Since 2001, I have been a RN and Certified Case Manager within the insurance industry. I have found providers and patients, (or “members” in insurance speak), are often confused about numerous aspects of medical insurance. Matching your needs to the correct medical insurance policy is so important. Why, you may ask, should I care about any of the nuances of medical insurance? I am healthy and never sick, you say. Yep, we all think we are invincible until we experience some unexpected health issue like “Oops there goes the ladder.” What do you mean my MRI has been denied! I am going to tell you why this may occur, the process the insurance company uses to review the request for that MRI and the processes that are available to your provider if a denial is issued. And, “I stayed in the hospital five days and just got a letter from the insurance company two of those days were approved. What about the other three days!” I am going to cover that also. In network providers versus out of network providers is a big, big issue in terms of your money. Why? This is covered in this book. It would be nice to think you don’t need to be involved in all of this, but you do. I am hoping to give you the knowledge to make your life more stress free, save you money in the long run and pick the right medical insurance policy without making you feel you are eating a box of saltines with no water to drink-dry, unpalatable and boring. Hopefully you will think I have succeeded in giving you the information you need without putting you to sleep!
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