Is there a specific reason why the bills aren't covered?
If you have insurance, the company has to tell you why a specific service or bill isn't covered. With a lot of insurers, you can only use doctors within their specific network, so it pays to check beforehand. Many companies have websites which list participating providers. If you need to see a particular specialist who isn't in your network, try contacting your insurance company for permission to go out of network. I have done this several times because there are few specialists in my area.
If you have a very serious or chronic condition, many insurance companies have case managers they will assign to work directly with you to coordinate your medical care. This can be good because you can deal with one person, who may be willing to work the system on your behalf. If a bill was denied that you think should have been paid, appeal! Don't be afraid to ask your doctor's billing office for help - they have a vested interest in getting your insurance to pay up.
As for hospital bills, most hospitals have financial assistance programs you may qualify for , so be sure to ask. Most hospital social workers are very knowledgeable about what kind of help might be available. If you are having problems getting your meds, check out the Parternership for Prescription Assistance website - you may be able to get meds free or much cheaper. I know how stressful the medicals bills can be - my last hospitalization was almost four months long, with 2 weeks in ICU. i stopped worrying about the totals a long time ago, if I ever sat down and totalled up all my bills from the past six years, I'd probably have a heart attack. Do the best you can, and try to find as much help as possible.
JESSICA, IF YOU DO NOT HAVE DRUG COVERAGE, CHECK OUT THE PPA
COPIED FROM THEIR WEBSITE - PPARx.org - or call 1-888-4PPA-NOW - YOU MIGHT BE ABLE TO GET AT LEAST SOME OF YOUR MEDS FREE. THIS IS A LEGIT ORGANIZATION AND DEFINITELY WORTH CHECKING IN TO.
The Partnership for Prescription Assistance brings together America's pharmaceutical companies, doctors, other health care providers, patient advocacy organizations and community groups to help qualifying patients who lack prescription coverage get the medicines they need through the public or private program that's right for them. Many will get them free or nearly free. Among the organizations collaborating on this program are the American Academy of Family Physicians, the American Autoimmune Related Diseases Association, the Lupus Foundation of America, the NAACP, the National Alliance for Hispanic Health and the National Medical Association. To access the Partnership for Prescription Assistance by phone, you can call toll-free, 1-888-4PPA-NOW (1-888-477-2669).
Jessica, the programs are for people with no drug coverage
There my be some specific programs that have an age requirement, but I get several of my meds and started at age 38. So it's worth making the call to see if you're eligible.
Buddhabelly - about insurance
If your insurance is through your job, the benefits manager at your employer should have a members' handbook or manual that lists all covered services. If you buy your insurance directly, call the company and ask for a list of covered services and any exclusions (things your insurance won't cover). Most insurance companies will cover laboratory tests like blood tests if they are ordered by a doctor who's in your network. If the doctor is out of network, many companies won't pay for tests ordered by that doctor. Your insurance company may also want you to use a specific lab for tests.
If you have to use a specialist who is out of network, get your network doc to order the tests and send copies to the other docs. That way the insurance should pay. If you use a specialist who is in network, you should only have to pay the co-pay amount. Be aware the specialist co-pay is usually higher. Also, many insurers have strict policies about seeing specialists. You may need a referral from your PCP, and there may be a limit on how often you can see a particular specialist. Just be sure you know your particular insurer's rules.
If the kind of specialist you need isn't available in your network, the insurer will generally let you go to the nearest available specialist regardless of network, but you do have to get permission from the insurance company in advance.
Remember you always have the right to appeal any decision by the insurance company about your coverage. Most insurance companies have a person called an ombudsman whose job is to resolve complaints. If a number of your claims have been denied and you don't know why, this is the person to contact. If you think you have been treated illegally or unfairly, contact your state insurance commission for help. All states have statutes and regulations about how insurance companies do business - and those laws are to protect you.
I guess the main thing is don't be afraid to ask questions and demand answers. If you have been hospitalized, or had a number of tests done, always ask for an itemized bill and review it to make sure you weren't charged for things you never got. On my last hospital bill, I was charged over $1,000 for I.V. gentamycin, which I know wasn't mine because I'm extremely allergic to it, and it's on
my medical records, so the hospital had to delete the charge. Stuff like that happens all the time, so you have to be careful to check your bills.
Hope this helped - sorry it was so long!