Health insurance is extremely important but also very complex. It is essential that you understand your health insurance coverage because it directly impacts your well-being—you need good coverage to receive quality care and manage your primary immunodeficiency (PI).
Without insurance, medical bills can wreak havoc on your finances. Your health insurance can give you peace of mind in knowing you are protected from most of these costs. Unfortunately making sense of your health insurance coverage can be frustrating. With some preparation and valuable information, you can be your own best advocate when it comes to health insurance.
Ways to Get Insurance
Most people get health insurance through their employers, but there are other ways to obtain health insurance:
Choosing and Managing a Plan
When deciding on a health insurance policy, you really need to do the research to make a wise decision. And once you have a plan, you need to keep on top of the details to ensure that you are getting all your benefits. If you do not take the time and evaluate all areas of coverage when choosing a plan, than there could be negative consequences to your choice.
If your problem becomes more complicated, there are other courses of action. You, and/or your clinician, may appeal to the medical director of the insurance company and may need to work with the provider to submit additional justification of your claim. Often, in the case of PI diseases, insurers need to be educated as to what the condition is and what the approved forms of treatment are. Most of the manufacturers of Ig offer reimbursement support services for their products and can be an excellent source of information.
There may come a time when an insurance company terminates your policy. If it does so for any other reason than bankruptcy, they are required by state and federal law to find you new coverage. Enforcing this law is up to the State Insurance Commissioner. You should contact them, especially if you feel your cancellation is due to a pre-existing condition. Arbitrary cancellation is illegal.
For more detailed information about health insurance, including a glossary of terms, visit the IDF Patient Insurance Center.
You can also visit the young adults section at healthcare.gov: http://www.healthcare.gov/law/information-for-you/young-adults.html