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Pennsylvania Health Insurance Tips & Advice

Health Insurance Tips

Check Agents and Companies: Make sure the agent and company you are dealing with are licensed to sell health insurance by the Pennsylvania Insurance Department.

Review Applications: Make sure any pre-existing conditions are listed on your application, and that all information is correct. False information or misrepresentation of health conditions in your application is against the law and may result in the denial of benefits or cancellation of your policy. If the insurance agent fills out the application for you and makes a mistake, tell him or her to complete another application. If you find a mistake after the application has been forwarded to the company, notify the company in writing immediately. Do not sign a blank application.

Replacing a Policy: If you are replacing an existing policy with a new one, do not cancel your current policy until you are sure your application for the new policy has been approved by the new company and your coverage is in effect. Although a premium may have been paid, coverage usually does not become effective until the application has been approved by the company. Ask your agent when your new coverage will become effective.

If you have an illness that would be considered a pre-existing condition under a new policy, that condition may not be covered for a certain period of time under that policy.

Free Look: Pennsylvania law requires that you have a minimum of ten (10) days to review your policy from the date you receive it. If a copy of the application is included with the policy, check it again for errors. If you decide you don't want the policy, you may return it to the company within the free look period and receive a full refund of any premium paid.

Paying the Premium: Always pay your health insurance premium with a check, money order or bank draft. Make your check out to the insurance company, not to the agent or agency. Whenever you pay a premium in person, always obtain a premium receipt.

Filing Claims: You should furnish your insurance company with written notice of a claim within 20 days or as soon as possible after an accident or illness. You also should notify your agent that you have a claim. Make sure all claim forms are filled out accurately and completely.

Ask your doctor to fill out the proper portion of the form or leave your insurance information with the hospital and ask them to complete the claim form. In some instances you may be asked to assign your benefits to the hospital, doctor or other provider. This means benefits will not be paid to you, but will be paid directly to the provider. Following these instructions will help speed the payment process.