Question

1. The clinic's patient has been diagnosed with non-Hodakin's lymphoma (diffuse large B-cell lymphoma) in stage 3. Surgery and aggressive chemotherapy are in process. The patient has Medicare and a small Medigap policy. You know there are expenses coming soon that nei- ther insurance will cover. What can you suggest? 2. This patient has been with the clinic for 11 years and was covered most of the time by! excellent private insurance. The circumstances have changed, however. Today the patient works part time, has only Medicaid insurance, and has very few private funds. The provider's diagnosis is severe depression, and the provider instructs the patient to make two appoint- ments weekly until the medication prescribed begins to make a significant difference in this patient's life. You know there are severe limitations to reimbursement from the state regarding this diagnosis. What steps will you take?

Answer 1

1. Ask the doctor's office to send a letter to your insurance company that explains why you need or needed the treatment. Make sure it goes to the address listed in your plan's appeals process.

2. He can claim reimbursement of medical expenses by submitting the original bills to the employer. The employer would accordingly reimburse such expenses incurred subject to the overall limit of Rs 15,000 without tax deduction