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Health Insurance Companies In Az Question & Answers

2014 March 5
by Sarah Fields

Jenny asks…

How do I fight my denied health insurance claim?

While on vacation in AZ, I visited a CVS minute clinic for my sore throat. The cost was $107 but Blue Shield wouldn’t cover it, claiming in a letter that by visiting CVS, i had literally designated MYSELF as my own doctor instead of my regular primary care physician! The letter even stated “M.D.” next to my name as the primary care physician that I visited at CVS!! How do I fight this? Who can I talk to?

Sarah Fields answers:

Perhaps your provider is confused? They may think you ‘self-medicated’ with OTC treatments purchased at CVS, rather than seeing a doctor at the clinic. I would call and talk to someone there, and explain the situation. First, you can visit the Minute clinic site, and check that your provider covers their services:

The Minute Clinic site recommends you check with your insurance provider before treatment:

MinuteClinic accepts most major insurance companies, and we’re continually working to add more for our patients. To view insurance information for your state, select your location from the pull-down box above and click “Insurance”.
We recommend that you contact your insurance company prior to visiting MinuteClinic to verify coverage of the specific service you are seeking as well as any copays, co-insurance or deductibles. Confirming this information in advance will help you avoid unforeseen charges.

To help you verify if your insurance is accepted at MinuteClinic, please take the following steps.

1Get out your insurance card and call the member service information phone number on the back. 2Inform your insurance company that you’re going to visit a MinuteClinic in your area. 3Confirm your benefits and coverage for the specific service you are seeking. To see MinuteClinic treatment and cost information, click here. If coverage is confirmed, you can see MinuteClinic 7 days a week with no appointment.
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HMO Members, please confirm your plan’s rules to access MinuteClinic. Your out-of-pocket payment will be higher if you do not adhere to your plan’s rules.4If you find out that the service you’re seeking will not be covered, visit MinuteClinic and pay the listed price with cash or credit. MinuteClinic provides quick, convenient and high-quality health care at an affordable price.

Your opinion matters! If MinuteClinic is not in-network with your insurance company, please ask your insurance company to add MinuteClinic as a participating health care provider.

Mandy asks…

Why can’t groups and organizations like the AZ Chamber of Commerce be able to buy group health insurance?

fro their members. That would help the smaller businesses buy insurance for them and their families. A politician told me that the dems do not want this because the unions want to keep more power. Could this be true? The unions want the health care security and do not want the smaller business owners to be able to have that too?

Sarah Fields answers:

This has been tried and failed.

Group policies must follow the state mandates, which generally means that a group policy is much more expensive than individual policies for the general population. Associations and Organizations would need to follow those group mandates. This means the younger, more healthy people would not buy the association plan but instead would buy an individual policy, leaving the older, less healthy people buying the association plan. This results in higher and higher premiums until even the sick cannot continue to afford the premium.

It’s not the unions not allowing this, although I agree they want to keep as much power as they can. It is there are no insurance companies willing to take a loss, which is what happens with these plans.

Charles asks…

what is the best individual insurance to help pay cost to dermatology care in arizona?

i need Information on what insurances pay for in this area. i have a skin condition that has not been diagnosis yet? i may need laser treatments or skin repairing not sure can someone help me out i live in arizona and i see a few dermatology clinic but has no idea how im go in to pay extra costs if it comes to that.

Sarah Fields answers:

None of the companies in AZ will accept anyone with an undiagnosed condition except for a couple of defined benefit plans which do not help much and will still probably cost you a lot for your treatments. Plus, they wouldn’t cover your health condition for 6 months. Your only option to keep your costs low would be to get a job that has health benefits.

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