More Questions and Answers about Alabama Health Insurance Coverage

Q. My insurance company has rescinded my health insurance policy. What does this mean?

A. Rescission usually occurs as a result of incomplete or inaccurate information submitted on the application, or an omission of information that is pertinent to the underwriting of the policy. Rescission means that the policy will be null and void from the beginning. All premiums should be refunded to the insured.

Q. What is a PPO plan?

A. A PPO (Preferred Provider Organization) plan is a plan where preferred providers of service (including doctors and hospitals) have a contract with an insurance company or a health plan to offer service for their policyholders. Generally, the preferred service provider agreed to accept an insurance company's usual and customary payment. If you have a PPO contract, and do not use the preferred service providers, you may find yourself paying more for services rendered by the physician or hospital.

Q. I applied for health insurance nearly two months ago, I still have not received a policy. Now they tell me that I am not accepted. I have bills from the doctor and hospital. I paid my premium. Why do they not have to pay these bills?

A. Premiums for a health insurance policy are usually not binding until the application has been approved and the policy is issued.

Q. Are mammograms covered under health insurance?

A. Every policy which provides coverage for surgical services for a mastectomy must provide certain mammography coverage.

Q. My health insurance company is reducing my benefit payment, because I did not pre-certify my hospital stay. Can they do this?

A. It is very important for you to read your policy and look at the section dealing with pre-certification. If your contract states that you must pre-certify a hospital stay, then the company may either reduce or deny benefits, according to the terms of your policy.

Q. How long does it take for a policy to be issued?

A. If you have not received your policy within 60 days from the date you completed the application, file a Request for Assistance, and we will contact the company to find out why the company is delaying your policy.