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Medical Insurance Coverage

Information and Resources specific to particular kinds of medical insurances

Summer Break & College Students

For those of us who work in the Emergency Rooms in hospitals we have all experience the same thing. Kids in college and those who go on spring break in our area for some reason don’t know anything about their parents or the insurance that they are covered under. I mean you go off to college and are still covered under your parent’s insurance until you graduate. Great for you as you don’t have to pay for it. Young kids going on a school trip have a form that is filled out for them with their parents information and the insurance stuff. Please, please, please before you go off to college get the same information and keep it in your wallets! Most of you are over 18 and are supposed to be adults and should know the basics. For instance, you should know your parents full name, date of birth and where they work. If your parents don’t want to give you an insurance card then just make a copy of it front and back and write your parents information on the copy. That way when you have to be seen in an emergency room or urgent care center you can give them the copy, sign your forms and your bills will be paid. MAKE sure you get your copy back or better yet make several copies. (Keep those copies safe!…you don’t want your parents information floating around the commons.) You can download a copy by clicking here sample form .

Well, that was my rant for today. Be safe and come back again.

Pregnancy & Insurance Coverages

Today most women can get insurance coverage for themselves if they are pregnant. It didn’t use to always be like that. Around 1997 or 1998 the beginnings of the HIPAA began. It was originally, the Health Insurance Portability & Accountability Act. The insurance companies were denying coverage to women who became pregnant before their waiting period was up if they were in a new job or were getting insurance for the first time. And was not allowing the newborns to be added. The Act was to help ensure that insurance could not deny coverage for certain diagnosis if the patient had continuous coverage. That is why your patients must get insurance within a certain time period after canceling one or changing jobs. The patients are issued a “statement of continuous coverage” from the old insurance to present to the new one. Those are just a few of the components to the Act but it was the beginning of changes for state sponsored insurance as well. For instance, in the state of Florida if you don’t have insurance and become pregnant you will more than likely qualify for insurance through Medicaid. The process is fairly easy to start you just have to go online and apply.  The hard part will be to find an OB doctor that accepts Medicaid and is accepting new patients. But they are out there.

Generally, Medicaid will cover the newborn for at least 12 months or in some cases longer if the parent is unable to find affordable coverage. The reasoning behind it is the government wants to promote prenatal care for the mother and unborn babies as soon as possible thus increasing the odds that the baby will be born healthy and not need as much medical care in the future. That is why the baby is usually covered for a couple of years to make sure he or she receives all their immunizations shots, get regular visits to a pediatrician without cost or a small copay, to the parent who may not be able to afford it otherwise.

The principal is sound and the paperwork is not too bad. I have always encouraged our patients to seek help through whatever sources they are qualified for. It’s good for them because they are being taken care of medically and it’s good for our medical facility because we have a little bit less bad debt and a little bit more revenue than we would have otherwise.

TO OUR PREGNANT PATIENTS:

I have two other points to make before I close for today. First, for those of you who are covered under their parents insurance and pregnant. Don’t get married unless your “soon to be husband” has insurance and is able to add you right away with no pre-existing clauses. Your insurance through your parents ends the day after you get married! Second, if your are covered by your parents and not getting married before the baby is born then PLEASE, PLEASE, PLEASE, get Medicaid or some kind of insurance for your newborn before it gets here. The coverage may not start until the day he/she is born but get the process started right because MOST all insurance will not cover a grandchild.

 

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