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[H168]Health Insurance For Disabled

by Jordan Feross, Jor

Sometimes residents of Texas who have physical or mental challenges find it difficult to find health insurance. And sometimes even those that do get health insurance in Texas aren't getting the coverage they really need. Some of the problems that disabled people face include outrageous insurance premiums, unreasonable policy cancellations, claims are unjustly or improperly denied. It may often be more difficult for the people who are already dealing with challenges to take this unfair treatment on top of everything else they are dealing with.

Everyone is entitled to the same rights under the law when it comes to health insurance in Texas. In fact, if anything, disabled people are and should be entitled to extra protection under the law. These people have the right to take legal action against any insurance carrier that has not treated them appropriately. Disabled people have every right to the same health benefits as everyone and in some cases even more so.

To be considered "disabled" under the law does not necessarily mean having zero functioning, for example a "legally blind" person may still have some sight, or a physically disabled person may be able to walk with the use of a walker. Being disabled generally means having an impaired ability to see, hear, walk or reason, as a few examples. Sadly, it is far too common for people who already face additional challenges in life because of their disability to also have to deal with discrimination, but when it comes to health insurance in Texas, a disabled person doesn't have to take it.

Sometimes a person with a disability will be labeled by the insurance company as having a "pre-existing medical condition" and may have to pay a higher premium for health insurance in Texas. Some people, however, feel that this is unjust and some have been successful in fighting this in court. Other insurance companies put limitations on what they will and will not cover for the disabled person and they may need to fight for their rights.

Some disabilities don't seem to pose any kind of problem when it comes to getting health insurance in Texas. Vision or hearing loss issues don't always raise the same red flags with the insurance companies that certain other disabilities do.

When it comes to health insurance in Texas, state laws prohibit an insurance company from denying service or claims for a person just because they are disabled. In some cases, the insurance company has proven that covering specific disabilities causes too much loss for them and many disabled people are automatically eligible for Medicaid just based on the type of disability they have. A person who is disabled has the right to receive a written explanation of why they were denied health insurance with a particular insurance company.

The Americans with Disabilities Act was put into place in order to keep disabled people from being discriminated against for things like employment and insurance coverage. Although things have improved in the last ten years, there is still much to be done. Until society comes around and completely eliminates discrimination of all kinds, disabled people will have to continue to fight for their rights, including their right to fair health insurance in Texas.

Health insurance can be defined as a policy that will pay a fixed amount of money for medical expenses and treatments. Health insurance is basically a way to ensure protection against any sickness or injury. Health insurance includes various types of insurance such as accident insurance, disability income insurance, medical expense insurance, and accidental death and dismemberment insurance.

Health insurance is your best friend in the hours of need. It is a great support to your family when hefty medical bills fall over their heads and there is immense expenditure on recovery of the person concerned.

Based on the needs and requirements of people there are different kinds of health insurance policies available-

•Fee-for-Service Plans- is that where the insurance companies pay fees for the services offered to the insured people. The insurer only pays for part of your doctor and hospital bills and pays monthly fee called premium. Before the insurance payments begin, a specified amount of money in the form of deductibles is to be paid. After paying the deductible for the year you share the bill with the insurance company and then your part is known as ‘coinsurance’. Fee-for-service comes in two ways- Basic protection and Major medical.

•Health Maintenance Organizations- these organizations are prepaid health plans. HMO members pay a monthly premium in return of which the HMOs provide complete care to you and your family. This also includes the visits of doctors, hospital stays, emergency care, surgery, lab tests, x-rays and other therapies.

•POS plan- many HMOs offer an indemnity-type of option known as a POS plan. Those who opt for POS plan can refer to doctors and medical assistance outside the plan and still get some coverage. If a doctor makes a referral out of the network, the plan pays all or most of the bill.

•PPO- Preferred Provider Organization- is basically a combination of fee-for-service and an HMO. As in HMO plan, in PPO too the options are confined to a set of doctors and hospitals. Medical expenses are covered by the PPO only when the insured person resorts to the preferred or network providers.

•EPO- Exclusive Provider Organization- is akin to HMO except that it is regulated by the California Department of Insurance and generally pays physicians and other health care providers differently. EPOs will meet your expenditure only if the physician you opt for is within EPO’s network. However exigency situations can be considered as exceptions.

Prior to opting for a plan it is better to ponder over your needs and family requirements. You may even want to use the checklist of the agency through which you are purchasing the policy and ask for more information from the health benefits manager at your workplace or a health plan representative. You can also seek advice from your physician who is already familiar with all health plans and your medical history.

Article Source : General Accident Insurance

About Author

Both Jordan Feross & Mansi Gupta are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.

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