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medical liability insurance carriers glossary

 

Question: What is open enrollment and why is it crucial?

A: Typically, job providers set aside an open enrollment window for employees to review, compare and choose from the health plans offered by the company. In most cases, open enrollment comes once a year, so it's important to take advantage of this time period to comparison-shop and ask your benefits administrator about specific questions you may have about coverage. Separately, life-changing events – like the birth of a child or loss of a loved one – may qualify you to make changes outside of the open enrollment window. Learn more about changing your health insurance policies.

Question: Will I have to select a new doctor during open enrollment? And what if my employer has switched insurance carriers?

A: During open enrollment, you can compare health services and make changes to your coverage. If you stay with your current medical insurance carrier, it's not likely that you'll be required to select new physicians – unless your provider is dropped from the programs network, retires, etc. Should you elect a new insurance carrier – or your employer discontinues its previous plan – you may have to do some research. In any case, you'll want to double-check whether your physician falls in the policies provider network. Follow these pointers in choosing a doctor.

Question: What should I look for in a plan?

Answer: Good question. A health insurance plan generally offers coverage for a mix of health care services ranging from traditional medical (e.g., office visits and hospital/emergency room treatment) and preventive care to rehabilitation and alternative or complementary medicine. The key is knowing the total amount you can expect to spend for care. A health insurance broker may be able to offer money-saving tips.

Question: How do I evaluate prescription drug coverage? How do I find out if a particular prescription is covered?

A: It's important to understand your insurer's prescription drug benefits before you purchase your medication. You may pay by using in-network pharmacies, asking for generic drugs or using mail-order services that deliver to your door. Keep these prescription drug facts in mind.

Question: Are dental benefits included in my coverage?

Answer: Don't assume that your health insurance includes dental, vision, mental health or other services at the same level – or at all – until you review the fine print in your health programs. If your coverage does not look adequate for your family's needs, you may need to consider supplemental insurance. A supplemental health plan may offer you some limited benefits to complement your primary programs.

Question: What are deductibles and co-pays? How do they work?

Answer: insurance deductibles and co-pays are out-of-pocket expenses for which you're generally responsible. For a listing of common expenses, review our health expense chart. You can, however, take steps to limit your costs with a tax-free account for future expenses.

Q: I have a pre-existing condition. Can I get insurance coverage? How will my pre-existing conditions impact my plans and rates?

A: As you apply for health insurance – even an employer's group policies – keep in mind that pre-existing conditions may lead to higher premiums and, in some states, denial of coverage. Here's what you need to know about pre-existing conditions and insurance premiums.

Q: Will my doctor accept this plan? How do I make sure my doctor is in a specific insurance policies network? What does it mean to be in-network or out-of-network?

A: An out-of-network provider is not in your insurance company's preferred network. You may be required to pay your physician at the time of service and file a claim with your insurance company separately for reimbursement. In the end, consumers typically pay more for out-of-network services. Consult with your benefits administrator, review your plans provider network booklet or website, or double-check with your provider for network status. If your plan has changed and you're shopping for a provider, search by specialty, condition, treatment or procedure.

Q: How do I know if a particular service or procedure is covered by my insurance?

Answer: Your benefits administrator or insurance carrier should be able to give you a complete breakdown of coverage for office visits, diagnostics and testing, emergency care and a host of other services. Not satisfied with your plan? Get a medical insurance quote from another carrier or consult with a health insurance broker to find the best health insurance plan for your needs.

Question: What is COBRA?

Answer:COBRA is a law that may offer you some protections – and extend your health care coverage – if you lose your job or a spouse's medical insurance benefits. Find out about COBRA qualifications and costs.

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Goat Cheese and Heirloom Tomato Bruschetta

03/09/10 12:28 pm

This recipe was adapted from a Rachel Ray recipe that I saw on her talk show. I have slimmed it down by not adding the bacon or avocado. I did add some extra flavor by rubbing the warm bread with some garlic.Goat Cheese and Heirloom Tomato Bruschetta1 loaf crusty Italian bread1 tbsp extra [...]

Lemon Pepper Shrimp Scampi

03/09/10 12:28 pm

This recipe is from my summer cooking group. The theme for the summer is light and healthy dishes. I used this dish to throw together a quick dinner for 11 people. This was a very fast meal to put together, and was enjoyed by all. I was in such a hurry [...]

Second CSA Pick Up

03/09/10 12:28 pm

This is out second pick up from our CSA this summer. This was the first of the fruit share. Here is what we received this week: -Tatsoi -Hakurei Turnips -Evergreen Hardy Scallions -French Breakfast Radishes [...]

Chicken and Summer Vegetable Tostadas

03/09/10 12:28 pm

This was my recipe for our cooking group the Summer Weekend Wizards. My mother-in-law gave us lots of fresh vegetables from her garden, and I knew this was a perfect recipe to use them.The recipe comes from Cooking Light. You can view the recipe here:Chicken and Summer Vegetable Tostadasdoes anyone know when [...]

Hamburger Cupcakes and French Fries

03/09/10 12:28 pm

I saw this recipe on a few cooking blogs and I just knew I had to make these. Check out this bloghttp://bakerella.blogspot.com/2009/06/fast-food-fun.htmlThese were a crowd pleaser at 2 cookouts. Kids and adults went nuts for these cute little guys. I used a box mix for the brownies and the cake mix to [...]

Grilled Flank Steak with Corn, Black Bean and Avocado Salad

03/09/10 12:28 pm

This is another recipe from the Summer Weekend Wizards cooking group. This was very fast and easy to come together. This was my first time making flank steak, but it will not be my last. The steak was juicy and had great flavor. The salad was a nice contrast with the [...]

Apple Crisp

03/09/10 12:28 pm

We received some baking apples from our CSA this week. I used this classic recipe from the Better Homes and Gardens cookbook.Apple Crisp5 cups sliced and peeled cooking apples2 to 4 tbsp granulated sugar1/2 cup regular rolled oats1/2 cup packed brown sugar1/4 cup all-purpose flour1/4 tsp nutmeg1/4 cup butterPreheat oven to 375 degrees.Place fruit [...]

CSA Week 4

03/09/10 12:28 pm

Here are the fruits and vegetables that we received this week from our CSA.-Scarlett Nantes and/or Red Core Chantanney Carrots -Scarlett Queen Red Stem Turnips -Genovese Basil -Orion Fennel -Yellow Haricot Vert -Jalapeno, Islander (round), [...]

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