Attorneys

Health Insurance FAQs

• Q: What Is A Pre-Existing Condition?
  A: A pre­existing condition is an illness or other health problem that was diagnosed or treated before the policy was issued to you. Many policies will not pay … More
• Q: What Is A Preferred Provider Organization (Ppo)?
  A: A PPO is an arrangement where an insurance company or other carrier contracts with a group of health care providers who furnish services at lower than usual fees in … More
• Q: What Is A Premium?
  A: A premium is the periodic dollar amount required to keep a policy in force. Premiums are usually paid on a monthly or yearly basis.
• Q: What Is A Reasonable And Customary Charge?
  A: This is a charge for health care that is consistent with the ongoing rate or charge in a certain geographical area for identical or similar services.
• Q: What Is Supplemental Insurance?
  A: Supplemental insurance is a policy that provides benefits in addition to those payable under basic and major medical policies. Some examples are Medicare supplement … More
• Q: What Is A Waiting Or Elimination Period?
  A: This refers to the length of time that you must wait before benefits under your policy begin.
• Q: What Is A Major Medical Policy?
  A: Major medical plans provide the most comprehensive coverage for medical services either in or out of the hospital. Major medical plans require you to pay a deductible … More
• Q: What Is A Co-Payment?
  A: A co­payment is the percentage payment that you must pay for each claim. In other words, you must share in the payment of the covered expenses up to a certain … More
• Q: Can My Employer Make Me Wait Before Enrolling Me In The Company's Health Plan? When Is My Employer Allowed To Take Me Off Of The Plan?
  A: Insurance begins when you meet the eligibility requirements of the health insurance plan. An employer­sponsored plan is allowed to have a waiting period, which is … More
• Q: My Employer Says He Doesn't Have To Comply With State Laws Because His Plan Is Self-Funded. Is My Employer Correct?
  A: Yes, if your employer self­funds the plan and merely contracts with an insurance company to provide administration services only, then according to the Federal … More
• Q: I Want To Change Jobs. Can The New Employer's Plan Deny Me Coverage Because Of A Health Condition?
  A: No. Employees or dependents cannot be denied group health insurance based on their prior medical history. You cannot lose your insurance just because you get sick, or … More

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