Healthcare Shopper Advice

Answers to Your Questions About Health Insurance

Health Insurance Coverage

Individual Health Insurance for wife

Question: I have recently changed jobs where the health insurance is very cheap for me but very expensive to add my wife. I'd like to get a private plan for her, but she takes several medications that could make it prohibitive. Is there some obvious option for this situation? She's otherwise healthy and I would consider high deductibles.

Answer: Unfortunately, there is no obvious option for your wife. If she cannot qualify for individual health insurance because of preexisting medical conditions (her prescription medications), your only option is to enroll her on your employers group health plan.

Posted by Phil Daigle on October 23, 2008 11:29 AM
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Court Ordered Medical Coverage

QUESTION: I am required by court order to provide insurance for my child. Do I have to go on my group's policy or can I just enroll my child?

ANSWER: It's possible that a court could specify that you use your employer group policy to cover your dependent child. However, that would be exceptional. We have many clients who cover their children on individual health insurance policies to satisfy a court order.

Posted by Phil Daigle on August 14, 2008 1:48 PM
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Coverage for Expensive Preventative Screenings

Question: I'm over 50 which means that I need a bone scan. My doctor says its not necessary but will give me an Rx if I really think I cant live without it. How do I know if its covered on my plan?

Answer: Without knowing what kind of plan you have it's difficult for me to say with certainty whether or not a bone scan would be covered. I can give you some general information about how they are normally covered, however. Typically it is applied to the plan deductible and, if you stay in-network, you will receive a discount on the cost of service. There might be a rare instance where a bone scan is conducted in the primary physician's office, in which case the costs may be applied to the preventive care co-pay if the plan has one. This depends on how the doctor codes the bill, however. I would recommend contacting your insurance company directly and speaking with the Claims Department.

Posted by Phil Daigle on June 14, 2007 9:15 AM
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Which Plan Should I buy?

Question: When I ran a quote on the website it wasn't clear about bills that the insurance company would pay and what bills I pay . What happened the last time I had insurance was I went for some blood work and I ended up paying for the whole thing! The plan I was looking at was the Unicare performance 2000 in Texas. I can afford it ok. but does it cover the things I need?

Answer: One of the most prevalent issues in health insurance is that the consumer has not received sufficient education about the plan they have purchased. The responsibility for this education lies very much with the broker who sells the policy in the first place. The consumer also needs to ask a number of different questions, similar to the one you are asking here, to make sure they understand their plan at the point of purchase. Also, as questions crop up once the policy is in place, ideally the consumer would be able to contact their broker with questions or for help with any issues they struggling with. My advice to you would be to speak to an educated broker who cares that you get a plan that both fits your budget and meets your needs.

Posted by Phil Daigle on June 14, 2007 9:09 AM
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Multiple State Family Coverage

Question: I live in Texas and my wife and children are currently in Oklahoma and will be there through the end of the year. I'd like to be covered when I visit them and vise versa. Is there such a thing as an insurance plan that will cover all of us?

Answer: There is no insurance company that I know of that is able to offer insurance to out-of-state residents. The reason for this is that health insurance is subject to state regulations. What this means for you is that you will need to buy two separate insurance plans for your family, one in Texas and one in Oklahoma. Once your family joins you in Texas you can apply to have them added to your plan.

Posted by Phil Daigle on June 13, 2007 3:18 PM
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