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DISCLAIMER: This is a brief overview and a starting point. Please do your due diligence going forward — this is only what I have learned.
You Paid For It--Take Full Advantage of Your Health Insurance
Read the policy and clarify all the details with a representative.
Understand your responsibilities for copays and coinsurance for various procedures & items,
Understand in-network and out-of-network differences and potential out-of-pocket expenses.
Insist providers adhere to your insurance company's requirements and stipulations.
Collaborate with a representative at each facility to find the best options in your plan's network.
For Example: We needed to arrange for an ambulance to transport Matt across state lines from Pennsylvania to to an inpatient rehab hospital in New York close to to our home. Initially, the social worker thought we would incur a $2,000 expense. With persistence, she found an ambulance provider in-network at no cost.
Cross-reference hospital and other medical bills against insurance statements for accuracy.
SHORT-TERM DISABILITY INSURANCE
Short-term disability insurance is intended to cover you for a short period of time following an illness or injury that keeps you out of work.
Check your policy for details.
Long-Term Disability Insurance (LTD)
Permanent disability (PD) is any lasting disability from your work injury or illness that affects your ability to earn a living.
Long-term disability insurance covers you by replacing your income while you're not able to work.
Read the policy and clarify all the details with a representative.
In particular, how would employment impact your short-term and long-range financial situations?
Many plans offer Return to Work Incentives to encourage you to rejoin the workforce.
For Example, Matt's Policy:
For the first year, if the sum of Matt's LTD benefit + his Work Earnings is less than what he was making as a professor prior to his injury, he will continue to receive his full LTD amount in addition to his paycheck.
Thereafter, the incentive amount decreases, but minimally, he would receive $470/month until he is no longer deemed disabled.
180-Day Window: If Matt can't perform his job adequately and is let go, he has 180 days to apply, requesting his benefits be reinstated.
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