Brian Gruss Licensed Insurance Planner

Consider Short-Term Health Insurance While Looking for a New Job

If you find yourself in between jobs, you have already discovered that finding affordable health insurance is no easy task. While COBRA provides you the right to continue your previous employer’s coverage, the monthly premiums can be downright unaffordable.

Many people find short-term health insurance, also called temporary insurance, to be an affordable alternative to COBRA. This coverage helps bridge the gap between having an employer-sponsored plan and waiting for your next job.

Leaving a job often means leaving group medical coverage behind, a risky move if you don’t have other insurance options. Short-term insurance policies help remove the gamble, but they typically only protect against unforeseen sickness or injury.  Pre-existing conditions are usually excluded.

Premiums for short-term coverage are usually much cheaper than the premiums paid for COBRA. However, the costs can still seem high for a person who just lost their job. It may be tempting to forgo insurance altogether, but financial security is the main reason people buy short-term health insurance in the first place.

Without coverage, an unexpected trip to the hospital could send a person deep into debt. In fact, several published studies cite medical bills as a leading cause of bankruptcy. Short-term health insurance is designed to cover these catastrophic events.

Beyond financial protection, temporary insurance can also help prevent future insurance claims from being rejected under HIPAA, or Health Insurance Portability and Accountability Act, laws.  If an individual maintains creditable insurance coverage without more than a 63-day break in coverage, they are considered to have maintained continuous coverage, and exclusions for pre-existing conditions would not apply.  This applies even if the short-term policy excluded coverage for those same pre-existing conditions.  Approved short-term insurance policies are considered creditable coverage.

The terms of short-term medical plans usually run from 30 days to a maximum of one year, depending on state requirements. Some policies are designed to provide coverage for a specific number of days with premiums paid upfront, while other policies offer flexible monthly payment plans.

Since temporary insurance is only designed to last a few months, policyholders still need to plan for a long-term solution. If you find a new job and enroll in your new employer’s group insurance plan, make sure to find out when the new coverage starts. While it’s not a long-term solution, people in transition should consider temporary insurance as an interim solution to ease financial and healthcare concerns.

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Four Solutions to Medical Bill Problems

There’s just something a little scary about receiving a medical bill or a letter from your insurance company claiming you owe money. These tiny sheets of paper have the power to send many of us into full-on panic mode.

As soon as you receive a medical bill or explanation of benefits (EOB) from your insurance provider, do you immediately whip out your checkbook and mail in your payment? Are you terrified you’ll be turned over to a collection agency if you don’t pay the bill right away?

Not so fast! Before you cough up the cash for that medical bill or EOB, it’s important to do a little homework. Don’t simply assume that you have to pay the bill. First of all, it could be a mistake. Secondly, the doctor’s office or hospital will not send your bill to collections right away. And most importantly, if you pay the bill only to realize later that it was covered by your insurance, it can be extremely difficult to get a refund.

So, put away that checkbook and read on to learn the solutions to four common medical bill problems:

Common Problem #1:  You receive a bill for a covered service.

Let’s your medical provider sends you a bill for a service or procedure that your insurance has always covered in the past. Don’t assume your insurance provider has simply changed their coverage. More often than not, this just means that the insurance company hasn’t had a chance to pay the bill.

If you receive a bill for commonly covered service, let it sit for 30 days. This should give your insurance provider plenty of time to pay off the bill. However, if you receive another bill from the medical provider, give your insurance company a call to find out what’s going on. You should also call the medical provider to let them know that you’re working with the insurance company to make sure they pay.

Common Problem #2: You see the word “DENIED.”

You go to the doctor or dentist for a standard service that’s usually covered by your insurance company. However, a few weeks later, you receive a claim stamped with the menacing word, “DENIED” in bright red letters.

Don’t freak out because it’s probably just a mistake. The medical provider may have incorrectly coded the treatment. Call your insurance company and make sure the claim matches the actually service you received. If not, let them know what happened, and find out the proper code for your treatment. You may need to follow up with the medical provider, as well.

Common Problem #3: You have a jumbled pile of EOBs and bills and no idea what you owe.

If you have a whole mess of EOBs and medical bills, it can be difficult to figure out what goes with what and how much you need to pay. That’s why it’s important to keep all of your medical records as organized as possible. A little bit of organization could save you a whole lot of time, money and frustration down the road.

When you receive a bill from your medical provider, staple it to the coordinating EOB from your insurance company. Keep all of your bills in a folder so you can easily and quickly access them. If you call your insurance company or medical provider to discuss a particular claim, write notes on the EOB or bill to keep track of who you talked to and what you discussed.

Common Problem #4: Only a portion of your claim was paid.

Let’s say you received a standard medical treatment that’s typically covered in full by your insurer. But a few weeks later, you discover your insurance company covered only a portion of the claim. It could be a slip-up on the insurer’s end or the medical provider could have coded the treatment incorrectly. But more often than not, this happens when you go to an out-of-network provider.

If that’s the case, you’ll probably have to pay this claim. When you go to a provider that is not part of your insurer’s network, you often have to pay more out of pocket. However, if you receive this kind of bill and you’re certain you saw a network provider, give your insurance company a call. It could simply be a mistake.

Of course, this is just a handful of medical billing problems. Patients deal with these and countless other medical billing issues day in and day out. So, the next time you receive a bill or EOB in the mail, don’t panic. When in doubt, call your insurance company and/or the medical provider to discuss your concerns.

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If you reside in the State of California and would like to apply for Short Term Medical and do not want to apply online.  You can print out the application below and fax or mail it in.

california-short-term-medical-application

Tags: California Medical, Fax, Mail, Medical Application, State California, State Of California