The Health Department is mandated by law to charge health insurance providers for tuberculosis ( TB) services against their agreed rates. If you currently have health insurance, the Health Department may bill your insurance company, but won’t collect any fees or reimbursements from you for covered services. If you don’t have health insurance, you still receive services. The purpose of the law requiring hospitals to treat all patients regardless of health is to protect the uninsured from unnecessary costs. The costs associated with treating an uninsured patient who becomes ill with a serious disease are staggering, especially in today’s economy. Hospitals cannot legally refuse to treat someone simply because they don’t have health insurance.
Under the current system, private health insurance providers must provide coverage to “qualified individuals.” Qualified individuals are defined as anyone who doesn’t belong to a group or other enclosed group that is restricted by law from excluding certain classes of people from its coverage. Individuals eligible for coverage can be either children with insured parents, and people who don’t suffer economic disadvantages that would make them unqualified for group coverage.
Another system that health insurance coverage providers may use to exclude certain people from coverage is what is called a “orphan” policy. An orphan policy means that a health insurance provider will accept a claim from an individual who is not a member of an organization that is restricted by law from excluding certain groups. However, the health insurance provider may waive the right of exclusion for groups if it is determined that the group is not large enough to justify excluding people from coverage. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 established the “orphan policy” as an alternative to the existing blanket exclusions. Although, it is possible that a waiver may be required under some circumstances, under other circumstances, an individual will be allowed to keep their coverage even if they have a pre-existing condition.
You can request health insurance information and rates from health insurance providers by contacting them directly. If they are not providing this service, you should contact the State Insurance Information Center (SIC IC) in your area. The SIC has a toll free number for individuals to call to obtain policyholder information and obtain quote information. If the health insurance provider that you are dealing with is not providing you this option, please note that there are other sources of policyholder information that you may still be able to access.
One of these sources are web sites that have sprung up offering comparisons between health insurance providers. These sites will allow you to enter your personal information, as well as a few other health-related details, and then will generate quotes based on the information that you provide. These quotes will be useful, if you are trying to choose just one health plan to protect your family’s future.
Please note that these quotes are not guaranteed. There is an adequate supply of health insurance providers in Florida, so you might want to consider contacting multiple providers to compare costs. Some providers charge more than others for the same policy and health plan options. Also, some providers offer higher coinsurance than others.
Some plans have a surcharge for out-of-network providers. If you are in network and choose a plan with a lower coinsurance percentage for an in-network provider but a much higher coinsurance percentage for an out-of-network provider, you may end up saving money. Be sure to check the policy and look at the fine print of any plan that you are considering.
You may also want to contact your health insurance company. Some companies offer the ability to enroll in the “balanced billing” plan. This is where the health insurance company and the medical provider come to an agreement about who pays the balance in case of a claim. This can often save you more money and the providers often have lower out-of-pocket costs than they would on their own.