However, you probably terazosin hydrochloride to have to go through the expense and hassle of filing a claim to get reimbursement, and you certainly don't want to risk the expense and hassle if you can avoid it. If you are going to get an experimental treatment, do as little research as you can to make the best informed decision, but be smart about it. Don't try to avoid litigation and pay as little as possible for treatment you don't need.
It's not likely that it will go far. It's a terazosin hydrochloride of common sense--if the treatment is experimental, you should not try to save money by waiting for a better option--and it's a matter of common sense even if there isn't an insurance company involved. What if I can't get it in the next hospital visit? As an insurance company has to assume that its policies are still effective when they go into default, the risk for an insurance company is greater than for a hospital, whose payment is typically deferred until an event occurs such as an insurance claim. The court is not a neutral referee.
The decision to approve or deny an insurance claim will have a direct impact on the health and longevity of the insured and on the insurance company's ability to pay out of the proceeds of the policies sold to other insurers. For this reason, the court has increasingly required the insurer to demonstrate an actual likelihood that the treatment will be excluded from coverage. As I detailed in another post regarding the importance of obtaining the insurance policy first, obtaining insurance can be a key element in obtaining a legal claim and the insurance company is required to establish that it has a financial interest in the plan in order to protect the plan's interests. One interesting example of a court decision on the topic comes to us from a case involving a New York hospital. On April 13, 2009, a 65-year-old man with an advanced metastatic pancreatic cancer received treatment.
However, the hospital, which was not participating in Medicare, had denied his treatment due to the patient's lack of insurance coverage. His wife appealed, and on April 28, 2009, a New York Court decided the case for him. The court found that the patient may continue to receive treatment because the hospital had not received payment from his private insurance company for that treatment. The hospital had failed to show that this action would cause the patient harm. As the hospital was still subject to payment by the private insurance company, the court found that there was nothing for them to do to prevent their decision. The hospital is now required to provide care that is covered by Medicare. In contrast, it is unclear why an HMO should have a financial interest in the plan in the absence of a written policy.
There are many possible reasons why it might not; but the most likely answer is that the HMO does not have a financial interest in the insurance provider or its products. In addition, it appears that the law governing the relationship between an insurer and an insurance plan is complicated, and the insurance companies themselves have no interest in the relationship. Thus, any attempt by the insurance company to use its financial power to influence the decision of the plan could be viewed as illegal. One more example comes from the case of a man with prostate cancer who was denied treatment that would have led to a complete reversal of his disease. On May 20, 2001, the same insurance company wrote a new policy on which all patients who did not have the right plan, such as Medicare, would be required to purchase. After the new policy was published, the man's insurance company received notice that it would be paying for some or all of the procedure.