For My Dad's Insurance and Treatments

[geercom]

Hi

My Dad has been diagnosed with esophagus cancer. He has Humana and was referred by his doctor to the one that found it. Then that doctor referred him to other specialists for tests and consultations.

With the Humana PPO coverage, he has never had to file special forms etc with Humana in order to have things covered. I am just wondering whether this will be the same?

 

[Yagents]

Hi

My Dad has been diagnosed with esophagus cancer. He has Humana and was referred by his doctor to the one that found it. Then that doctor referred him to other specialists for tests and consultations.

With the Humana PPO coverage, he has never had to file special forms etc with Humana in order to have things covered. I am just wondering whether this will be the same?

It's obviously medically necessary, and should be covered, unless there were prior riders/exclusions placed on the policy for that condition, and only if it was a Pre-ACA plan. If post ACA plan (obamacare) with effective date of 1/1/14 or after, there are no exclusions, and it will be covered.

Just be sure all providers he sees are in the PPO network (your responsibility, not the referring doctors'), have those specialists/providers send a claim into Humana, then you should receive an EOB (explanation of benefits), that will show a reduced network price, and they will put it towards the deductible/copays, and then send you a bill if anything remaining is due.

Does that answer your question?