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You cannot be a patient and a watchdog at the same time. When you are sick, you cannot be expected to negotiate the best care and coverage under your health insurance plan. Being ill is often a humiliating experience. Being denied the care you feel you deserve adds to distress.
Pre-planning can save you and your family a lot of heartache. If you are contemplating
extensive medical care or are facing a serious illness, you may wish to arrange
for a trusted friend or family member to act on your behalf during the time
you will be incapacitated. You need to determine ahead of time the extent of
your health insurance benefits so that you know what care will and will not
be covered. You will need to know how your health care will be affected and
who will make the decisions regarding your treatment. Ask your health plan
the following questions:
- Will the procedure or surgery be covered? If so, what will the benefits be?
- Will there be any limits regarding the procedure or surgery?
- Is there preauthorization required? If so, do I have the responsibility or does it belong to my doctor?
- Will the benefits be reduced if I need to consult a specialist in an emergency situation?
- Your recovery should be your most important concern. You need peace of mind in order to direct your energy toward your health, rather than your health insurance coverage.
If you have concerns about your coverage or if you believe your health plan is denying you coverage that you are entitled to receive, the law office of Constance N. Zarkowski can help make a trying experience more tolerable by assisting you and your family in negotiating for the health care you are entitled to receive under your health plan
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