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When Do You Need Healthcare Navigation?

  • You are too busy to review insurance statements and bills.
  • Your parents or in-laws need help with their coverage and paperwork.
  • You have a serious medical condition.
  • You've used an out-of-network provider and have large medical bills.
  • You are going through a transition that affects coverage, such as leaving a job, turning 65, retirement, divorce, death of a spouse or graduation from college. You don't understand your insurance coverage.
  • You've been denied coverage or payment for services.

You want answers to questions about your healthcare coverage or a family member's healthcare coverage such as:

  • What is the lifetime maximum of my plan and/or is there a maximum per condition?
  • What other benefits, like prescription drugs or therapies have significant limitations or caps?
  • What types of penalties might result from not following the plans pre-authorization requirements?
  • My retiree coverage is costing more and covering less, is it worth keeping?
  • Do I have adequate travel insurance protection when I travel outside the United States?
  • When will Medicare cover a nursing home stay?
  • Will Medicare cover any services if my mother needs help at home?
  • If I lose group benefits, is coverage through COBRA my best option?
  • Can I keep my group coverage rather than enroll in Medicare?
  • If my child has seen a psychiatrist or psychologist, will that be considered a pre-existing condition and prevent him/her from getting good coverage?


 

 

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