Insurance Company Refused to Cover than Reconsidered Too Late

Welcome to 2008, hopefully your family had a better end to the year 2007 than the family of Natiline Sarkisyan. Their year ended with a funeral for their teen-aged daughter who died after her health and medical insurance company refused to pay for a liver transplant and then reconsidered. The Philadelphia-based Cigna HealthCare insurer has a history of approving coverage for over 90% of all transplants claims requested by their insured members, with over 90% of the liver transplant request being approved according to Cigna company President David Cordani in a memo addressed to employees and distributed to the media. … Continue reading

Why is My Pain Treated Differently at Work?

I have a close friend who works all day behind a computer and has for over 20 years. During the past five years his hands, elbows, shoulders and neck have started to feel the stress. Over the last year the pain and difficulty has become progressively worse and the company Ergonomics department has actively attempted to make his work area a custom fit in order to reduce the stress. My friend earns a great living at what he does, and over the last five months returns home a little early in order to make out with a heating pad, take … Continue reading

Copy of All Documents, Relevant to Your Appeal.

In a previous Blog I outlined our situation and the fact our Employer Provided Group Health Insurance had sent us an Initial Denial of Authorization for continued psychiatric residential treatment our 9-year-old daughter needs. We expected the letter, and knew our private group health policy had decided in a Doctor to Doctor meeting they would not authorize any further care. This time however, I decided to request a copy of all the documents the insurance company use to make their decision. I called the “Appeals” number provided in the initial denial of authorization letter and exercised my rights to receive … Continue reading

Initial Denial of Authorization: The Letter

It’s not easy to parent a child who suffers from mental, emotional, and physical disabilities. Navigating the medical and mental health system can be a job in itself. Top things off with a less than cooperative Employer provided group health plan and life can become more then just a little stressful. Our beautiful 9-year-old daughter was placed for adoption with us at the age of 5. It’s been a long hard road filled with difficult parenting choices. I thought I knew everything after raising my older two children. Helping Makala has become the definition of Advocating for the best interest … Continue reading

Doctor to Doctor Review: Employer Provided Group Health Insurance

It’s been one thing after another since the placement of our special needs siblings for adoption in 2003. We added our children to our Employer Provided Group Health Insurance as soon as possible. In order to be sure all of their needs are met children adopted from foster care have Medicaid or State medical benefits until the age of 18 as part of the Adoption Assistance provided for special needs children. Our private employer group health insurance is seen as Primary with the Medicaid/State medical as secondary. Recently the federal government has passed laws requiring insurance companies treat mental health … Continue reading

Primary and Secondary Health Insurance Coverage

Our family has had a difficult start to the year 2007! As some may know we are the Adoptive Parents of two special needs siblings placed through the state foster care system. Our daughter, Makala, was 5-years-old and her biological brother Jeremiah was 1-year-old at the time they were placed for adoption in our family during 2003. This has been an interesting and long four years. Our little girl has had several issues no one knew existed among them Alcohol-Related Neurodevelopmental Disorders, (ARND). Special Needs children adopted from the child services system often have continued benefits. Older, or special needs … Continue reading

Understanding Employer Provided Group Health Insurance

Working Americans fortunate enough to have private health insurance are covered under an employer provided group health insurance plan. There are two popular plans employers might choose for their worker’s benefits package. A standard indemnity health insurance policy, allows employees and their insured dependents the freedom to visit any health care provider they choose. The cost of the appointment or medical service is paid out of pocket by the employee and insurance plan reimburses covered members for a portion of the paid services. The other most common health plan employers choose is a managed care plan. Managed care plans offer … Continue reading

Insurance Blog Week In Review January 2-8, 2007

The first week of 2007 has been an inspiring week for this Insurance Blogger! Not only because I have some great ideas and insurance things to write about–but, also because I have learned a few new things about Insurance myself. Insurance Term Of The Week: Insurance Credit Score Credit Protection Insurance. Consumer Credit Scores What Decides Score? How is the Score Used Errors Concerns Information Many of your are aware that my husband and I are adoptive parents of special needs siblings from the foster care system. I wrote many Adoption Blogs at before I took this position writing … Continue reading

Mental Health and Insurance: Advocating for Makala

It’s been a long four-years since this picture was taken and we brought Makala and Jeremiah home to be our children. It required nearly two-years before we met them to complete the application for adoption, training as special needs parents, and have our home study done by the state. We chose to adopt special needs siblings from our state foster care system. Our lives were stable and we had experience raising Sean and Tori who were on their way to college. We wanted and worked hard to get into a position of making a huge change in the lives of … Continue reading