Health Insurance Gaps
According to the Milwaukee Journal Sentinel, people who buy individual health insurance policies need to be aware of possible gaps in coverage.
One woman, Phyllis Mroz, learned about medical insurance gaps the hard way: she found out that a standard medical procedure that could save her life wouldn't be covered until she had her health plan for 12 months. But Mroz knew that her chances of survival would drastically decrease if she didn't get the procedure right away.
Mroz had health insurance for the past 35 years through her husband's plan; he was a high school music teacher and band director. When Mroz's husband retired, she realized that she could buy an individual health plan for less than it cost to remain in the school district's policy.
Remaining in the school policy would've cost the family $18,000 a year. But as a real estate agent in good health, Mroz could buy an individual plan for $221.00 per month, or $2,652 a year with a $1,500 deductible.
It was the first time Mroz bought her own health insurance plan, and she wasn't alone. Even though most people get health insurance at work, more and more people are shopping for their own health coverage. Over 17 million people under 65 have their own health insurance.
After enrolling in her new plan, Mroz was diagnosed with leukemia. She needed a stem cell transplant that could cost $200,000. The procedure would increase her chance of survival by 60%. Not having the operation would increase the chance of the cancer returning by 90%.
Her insurance company denied her coverage because Mroz had not yet had the policy for 12 months. All because of a one-sentence exclusion in a 42-page document - the insurance company didn't cover transplants for the first year.
Mroz and her family tried to convince her insurance company to approve the procedure, but they declined her case because they stated it wouldn't be fair to other policy holders if they gave her special treatment.
But after a reporter contacted the insurance company inquiring about the 12-month exclusion policy, a new plan was introduced, and the insurance company called Mroz telling her they had found a way to help her.
Mroz didn't know everything about her health insurance policy because she had only read the 2-page summary of the plan. She's not alone; most people don't read the whole 42-page plan.
Mroz's experience shows how important it is to learn as much as you can about your health insurance plan. Find out if there are exclusions so you know what's covered.
As more people buy private health insurance, it's good to know that affordable health insurance quotes are available online. Just be sure to find out as much about your plan as possible.
One woman, Phyllis Mroz, learned about medical insurance gaps the hard way: she found out that a standard medical procedure that could save her life wouldn't be covered until she had her health plan for 12 months. But Mroz knew that her chances of survival would drastically decrease if she didn't get the procedure right away.
Mroz had health insurance for the past 35 years through her husband's plan; he was a high school music teacher and band director. When Mroz's husband retired, she realized that she could buy an individual health plan for less than it cost to remain in the school district's policy.
Remaining in the school policy would've cost the family $18,000 a year. But as a real estate agent in good health, Mroz could buy an individual plan for $221.00 per month, or $2,652 a year with a $1,500 deductible.
It was the first time Mroz bought her own health insurance plan, and she wasn't alone. Even though most people get health insurance at work, more and more people are shopping for their own health coverage. Over 17 million people under 65 have their own health insurance.
After enrolling in her new plan, Mroz was diagnosed with leukemia. She needed a stem cell transplant that could cost $200,000. The procedure would increase her chance of survival by 60%. Not having the operation would increase the chance of the cancer returning by 90%.
Her insurance company denied her coverage because Mroz had not yet had the policy for 12 months. All because of a one-sentence exclusion in a 42-page document - the insurance company didn't cover transplants for the first year.
Mroz and her family tried to convince her insurance company to approve the procedure, but they declined her case because they stated it wouldn't be fair to other policy holders if they gave her special treatment.
But after a reporter contacted the insurance company inquiring about the 12-month exclusion policy, a new plan was introduced, and the insurance company called Mroz telling her they had found a way to help her.
Mroz didn't know everything about her health insurance policy because she had only read the 2-page summary of the plan. She's not alone; most people don't read the whole 42-page plan.
Mroz's experience shows how important it is to learn as much as you can about your health insurance plan. Find out if there are exclusions so you know what's covered.
As more people buy private health insurance, it's good to know that affordable health insurance quotes are available online. Just be sure to find out as much about your plan as possible.
