When it comes to their health, each person and each family is fresh, so it is not surprising that choosing an individual health insurance idea is a complex process. Cost, convenience, and your novel health issues all near into play. Somehow, out of the myriad of choices, you are supposed to get the accurate combination for you. Here is a roadmap to simplify the process:

1. Open at affordability. It is easy to consider insurance should shroud every need and contingency. Remember, it is there to support you from going into debt, not to assign you in debt. Station a budget that makes sense and do the best you can within that framework.

2. Recede to your existing physician. If you have a ample relationship with your novel doctor and want to continue seeing him or her, your choices may be minute for individual health insurance. Accumulate out if your doctor is affiliated with an HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), POS (Point of Service), or IPA (Individual Practice Association). If your doctor is in one network, then your decision is simple. If he or she is in more than one, you can weight other concept features. If your doctor is not in any network, you will need a “fee-for-service” or indemnity view. Under this view, you go to any doctor or hospital you wish. An indemnity opinion normally will hide only a percentage of the changes-usually 80 percent. You are responsible for the other 20 percent. The insurance company also sets its maintain “usual and stale” rates for services. If your doctor charges more than the usual and conventional rate, you will have to design up the contrast.

3. Signal your health issues. You will need to swear the insurer of any medical conditions for which you have been diagnosed or treated. The insurer will mediate these “pre-existing” conditions. If you were joining a group policy, the insurance company would be required by law to screen the pre-existing condition without a waiting period, assuming you had insurance coverage in the previous twelve months. When you are buying individual health insurance coverage, however, the insurance company has the accurate to announce a waiting period for payments related to the pre-existing condition or to decline to cloak you at all. Five states have made denial of coverage illegal. Maine, Massachusetts, Novel York, Fresh Jersey and Vermont all have adopted “guarantee order” laws that perform insurance companies offer health insurance to everyone regardless of their medical conditions. Other states have created insurance “pools” that provide coverage to high-risk individuals.

4. Listless down for prescription drugs. If you have found two or more plans that are comparable, rob a moment to review their prescription drug benefits. Some plans veil medications immediately, requiring nothing more than a co-payment. Other plans do not pay for prescription drugs until the annual deductible has been met. Be certain to compare the co-payment amounts to view what the incompatibility would be, especially over time. Most insurance companies conceal medications on a non-preferred for name designate drugs, but others shroud only generic brands (when available). If name brands are considerable to you, build certain you settle the view that offers them.

5. Peek for falling taxes. If someone wanted to hand you a check for $2,539, would you prefer it? That is what the Uncle Sam is doing with Health Savings Accounts. You can deposit up to $5,650 into a Health Savings Tale (HSA), sheltering it from as considerable as 9.3% in site income tax, 28% in federal income tax, and 7.65% in Federal Insurance Contributions Act (FICA) tax. That is a total tax savings of 44.95%, or $2,539 out of a $5,650 contribution. The HSA contribution rolls over from year to year, and remains tax-free, provided you withdraw the funds after age 65 or exhaust them for medical expenses. In addition, the earnings on HSA funds are tax-deferred. To initiate an HSA, you must enroll in a High Deductible Health Opinion (HDHP), with minimum deductibles of $1,100 for an individual or $2,200 for a family. The deductibles are paid with untaxed dollars from the HSA tale, increasing your buying power. Because of the high deductible amount, the monthly premium is rude, making an HDHP concept an pretty option for many people.

By following this roadmap, you should approach at a choice that is relatively simple to beget.

When it comes to their health, each person and each family is unusual, so it is not surprising that choosing an individual health insurance thought is a complex process. Cost, convenience, and your unusual health issues all arrive into play. Somehow, out of the myriad of choices, you are supposed to acquire the moral combination for you. Here is a roadmap to simplify the process:

1. Originate at affordability. It is easy to believe insurance should shroud every need and contingency. Remember, it is there to withhold you from going into debt, not to effect you in debt. Position a budget that makes sense and do the best you can within that framework.

2. Depart to your existing physician. If you have a friendly relationship with your original doctor and want to continue seeing him or her, your choices may be puny for individual health insurance. Glean out if your doctor is affiliated with an HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), POS (Point of Service), or IPA (Individual Practice Association). If your doctor is in one network, then your decision is simple. If he or she is in more than one, you can weight other belief features. If your doctor is not in any network, you will need a “fee-for-service” or indemnity belief. Under this thought, you go to any doctor or hospital you wish. An indemnity understanding normally will cloak only a percentage of the changes-usually 80 percent. You are responsible for the other 20 percent. The insurance company also sets its gain “usual and old” rates for services. If your doctor charges more than the usual and feeble rate, you will have to invent up the inequity.

3. Signal your health issues. You will need to train the insurer of any medical conditions for which you have been diagnosed or treated. The insurer will mediate these “pre-existing” conditions. If you were joining a group policy, the insurance company would be required by law to mask the pre-existing condition without a waiting period, assuming you had insurance coverage in the previous twelve months. When you are buying individual health insurance coverage, however, the insurance company has the honest to squawk a waiting period for payments related to the pre-existing condition or to decline to screen you at all. Five states have made denial of coverage illegal. Maine, Massachusetts, Novel York, Current Jersey and Vermont all have adopted “guarantee allege” laws that create insurance companies offer health insurance to everyone regardless of their medical conditions. Other states have created insurance “pools” that provide coverage to high-risk individuals.

4. Insensible down for prescription drugs. If you have found two or more plans that are comparable, choose a moment to review their prescription drug benefits. Some plans screen medications immediately, requiring nothing more than a co-payment. Other plans do not pay for prescription drugs until the annual deductible has been met. Be determined to compare the co-payment amounts to scrutinize what the dissimilarity would be, especially over time. Most insurance companies hide medications on a non-preferred for name sign drugs, but others shroud only generic brands (when available). If name brands are essential to you, produce obvious you decide the belief that offers them.

5. Peer for falling taxes. If someone wanted to hand you a check for $2,539, would you pick it? That is what the Uncle Sam is doing with Health Savings Accounts. You can deposit up to $5,650 into a Health Savings Memoir (HSA), sheltering it from as remarkable as 9.3% in station income tax, 28% in federal income tax, and 7.65% in Federal Insurance Contributions Act (FICA) tax. That is a total tax savings of 44.95%, or $2,539 out of a $5,650 contribution. The HSA contribution rolls over from year to year, and remains tax-free, provided you withdraw the funds after age 65 or expend them for medical expenses. In addition, the earnings on HSA funds are tax-deferred. To inaugurate an HSA, you must enroll in a High Deductible Health Concept (HDHP), with minimum deductibles of $1,100 for an individual or $2,200 for a family. The deductibles are paid with untaxed dollars from the HSA tale, increasing your buying power. Because of the high deductible amount, the monthly premium is extreme, making an HDHP concept an fair option for many people.

By following this roadmap, you should approach at a choice that is relatively simple to acquire.

When people suffer from mental health issues, it is unbiased the same as any other medical condition or disease that should be covered by all health insurance companies. However, this is not the case. Millions of people in America are afflicted with mental health problems every year, but only about one third of those Americans will accumulate adequate insurance coverage for their mental health problems. Many Americans either don’t have insurance at all therefore can not gawk treatment, or they do have coverage and are jumpy that their mental illness will be recorded and flagged, so they do not study treatment at all. There are some Americans that do not explore treatment for their mental illness simply because they are embarrassed.

When you are considering mental health insurance you should obtain determined that it covers the following, but is not little to.

1. Therapist coverage- at least 20 to 30 visits per year

2. That it covers Anxiety

3. Depression- Manic Depressive

4. Schizophrenia

These are the most commonly covered mental health problems. Insurance companies do not cloak Drug and Alcohol treatment (call your carrier). Always remember that insurance companies no longer pay for mental health problems like they venerable to, so it is primary for each individual to contact their insurance carrier to glean out what is covered.

There also are situation agencies that do benefit with mental health coverage, you will need to score in contact with your local Human Services Department for further information. Today there are 43 states that have passed legislations providing some sort of mental health coverage for their residents.

Here are some of the mental health plans that are in my location of Kentucky. I have do in the information for a 40-year-old female, smoker with mental illness and I received prices from 4 carriers with 5 different plans. The four carriers were Anthem BC/BS, United Health Care, Humana, and Aetna and here are the plans.

1. Anthem Blue Access Value 2000- idea type PPO, $2,000 annual deductible, office vistit co-pay $30.00, co-insurance 30% with a monthly premium of $155.25.

2. Anthem Premier 100- notion type PPO, $2,500 annual deductible, co-insurance 0%, $30.00 office visit co-pay
with a monthly premium of $239.89.

3. Humana One-Monogram Total/7500 Plus Rx- concept type PPO, $7,500 annual deductible, $25.00 co-pay for
office visit until deductible has been met with a monthly premium of 96.85.

4. Aetna PPO 2500- thought type PPO, $2,500 annual deductible, 20% co-insurance, $30.00 office visit co-pay until
deductible has been met with a $197.00 monthly premium.

5. United Health One Co-Pay Take 80/2500- opinion type is network, $2,500 annual deductible, 20% co-insurance,
and $35.00 office visit co-pay with a monthly premium of $218.59.

All of these health insurance plans offer mental health coverage, hospitalization, specialist and prescription coverage at affordable rates. Remember to do the research before you commit to purchasing health insurance.

References for this article came from ehealthinsurance.com and healthinsurance.com

When people suffer from mental health issues, it is unprejudiced the same as any other medical condition or disease that should be covered by all health insurance companies. However, this is not the case. Millions of people in America are afflicted with mental health problems every year, but only about one third of those Americans will accumulate adequate insurance coverage for their mental health problems. Many Americans either don’t have insurance at all therefore can not recognize treatment, or they do have coverage and are shrinking that their mental illness will be recorded and flagged, so they do not scrutinize treatment at all. There are some Americans that do not glimpse treatment for their mental illness simply because they are embarrassed.

When you are considering mental health insurance you should build positive that it covers the following, but is not diminutive to.

1. Therapist coverage- at least 20 to 30 visits per year

2. That it covers Anxiety

3. Depression- Manic Depressive

4. Schizophrenia

These are the most commonly covered mental health problems. Insurance companies do not veil Drug and Alcohol treatment (call your carrier). Always remember that insurance companies no longer pay for mental health problems like they primitive to, so it is well-known for each individual to contact their insurance carrier to come by out what is covered.

There also are residence agencies that do support with mental health coverage, you will need to fetch in contact with your local Human Services Department for further information. Today there are 43 states that have passed legislations providing some sort of mental health coverage for their residents.

Here are some of the mental health plans that are in my area of Kentucky. I have place in the information for a 40-year-old female, smoker with mental illness and I received prices from 4 carriers with 5 different plans. The four carriers were Anthem BC/BS, United Health Care, Humana, and Aetna and here are the plans.

1. Anthem Blue Access Value 2000- notion type PPO, $2,000 annual deductible, office vistit co-pay $30.00, co-insurance 30% with a monthly premium of $155.25.

2. Anthem Premier 100- conception type PPO, $2,500 annual deductible, co-insurance 0%, $30.00 office visit co-pay
with a monthly premium of $239.89.

3. Humana One-Monogram Total/7500 Plus Rx- thought type PPO, $7,500 annual deductible, $25.00 co-pay for
office visit until deductible has been met with a monthly premium of 96.85.

4. Aetna PPO 2500- belief type PPO, $2,500 annual deductible, 20% co-insurance, $30.00 office visit co-pay until
deductible has been met with a $197.00 monthly premium.

5. United Health One Co-Pay Bewitch 80/2500- thought type is network, $2,500 annual deductible, 20% co-insurance,
and $35.00 office visit co-pay with a monthly premium of $218.59.

All of these health insurance plans offer mental health coverage, hospitalization, specialist and prescription coverage at affordable rates. Remember to do the research before you commit to purchasing health insurance.

References for this article came from ehealthinsurance.com and healthinsurance.com

I had the option of paying $308 out of pocket for the health notion at work – unprejudiced for me, but knew I could never aford that, so I started shopping around. I purchased a Kaiser view for $170, but it turned out to be too mighty for our family budget, so I started looking again.

The internet may not seem like a genuine spot to choose insurance, but if your coverage needs are simple you can assign Hundreds of dollars every month. Here is where to go on the internet to review policies, pricing, coverage, and to ultimately recall healthcare coverage at crude prices. Each understanding is a diminutive different, be positive it meets your needs. Here are the places I looked at – One being the best and where I found the best deal for me at $48.

5) United Health Care Coverage can be found on the web at: http://www.uhc.com/ . On the main page is a button where you can ‘Get an Individual or Family Quote’. Click on this button to be directed to a quote generating engine. For a 26 year conventional female in Colorado prices range from $59 - $108. Achieve in your enjoy information or your children’s information for coverage quotes. Be clear to assume a contemplate at the Health Succor Concept Description in the fair hand column you do not want any surprises.

4) Anthem Blue Cross/ Blue Shield requests that you beget out an inquiry obtain on their web page Here with your name, phone number, and e-mail address so that they can bag in touch with you. If you would rather, you can call their toll free number to direct directly with an agent at 1-866-806-6709.

3) One of the many online insurance brokers is http://myinsurancerates.com . They allow you to score quotes and apply completely online also. They claim to carry multiple insurers, though the only two that came up for a 26 year former female in Colorado were United Health One and Celtic. The prices ranged from $60 – $250 a month for individual coverage.

2) Humana One Insurance coverage can be located at Humana One. The invent needs only your set, zip code, gender, and birth date to generate quotes for you online. Their prices for a 26 year faded female in Colorado are $52.14 – $202.

1) My number one celebrated location and the one I ended up using is ehealthinsurance . They have plans to offer from Aetna, Anthem, Kaiser, CELTIC, RMHP, United Health One, and Companion. There are 105 plans available for a 26 yr extinct female with a trace range from $48 - $303 in every possible combination of benefits. You can compare plans side by side by using the check marks on the left hand side of the page. If you are concerned about being able to preserve your doctor there is a button to search for doctors attached to the belief, and a understanding details button. Remember to eye at this before you recall insurance!

Sources:

https://www.ehealthinsurance.com

https://www.humana-one.com/secured/individual-health-insurance-quotes.asp

http://www.anthemforco.com/

http://myinsurancerates.com

http://www.uhc.com/

I had the option of paying $308 out of pocket for the health thought at work – fair for me, but knew I could never aford that, so I started shopping around. I purchased a Kaiser notion for $170, but it turned out to be too remarkable for our family budget, so I started looking again.

The internet may not seem like a noble set to choose insurance, but if your coverage needs are simple you can attach Hundreds of dollars every month. Here is where to go on the internet to review policies, pricing, coverage, and to ultimately choose healthcare coverage at shameful prices. Each conception is a small different, be certain it meets your needs. Here are the places I looked at – One being the best and where I found the best deal for me at $48.

5) United Health Care Coverage can be found on the web at: http://www.uhc.com/ . On the main page is a button where you can ‘Get an Individual or Family Quote’. Click on this button to be directed to a quote generating engine. For a 26 year dilapidated female in Colorado prices range from $59 - $108. Assign in your maintain information or your children’s information for coverage quotes. Be positive to capture a peek at the Health Aid View Description in the just hand column you do not want any surprises.

4) Anthem Blue Cross/ Blue Shield requests that you have out an inquiry invent on their web page Here with your name, phone number, and e-mail address so that they can pick up in touch with you. If you would rather, you can call their toll free number to bellow directly with an agent at 1-866-806-6709.

3) One of the many online insurance brokers is http://myinsurancerates.com . They allow you to acquire quotes and apply completely online also. They claim to carry multiple insurers, though the only two that came up for a 26 year outmoded female in Colorado were United Health One and Celtic. The prices ranged from $60 – $250 a month for individual coverage.

2) Humana One Insurance coverage can be located at Humana One. The build needs only your location, zip code, gender, and birth date to generate quotes for you online. Their prices for a 26 year conventional female in Colorado are $52.14 – $202.

1) My number one celebrated situation and the one I ended up using is ehealthinsurance . They have plans to offer from Aetna, Anthem, Kaiser, CELTIC, RMHP, United Health One, and Companion. There are 105 plans available for a 26 yr worn female with a impress range from $48 - $303 in every possible combination of benefits. You can compare plans side by side by using the check marks on the left hand side of the page. If you are concerned about being able to preserve your doctor there is a button to search for doctors attached to the idea, and a conception details button. Remember to notice at this before you seize insurance!

Sources:

https://www.ehealthinsurance.com

https://www.humana-one.com/secured/individual-health-insurance-quotes.asp

http://www.anthemforco.com/

http://myinsurancerates.com

http://www.uhc.com/

A medical crisis is a two-part nightmare. First, there is hurt and panic, doctors and hospitals, tests and surgeries. Patients and their families pass through the days in a dreamlike spot, trying to understand the complicated language of medicine. Then, finally, there comes the time of recovery, when the body and mind can open to heal.

Then the bills arrive, and the second allotment of the nightmare begins.

As the health insurance industry becomes more and more complex, and medical billing more and more complex, those who must avail themselves of medical treatment often earn it impossible to navigate the systems. How do we, as consumers, know if we are being charged fairly? How can we be expected to understand the language and codes frail by insurance companies and medical treatment centers? What can we do if a claim is denied, or, as in my case, we are being billed for unspecified services?

In February of 2005, my husband had what the doctors called a cardiac incident. He was in and out of the hospital four more times due to heart disease. By May, he needed a triple bypass.

Though we have fine insurance benefits through my husband’s company we unruffled incurred a substantial many bills. There were bills from doctors I never heard of, bills for services I didn’t understand, bills for items I couldn’t identify. Some of these bills were pages and pages of numbers and words that made no sense to me. How was I going to figure out what was what, and more importantly, what I should and shouldn’t be paying for?

I managed to sort through the piles of paper and decide what payments I was responsible for and which were covered by insurance. Everything was in order. I idea the billing nightmare was coming to an slay. I was harmful.

The hospital at which my husband had his surgery sent a bill for $364.45. This bill came in January of 2006, eight months after he had been released. The amount was identified as Recent Balance. No other explanation was given.

I called the number on the bill. I asked what the charge was for. The woman who answered could only remark me that the amount was the modern balance left on the bill. Obviously, she was not going to be of any assistance.

After several phone calls, I ended up on a three-way conference call with the insurance company and the hospital. The hospital representative could not identify the charge, only that it was to be paid. The insurance company representative pointed out that it would not pay for an unidentified charge. The hospital representative pointed out that that was why it was billed to the patient, because the insurance company didn’t pay it.

I stated that I was not going to pay for something without radiant what that service or item was. No resolution was reached. The hospital handed the bill over to a collection agency.

By this time I was ready to have a cardiac incident of my have.

Health Advocate to the rescue!

My husband came home from work one day and said he found out that piece of the insurance coverage benefits was access to a health advocacy service. Not incandescent what that was, I asked what it would cost us.

It would cost us nothing. We only had to develop a phone call and clarify the position.

Could anything enchanting medical bills, health insurance, and hospitals be that simple? Based on my past experience, I had my doubts.

I handed over all the pertinent paperwork, including my notations of dates of phone calls and names of personnel written on the backs of billing envelopes, to my husband. I had had enough of this, and figured my husband was well enough to assume a miniature added stress. I wasn’t distinct my possess health would have stood another moment of this nightmare.

My husband made the call, and explained the location to a PHA, a Personal Health Advocate, named Carl.

Within two weeks Carl called my husband and said the grunt had been resolved. We did not need to pay the $364.45. Furthermore, we were entitled to a $40 refund.

I was afraid. I was grateful. I couldn’t contain there was someone out there that could navigate the complex structure that is our health care system and settle this articulate to our favor. The nightmare was over.

But who are these health care advocates and how do they banish the nightmares?

From this quagmire that is now our health care system a unusual industry is emerging. It is the health advocacy industry and it is in acknowledge to an ever-increasing number of consumer complaints and lawsuits.

Health Advocate is an industry leader. Established in 2001, the privately held company was founded by five extinct Aetna Healthcare executives.(1) The company contracts with organizations that provide group health plans to their employees. Their services are in advocacy to the members of the health plans, the employees. The Personal Health Advocates are trained professionals, backed up by staff drawn from the medical community, such as administrators and medical experts. They understand the inner workings of health care, billing, insurance, and other aspects of the system. When an employee contacts Health Advocate for assistance, he or she is assigned a Personal Health Advocate,(PHA) and that is his or her contact. That is the person the employee will jabber with, each and every time.

It is the job of the PHA to assess the employee’s place, contact all valuable parties, and arrive a resolution. All the hours I spent on the phone, all the fruitless conversations, all the stress I experienced, came from my lack of knowledge and contacts within the system. A Health Advocate PHA has the knowledge and contacts to avoid unbiased such a state.

As health care and health care coverage become more prominent issues in the news and in politics, it becomes sure that the average consumer will need greater assistance during times of medical crisis. Sarah Lawrence College offers a masters degree program in health advocacy. The college defines the field this way:

“Health advocacy encompasses yell service to the individual or family as well as activities that promote health and access to health care in communities and the larger public. Advocates befriend and promote the rights of the patient in the health care arena, encourage construct capacity to improve community health and enhance health policy initiatives focused on available, worthy and quality care.”(2)

Health advocates will be the people who stand between the consumer and the institutes. They will protect the patients’ rights in every situation, up to the legislative forums of Congress. They will be the interpreters of the medical language, the code breakers of billing, the investigators of spurious charges. They will improve the level of care in communities and lobby Congress to improve the health care systems.

Most of us secure our health care through our employers. I would wait on everyone to ask his or her employers if the health care conception offers an advocacy service. Such services offer not only assistance with billing, but with medical scheduling issues, aid with getting second opinions and dealing with claims, and plan complex medical diagnoses and terminology.

A medical crisis is a two-part nightmare. But now, at least, there is someone who can serve, someone who can challenge the demons of the health care systems. Health advocacy is a field filled with promise. Advocates will be able to sever the stress for patients and families, and will be notable in the restructuring of the health care system.

1)http://www.healthadvocate.com/companyprofile.asp

2) http://www.slc.edu/health-advocacy/Defining_the_Field.php

A medical crisis is a two-part nightmare. First, there is afflict and dismay, doctors and hospitals, tests and surgeries. Patients and their families pass through the days in a dreamlike situation, trying to understand the complicated language of medicine. Then, finally, there comes the time of recovery, when the body and mind can originate to heal.

Then the bills advance, and the second allotment of the nightmare begins.

As the health insurance industry becomes more and more complex, and medical billing more and more complex, those who must avail themselves of medical treatment often procure it impossible to navigate the systems. How do we, as consumers, know if we are being charged fairly? How can we be expected to understand the language and codes mature by insurance companies and medical treatment centers? What can we do if a claim is denied, or, as in my case, we are being billed for unspecified services?

In February of 2005, my husband had what the doctors called a cardiac incident. He was in and out of the hospital four more times due to heart disease. By May, he needed a triple bypass.

Though we have friendly insurance benefits through my husband’s company we unruffled incurred a grand many bills. There were bills from doctors I never heard of, bills for services I didn’t understand, bills for items I couldn’t identify. Some of these bills were pages and pages of numbers and words that made no sense to me. How was I going to figure out what was what, and more importantly, what I should and shouldn’t be paying for?

I managed to sort through the piles of paper and resolve what payments I was responsible for and which were covered by insurance. Everything was in order. I opinion the billing nightmare was coming to an destroy. I was horrible.

The hospital at which my husband had his surgery sent a bill for $364.45. This bill came in January of 2006, eight months after he had been released. The amount was identified as Recent Balance. No other explanation was given.

I called the number on the bill. I asked what the charge was for. The woman who answered could only suppose me that the amount was the novel balance left on the bill. Obviously, she was not going to be of any assistance.

After several phone calls, I ended up on a three-way conference call with the insurance company and the hospital. The hospital representative could not identify the charge, only that it was to be paid. The insurance company representative pointed out that it would not pay for an unidentified charge. The hospital representative pointed out that that was why it was billed to the patient, because the insurance company didn’t pay it.

I stated that I was not going to pay for something without luminous what that service or item was. No resolution was reached. The hospital handed the bill over to a collection agency.

By this time I was ready to have a cardiac incident of my gain.

Health Advocate to the rescue!

My husband came home from work one day and said he found out that piece of the insurance coverage benefits was access to a health advocacy service. Not bright what that was, I asked what it would cost us.

It would cost us nothing. We only had to gain a phone call and justify the residence.

Could anything moving medical bills, health insurance, and hospitals be that simple? Based on my past experience, I had my doubts.

I handed over all the pertinent paperwork, including my notations of dates of phone calls and names of personnel written on the backs of billing envelopes, to my husband. I had had enough of this, and figured my husband was well enough to assume a cramped added stress. I wasn’t distinct my fill health would have stood another moment of this nightmare.

My husband made the call, and explained the plot to a PHA, a Personal Health Advocate, named Carl.

Within two weeks Carl called my husband and said the recount had been resolved. We did not need to pay the $364.45. Furthermore, we were entitled to a $40 refund.

I was petrified. I was grateful. I couldn’t bear there was someone out there that could navigate the complex structure that is our health care system and determine this hiss to our favor. The nightmare was over.

But who are these health care advocates and how do they banish the nightmares?

From this quagmire that is now our health care system a unique industry is emerging. It is the health advocacy industry and it is in respond to an ever-increasing number of consumer complaints and lawsuits.

Health Advocate is an industry leader. Established in 2001, the privately held company was founded by five primitive Aetna Healthcare executives.(1) The company contracts with organizations that provide group health plans to their employees. Their services are in advocacy to the members of the health plans, the employees. The Personal Health Advocates are trained professionals, backed up by staff drawn from the medical community, such as administrators and medical experts. They understand the inner workings of health care, billing, insurance, and other aspects of the system. When an employee contacts Health Advocate for assistance, he or she is assigned a Personal Health Advocate,(PHA) and that is his or her contact. That is the person the employee will converse with, each and every time.

It is the job of the PHA to assess the employee’s status, contact all distinguished parties, and approach a resolution. All the hours I spent on the phone, all the fruitless conversations, all the stress I experienced, came from my lack of knowledge and contacts within the system. A Health Advocate PHA has the knowledge and contacts to avoid fair such a station.

As health care and health care coverage become more prominent issues in the news and in politics, it becomes determined that the average consumer will need greater assistance during times of medical crisis. Sarah Lawrence College offers a masters degree program in health advocacy. The college defines the field this way:

“Health advocacy encompasses state service to the individual or family as well as activities that promote health and access to health care in communities and the larger public. Advocates abet and promote the rights of the patient in the health care arena, befriend develop capacity to improve community health and enhance health policy initiatives focused on available, suited and quality care.”(2)

Health advocates will be the people who stand between the consumer and the institutes. They will protect the patients’ rights in every status, up to the legislative forums of Congress. They will be the interpreters of the medical language, the code breakers of billing, the investigators of fallacious charges. They will improve the level of care in communities and lobby Congress to improve the health care systems.

Most of us secure our health care through our employers. I would aid everyone to ask his or her employers if the health care view offers an advocacy service. Such services offer not only assistance with billing, but with medical scheduling issues, back with getting second opinions and dealing with claims, and opinion complex medical diagnoses and terminology.

A medical crisis is a two-part nightmare. But now, at least, there is someone who can relieve, someone who can challenge the demons of the health care systems. Health advocacy is a field filled with promise. Advocates will be able to prick the stress for patients and families, and will be well-known in the restructuring of the health care system.

1)http://www.healthadvocate.com/companyprofile.asp

2) http://www.slc.edu/health-advocacy/Defining_the_Field.php