Friday, July 11, 2014

Good news (kinda/sorta)

"Superior HealthPlan confirmed ... that the insurance company will cover Savannah's surgery at Texas Children's "for continuity reasons."

The reason for the "kinda/sorta" is twofold:

First, the plan is an HMO model, which typically doesn't cover out-of-network claims. It's not clear to me whether or not the Snodgrass family had chosen this kind of coverage intentionally, in which case I think the carrier was wrong to fold, or whether they just didn't understand (which is also possible - lots of folks just pull the trigger on lowest price).

The other reason is that ObamaTax "skinny networks:" are going to mirror a lot of this issue, with folks finding out last-minute that they may be digging deeper into their own pockets.

And there's this: how come no one is asking the provider why the surgery was cancelled for lack of coverage? Why is this all on the insurance company?
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