Under The Coverage
We talk to people who work behind the scenes but are also consumers of healthcare. We ask them what they know now that they wish every healthcare consumer knew. Find us on Twitter @UndrTheCoverage or send us a question to podcast@novahealthcare.com
Episodes
September 16, 2025 • 8 mins
If you or your spouse are the subscriber for your health insurance, you’ll be hearing from your HR team to remind you about open enrollment. There are certain life changes that allow you to modify enrollment if you are outside of the golden window of open enrollment. If you want a deeper dive, Carey joined us a while back to talk about aging off of your parent's benefit plan https://www.youtube.com/watch?v=T3xP8x5zjBw&list=PL78gef...
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November 13, 2024 • 24 mins
🚑 Ever wondered why a quick trip to the ER or a ride in an ambulance can lead to a shocking bill in your mailbox? In this episode, we break down everything you need to know about emergency services and the costs that come with them. From understanding when to dial 911, to the hidden fees that could catch you off guard, we’ve got you covered. We’ll also dive into the No Surprises Act—what it protects you from, and where it falls sh...
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November 6, 2024 • 22 mins
đź©şEver been faced with a scary, serious health situation and felt overwhelmed and unsure of where to turn for help? In this moving episode, we hear from Allison, a former patient whose life was profoundly impacted by the care and support provided by one of Nova's case management nurses. Allison recounts her journey, starting from the surprise of learning she was pregnant with twins to navigating a complicated pregnancy, serious he...
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October 30, 2024 • 14 mins
đź©ş Ready to take control of your health? Join Jolene and Sara for a quick, fun, acronym-filled dive into the world of preventive services, zero dollar copays and the ACIF and USPSTF! In this short episode, you'll learn why preventive care is essential and how the Affordable Care Act (ACA) guides your zero copay benefits.
We'll cover:
- Who is the USPSTF and the ACIP?
- What’s considered preventive
- Key screenings, counseling,...
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October 23, 2024 • 11 mins
đź’¸ Ever wonder why your medical benefits cost an arm and a leg? Join Jolene and Sara in this short and lively episode as they dive into the reasons behind the high price tags on insurance premiums in the United States.
This episode unpacks:
• The average annual cost of coverage in the United States.
• The pros and cons of cutting-edge treatments and pricey new drugs.
• The role of chronic diseases and an aging population in drivin...
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October 16, 2024 • 18 mins
Have you ever had a service reviewed or denied by your insurance with the explanation that it wasn’t “medically necessary”?
Join us as our medical management team helps us understand what medical necessity really means. We’ll explore:
• When something is reviewed for medical necessity
• Real-life examples
• Appeals process
• Practical advice for navigating this complex part of health insurance.
Tune in and empower yourself with ...
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October 9, 2024 • 20 mins
🏥 Whether it’s you or a loved one in the hospital you know that going home is a great relief, but it can also be worrisome. It can be a challenge to absorb and remember all the notes you get before discharge. You can call the doctor’s office, but you might also get a phone call from a nurse at your insurance company. Have you ever wondered why they’re calling? Jolene and Sara are here to uncover the secrets with two industry exper...
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October 2, 2024 • 14 mins
🏥 Ever wonder what exactly counts as Durable Medical Equipment (DME), a prosthetic, or an appliance? Join Jolene and Sara in this quick and lively episode as they team up with registered nurses Lorene and Stefanie to demystify these categories of medical devices.
Our expert panel will break down the key differences, helping you understand what your plan covers and how to navigate your healthcare options like a pro.
🔑 Episode Hi...
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September 25, 2024 • 13 mins
Ever felt like navigating your health insurance is like solving a riddle wrapped in a mystery? Fear not, dear listener! In this action-packed 10-minute episode, we're here to demystify the world of out-of-network benefits.
Join us as we unveil the secrets to discovering if you have out-of-network benefits and how to use them like a pro. Whether you’re planning a trip, switching doctors, or just want to be prepared for the unexpec...
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September 18, 2024 • 17 mins
Leaving a job often means losing your employer-sponsored health insurance. But, COBRA, the Consolidated Omnibus Budget Reconciliation Act, can be your lifeline during this transition.
COBRA allows you to temporarily continue your health coverage. It's like a bridge that helps you cross the gap between jobs without losing the benefit plan you have.
In this episode, we'll dive into the world of COBRA, covering eligibility, enroll...
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September 10, 2024 • 10 mins
✨ No one grows up dreaming of working in insurance, but let's face it—knowing the ins and outs can be a game-changer! Join industry veterans Jolene and Sara for a whirlwind tour through the surprisingly fascinating world of insurance lingo.
With over a decade of experience each, Jolene and Sara have learned terms that might sound boring but are actually the keys to asking the right questions, saving money, and advocating for themse...
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September 4, 2024 • 11 mins
Ever received an EOB (Explanation of Benefits) from your insurance company and thought, "What even is this?" Spoiler alert: it's not a bill! But it is your crystal ball, giving you a heads-up about any upcoming bills. Join us in this quick, fun, and enlightening episode as we break down the mystery of the EOB. We’ll walk you through the key info it contains, how to read it, and what it means for your wallet.
Episode Highlights:
...
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August 23, 2023 • 9 mins
Understanding health insurance benefits Ugh. Obviously, it’s stressful and we often find out we’re learning at the most vulnerable time – when we or one of our dependents are sick or are not feeling well. There’s nothing worse than trying to make sense of something when you are feeling your worst. Tracey joins the podcast to help us walk through how she has learned to get in front of the problem by understanding what’s not covered ...
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August 16, 2023 • 12 mins
Lower levels of literacy, English as a second language, transitioning to the United States from a foreign country – all of these factors make it increasingly more difficult to understand and use medical benefits. Abby Grainge works as a family nurse practitioner at Jericho Road Community Health Center in Buffalo, NY and is also the medical director of Vive, Jericho Road’s shelter for asylum seekers. She joined the podcast to talk a...
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August 9, 2023 • 15 mins
When you picture a nurse, you might envision a hospital or physician’s office. But nurses also work in a clinical capacity for health plan administrators. Lorene wants the world to know she and her team and other nurses in the industry work hard to walk with members on their journey to better health. In this episode she discusses how nurses work to help members, how they help patients who may face barriers to care, and why she what...
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August 2, 2023 • 12 mins
Congratulations, you’re hired! When you get a job offering health benefits it’s important to understand the basics. Where do you go if you’re sick? How much will it cost? Which physicians and facilities are in-network and what does that even mean? Jerame volunteers for a workplace readiness program where he often addresses health insurance questions. And he has some advice for you...
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July 26, 2023 • 10 mins
If there was a course in high school or college to help us understand how medical benefits work and what the terms mean, maybe we’d be better equipped to navigate health care systems. In this episode, Kyla talks to us about the questions she asks providers to avoid unnecessary cost, seeking the most cost-effective treatments for herself, and how she manages conversations around the cost of prescription drugs.
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July 19, 2023 • 16 mins
When you think of behavioral health and substance use services, you most likely don’t think to call your health insurance company. Here’s a secret: You can. And you should! Did you know there is a team of people working at your health insurance company who can help link you to in-network resources if you’re in need of mental health guidance and support? Registered Nurses, Corrine and Molly share insights on the processes put in pla...
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July 12, 2023 • 14 mins
Helping people become healthy and well is one of Steph’s passions. We second that, which is why we invited him to join us to discuss his background story and shed light on how important it is to utilize your benefits properly. At the end of the day, you’re paying for these services. Leveraging experience and advocacy can positively impact your health outcomes. Listen up!
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June 28, 2023 • 9 mins
High deductible health plans with health savings accounts can feel overwhelming. On one hand, the plan cost is usually less than that of a traditional copay plan but then you remember you may have to lay out a lot of money up front before your plan’s copays kick in. Jenelle shares how she started building funds in her HSA a little at a time over time and how she thinks about health care expenses.
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