Experts recommend that you never tell your health insurance plan that you are receiving an “investigational” or “experimental treatment; or if you are enrolled in a clinical trial. These phrases are codewords that make insurers more likely to look closer and reject your claims. First off, health insurance plans will cover treatment your physician considers medically necessary. When it comes to insurance, you obviously shouldn’t lie (that could lead to cancellation of your policy, leaving you uninsured); but you also shouldn’t give more information than is specifically asked for.

You may even be wrong about the experimental status of the procedure. Some procedures aren’t typically used, but are proven medically effective nonetheless. In that case, health insurance plans should cover it. Check with your doctor, even if he or she used wording such as wanting to “experiment with a treatment”. Don’t let semantics cost you!

Unfortunately, some people doesn’t find out what their health insurance plan does and doesn’t cover until it’s too late.  Avoid the underinsurance trap by reviewing your plan and talking with an insurance agent. The best solution is to find a plan that suits your needs and provides the most value. It’s important to save money on insurance, but don’t forget your health. If you are currently underinsured, you can get an affordable health insurance quote for a better plan.

(Image: Commonwealth Fund)

How do you know if you’re a victim of rationing, as opposed to a recipient of high-quality, sensible health care? In Newsweek magazine, medical school professor Christopher Moore acknowledged this dilemma. Sometimes, excess treatment can hurt the patient more than it helps. Take CT scans, for example. Admittedly, they are costly, with prices continuing to rise (and also being passed onto your family health insurance bill); but CT scanners are amazing medical technology that can identify if a head injury is life-threatening. However, studies have shown that the probability of that being the case are relatively tiny. Meanwhile, there is up to a 1-in-1,000 chance of each CT scan causing eventual death from cancer (due to the radiation involved), even more so for younger patients. The medical risks of doing a CT scan on a teenager with a concussion could outweigh the benefits, even after removing cost from the equation. Keeping a close watch on the patient might be a better bet.

So if your doctor refuses to perform an expensive test or other procedure, it’s very likely that he or she has a legitimate medical reason for it. If you get more affordable health insurance because of the reduced cost, so much the better, but that’s not the #1 priority.  Occasionally, a physician who performs the procedure might be doing it solely to avoid a malpractice lawsuit. The prospect of a government-run public option won’t stop that. Moore insists that a doctor who genuinely believes an expensive procedure is sorely needed won’t let cost concerns stop him or her from ordering it. Let’s hope so.

(Image: Akira Oghaki under CC 2.0)

Their health insurance plans were sold under the name OptiMed Health Plans, a subsidiary of United Group Programs (not to be confused with United HealthCare). The states of Montana and Washington have accused OptiMed of selling fraudulent, unauthorized policies from 2003 to 2007. People duped into buying discount health insurance from them ended up saddled with thousands of dollars in medical costs, since OptiMed failed pay its customers’ claims. It’s another example of why you should be careful when looking for health insurance. Speak with an agent to find reliable, affordable health insurance.

Q: How much is this going to cost?

A: It’s projected to cost a whopping $894 billion over ten years.

Q: How is the government planning to pay for reform?

A: It will raise income taxes on couples making over $1 million and individuals making over $500,000 yearly. In addition, Medicare spending will be cut by an unknown amount.  Liberal representatives also floated the idea of having the government dictate the rates paid to health care providers by the public option, but moderates managed to strip out that provision. (The government, as well as private insurers, will instead negotiate payment rates with hospitals and doctors.)

Q: Is a public option included?

A: Yes. Unlike the Senate version, the House’s bill doesn’t allow states to opt out of it. So far, it doesn’t include a so-called “trigger” either.

Q: Will illegal immigrants be covered by the public option?

A: As of now, it’s unclear. That’s one of the main sticking points preventing the House bill from reaching a vote. However, remember that illegal immigrants are already receiving a form of public healthcare: hospital emergency rooms are required to serve everyone who comes in.

Q: What about abortion? Will it be covered?

A: That’s another controversial topic that will see much debate before the bill hits the House floor. A handful of pro-life Democrats will probably try to have abortion coverage removed from the public option in order for it to receive their votes. Meanwhile, some pro-choice representatives oppose a bill that doesn’t include abortion services. Either way, the Democrats have a solid majority in the House and can afford to lose some votes in either direction.

Q: What if I have a pre-existing condition and can’t get insurance?

A: These reforms are supposed to change that. Health insurers will no longer be allowed to deny coverage to people with pre-existing conditions. They won’t be able to charge those with pre-existing conditions significantly more, either.

Q: When will healthcare reform take effect?

A: It’s hard to believe, but the bill won’t fully kick in until 2013. By then, a mandate will require everyone who can afford it to buy health insurance. They can be insured via the newly created exchange (consisting of private insurers, in addition to the public option), by their employer, or an existing government program such as Medicare or Medicaid.

Q: But I need health insurance now! What can I do in the meantime?

A: The government is putting together a temporary program to insure individuals and families that have been rejected by private insurers. Otherwise, do you really want to wait for the government’s health insurance plan? Keep in mind that the House bill needs to be reconciled with the Senate bill before there’s a final vote, and that could take months.

(Image: U.S. House of Representatives Portrait)

Why the delay? The Senate and the House of Representatives have to debate exactly what form the public option will take, and moderates hold its fate in their hands. They need to compromise between comprehensive health coverage and cost. Gaining Republican votes is a lost cause at this point, so party leaders will be forced to exert their power. For example, Reid may try to convince a swing vote with a seat on a prestigious Senate committee–that a Senator will only get if he or she votes with him on healthcare reform. The more liberal House has a more comprehensive public option proposal included in its bill, and it must be combined with the bill in the generally more conservative Senate prior. Afterward, it’ll see even further amendments by the rest of Congress before a final vote. There is also the possibility, albeit less likely, that some liberal politicians will vote against the bill because it doesn’t do enough to reform our health insurance system. However, centrist politicians receive more attention from leaders because they are the wild card. Can you wait for Washington to decide, or would you prefer to be safe and get health insurance quotes from multiple insurers now? If, years from now, you like what the public option shaped up to be better than your existing health insurance plan, you’ll be able to switch–but if you’re caught uninsured before then, you’ll wish you hadn’t waited.

Many people forget that psychiatrists are also medical doctors that treat a variety of conditions and put themselves in harm’s way each day. While it appears that this particular patient was too far gone, millions of individuals with mental health disorders have seen significant improvements with the help of psychiatric treatment. People who need treatment are more likely to get it if they have health insurance with mental health coverage. There are insurance plans that cover most or all of the cost of psychiatric and therapy visits, as well as medications.

Please don’t wait to get help until it’s too late. If you or someone you love is struggling with paying for treatment of their mental illness, get a health insurance quote instead of giving up. I wish you the best of luck.

(Image: Pink Sherbet Photography under CC 2.0)

Keeping your doctors consistently informed is vital, the more they know the easier it is to help you. Often doctors can cause harm because of misinformation, chopping off the wrong limb during a surgery. Don’t risk it! Start creating a data mine of your own, on yourself. Share it with family and doctors to keep you as healthy as possible. There are so many pharmaceuticals nowadays its almost impossible ot keep track of them all and which ones conflict.

As a side note: wouldn’t it be interesting if Google Health had a Datastore of all pharmaceuticals and their side effects, so that if you are taking two that can cause you harm it would put up a red flag? Perhaps I will suggest this myself.

This is not the best time to ask wether or not what is being done to you is covered by your insurance…

However, after the fact if your health insurance company tries to stick you with out of network fees for emergency services, argue till your head turns blue. You have no choice as to who picks you up and you MUST be treated in an emergency situation…but dont for a second believe that you MUST accept every charge the hospital gives you. Research it, look into it…but when you are healthy again.

Unfortunately, this type of argument is only usually done when someone has a third party such as a family member helping to mediate for you. Being sick or in an emergency often drains you, so look for support from friends and family if possible.