Out of Pocket (OOP) and OOP Maximum Out of pocket and out-of-pocket are terms (like copayment and co-payment) that are the same. You will see them both ways in the following text, so that you can get used to these formats. Your insurance policy will limit the dollar amount you have to pay in expenses […]
What to Expect in Final Days of Terminal Illness There are certain things that are expected in final days of terminal illness. It seems to be consistent, with some variability in the timing and sequence of end of terminal illness. To help you prepare, I’ll go over some of the more common issues related to: […]
Resources for Helping Others During Their Doctor Appointment These resources for helping are provided to make your job easier. The advice offered on the How to Prepare for Your Doctor Appointment pages may also give you a better idea of how to guide your friend or family member in getting into a mind-set for a […]
Whenever Possible, Take Someone With You Bringing someone with you is just as important as writing down your questions and answers! With such a limited amount of time, it is easy to feel rushed and forget the questions you had for your physician or misunderstand the answers he/she provides. This is definitely a case where […]
Who Should Buy Supplemental Insurance? In most cases, supplemental insurance is not needed. If you have a good, comprehensive insurance plan through your employer, union, or individual policy you should not have to purchase a supplemental medical policy. This is if your current policy includes all of the following: substantial life-time maximum good prescription benefit […]
Coordination of Benefits, or What Happens With Coinsurance If you have more than one medical policy, you may have heard the term “coordination of benefits” (COB). Insurance carriers have agreed among themselves how to determine which policy will be considered the main or primary policy when an individual is insured with more than one policy. […]
Terminal Agitation Terminal agitation or, as I like to call it, the heebie jebbies, seem to occur at the end-stage of the individual’s illness and can really catch you by surprise. Most people are unaware that this even exists. So what is it? Terminal agitation is a restlessness, and is also called “terminal restlessness”. It […]
The National Committee for Quality Assurance (NCQA) and Joint Commission on Accreditation of Healthcare Organizations (JCAHO) are two nonprofit review organizations you should be aware of, as they provide the lion share of accreditations within the healthcare industry and provide valuable information about PPO’s, HMO’s, hospitals and other healthcare providers. Within the United States, the […]
Hospital Checklist Form Having a checklist of things you need to do and things you need to bring with you for a vacation, or when planning a big event, can help ease the worries of leaving something behind. The same is true when you are preparing to go to the hospital. Having a hospital checklist […]
Experimental and investigational procedures are any medications, treatments or devices which are still part of an ongoing clinical trial. You may find yourself in a position where the standard treatment or therapy has been unable to help you. Either you or your physician may stumble upon something that is still in the investigational/experimental phase of […]
What are the factors that influence grief? What are some of the things that have happened in your life that change how you grieve? Perhaps you have a friend or family member with a terminal illness. You know that, too soon, the day will come when they will no longer be a part of your […]
Medicaid Description and Features Medicaid is jointly funded by the Federal and State governments to provide medical care to low-income United States citizens. The Federal government under Title XIX requires each State provide the following basic services under Medicaid: In- and out-patient services (which include skilled nursing facilities if you are 21 or older) Professional […]
The HMO denial process is slightly different from the PPO or FFS denial process. If your HMO has denied services or if you disagree with the payment of a claim by your HMO, you would submit your request to your medical insurance company to reconsider your request. Once your insurance carrier has received your request […]
Your Lifetime Max Benefits Each insurance policy has a lifetime maximum (lifetime max). This is the maximum (and cumulative) amount of money your policy will pay in benefits. Once that limit has been reached you are no longer eligible for any benefits under that policy. You will have to purchase another insurance policy. Typically, this […]
