Browse all the Lawforwa Resources on Health

Resource Description:

Questions answered by the resource:

What to do if You Have Problems Connected with Health Care
http://www.abanet.org/publiced/practical/health/pr
Source: American Bar Association

General guidance on what people can do if they have problems with the care they receive under health plans. Topics covered include: what to do if the plan refuses to cover treatment; whether people have a claim if the plan does not live up to promises in a brochure; whether people can recover from a plan for a doctor's mistake; and whether people can recover from a plan for negligence. Also includes definitions to several terms which relate to claims against health plans, including respondent superior, apparent authority, and corporate negligence liability.
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• If my health plan denies my claim for benefits, what should I do?
• Can I sue or recover damages from my health plan if my doctor made a mistake?
• Can I sue or recover damages from my health plan for negligence?

Washington DSHS Forms (Including Forms Relating to Medical Assistance)
http://www1.dshs.wa.gov/basicneeds/#med
Source: Washington State Department of Social and Health Services

Links to online forms for people who are applying for or appealing decisions regarding medical assistance. Forms include applications and a request for a fair hearing.
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• How can I apply for medical assistance/public health benefits in Washington?
• Where can I get DSHS forms?

Health Insurance: Patient's Bill of Rights Index
http://www.insurance.wa.gov/archives/pbor/pbor.sht
Source: Washington State Insurance Commissioner

Describes Washington's Patient Bill of Rights, which includes rights relating to privacy, disclosure of health plan benefits and exclusions, access to providers, redress for damages for failing to follow accepted standards of care, grievance procedures for denial of claims, and independent third party review of appeals. Includes detailed lists of who is covered and not covered by the Patient Bill of Rights.
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• Who is covered by the Patient Bill of Rights?
• How can I appeal if my health carrier denied coverage for health care services or benefits, and what standards govern the appeal process?
• My health carrier denied my appeal of a decision regarding plan benefits and services - what should I do?
• What information must be provided to me about my health plan?
• What remedies do I have if decisions my health carrier made about my care caused me harm?

Health Insurance Frequently Asked Questions
http://www.insurance.wa.gov/publications/health/he
Source: Washington State Office of the Insurance Commissioner

Common questions and answers about health insurance coverage in Washington. Topics covered include rights upon separation from employment, preexisting conditions, self-funded plans, and the guaranteed ability to obtain individual health insurance in Washington.
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• I had health insurance through my employer, but I no longer work there. When will my coverage terminate?
• Can I continue my health insurance coverage through COBRA?
• Is my employer's "self-funded" health insurance plan exempt from some state insurance laws?
• How do I appeal denial of a claim under a self-funded health insurance plan?
• Can my new employer's health plan deny me coverage because of a preexisting condition?
• Can my health plan exclude or limit coverage for preexisting conditions?
• My primary care physician won't refer me to the specialist I need. What are my rights?
• Do I have guaranteed access to health insurance in Washington?
• Can a participating provider in my managed care program charge me more than the company allows?

Insurance Factsheet: Options in the Individual Market
http://www.insurance.wa.gov/publications/index.sht
Source: Washington State Insurance Commissioner

Overview of issues consumers should consider when purchasing health insurance in Washington. Topics covered include: determining insurance needs, the three different types of health insurance in Washington, including health maintenance organizations (HMOs), health care service contractors (HCSCs), and commercial insurance companies, health screening, the individual market, and the Washington State Health Insurance Pool, managed care, and insurance agents. Also includes a list of precautions consumers should take when buying health insurance, and a list of some of the major health insurance companies in Washington.
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• How do I choose a health insurance company and policy?
• Can health insurance companies turn me down because of preexisting conditions?
• I am having trouble finding health insurance because of preexisting conditions. What should I do?
• I am looking for health insurance. What do I need to know to find the coverage I need and protect my rights?