Health insurance can be such a difficult product to deal with. Not only is the product difficult - the companies that offer health insurance can be just as difficult.
Think about it - here’s a ficticious example (though it may sound familiar to you): you are paying a health insurance business to cover the costs of managing your health, then along comes an ailment, and the insurance company does not always want to pay any or some of the cost to treat that ailment.
What are some of the arguments they might use to avoid responsibility? Who knows what is a valid argument these days, but its quite possible the arguments will include difficult to understand terminology for the average layperson. Here’s a few cryptic health insurance terms that I’ve deciphered over the years - information that will be useful to know.
Prior Authorization
This term refers to whether or not health insurance covered an expense in the past. For prescriptions - a doctor needs to provide “prior authorization” to the insurance provider.
Certificate or Creditable Coverage
This term refers to proof of coverage obtained prior to the current health insurance policy. It is probably related to pre-existing conditions. Some health insurance plans require a waiting period for covering new conditions, and even pre-existing conditions - if they haven’t been covered by any insurance company yet.
One factor regarding health insurance that many may find surprising is how complex it is, as well as how much paperwork is involved. In fact, I’ve heard someone state the following:
- Their insurance coverage involves a $3000 deductible (meaning they would have to incur and pay $3000 on their own before the insurance coverage kicks in).
- They would rather just pay the $3000 per year, instead of having to fill out all the paperwork and claim.
That sounds reasonable to me, but apparently not to the insurance provider! Seriously, why not? Is the new health insurance system mandated by the US Federal Government designed to bury its citizens in paperwork?
Over the years, I’ve had health insurance from the following providers:
- Care First
- United
- Tricare
- Humana Military
Tricare was by far the best. What do you think of your health care company?
