that are no longer included in your health care policy.

There are also a list of items and medical procedures that are not covered in your health insurance policy that may or may not be clear enough. Sometimes, in fact, many times the health insurance annual policies are written so technical that you really need to ask an attorney to read it and then explain it. Services that are no longer covered in your health insurance policy are:

1.    Testing for a qualified donor, initial cost, and initial diagnosis

2.    Necessary travel expenses, post transplant discharge prescription medication

3.    Medical physician office visit coverage, home health coverage

4.    Psychiatric health care coverage, harvest and storage fees for storage

Most important information to retrieve when it comes to the necessary health insurance expenses is to receive this information in writing as often as possible.

"Vista Health Solutions" www.nyhealthinsurer.com Tel (888)215-4045 Email [email protected]