Insurance
Health Insurance – You Can’t Afford Not to Have It!
May 23, 2010 | 
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In today’s world of rocky finances and unemployment, health insurance is something that a lot of people get rid of to save a few dollars. Health insurance premiums are expensive, but so is health care. Do you really think that dropping your coverage is the wisest thing to do?
No one wants to get sick or have an accident, but unfortunately life is unpredictable. You could find out you have cancer or your son could break his arm playing ball. If you have dropped your health insurance plan to save money, how do you plan to pay the medical bills?
Health care costs are on the rise with no sign of slowing down. A simple office visit can cost a minimum of $100 and any tests will be additional. And this is just for basic care. If you have a serious illness or an accident the costs could skyrocket into the tens of thousands or even more. If a family member needs to be airlifted to a bigger hospital, plan on a base cost of $10,000. Can you cover these costs without health insurance?
It is possible to find health coverage that doesn’t break the bank. If you are considering dropping your healthcare coverage to save money, here are a few things to think about that might make you reconsider.
Raise your deductible – By raising the out of pocket deductible on your insurance you can cut your premium costs. However, only raise the deductible to an amount you know you can afford. Then put the amount of the deductible in a savings account so it is there when you need it.
Shop around – Unless you are on a plan where your company picks up a portion of the premium, consider shopping around for better rates. You may be surprised what an independent insurance agent can offer you. You may find a better policy than the one you are leaving behind with a better rate too!
Request a review – You should meet with your insurance agent once a year to go over your insurance needs. If you don’t do this, you may find that you are paying for services you may not need. If your policy is through your employer, check to make sure everything is correct there as well. Many people find that they are still carrying children who have married or an ex-spouse on their health insurance. You have to notify your employer or insurance company when major life changes occur.
There are ways to reduce your health insurance costs. With the high cost of health care, you will be smart to keep your health coverage so you are covered in case of an emergency.
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Health Insurance – The Most Common Plans in the United States
Health insurance is the primary means people use to pay for medical care in the United States. In exchange for paying a provider a set of fees, an individual receives coverage for doctor’s visits, hospitals stays and prescription drugs. In the end, they save thousands of dollars, since they are not responsible for the majority of their medical expenses. Of course, the exact amount a person pays will depend on the type of healthcare plan they have. In the United States, the most popular ones will fall into one of three categories: group insurance, managed care and national insurance.
Most people will end up using group health insurance. With this type of healthcare, a person signs up for a plan through their employer. Acceptance is almost always guaranteed, thanks to HIPAA laws. Even if an employee has a preexisting condition, if they have been working at a company past their probationary period, they are eligible for the insurance. This is assuming their employer even has such a policy. If an employer does not have a waiting period, an individual can sign up for the insurance immediately. In addition, since most of the fees are taken out with each paycheck, employees do not have to worry about budgeting for their healthcare expenses. Under the best plans, they only have to worry about a small co-pay.
However, if a group plan is provided through a managed care network, things work a little differently. This is a type of health insurance where providers work with a specific network of doctors, clinics and hospitals. In an HMO managed care plan, a person must stick with one particular provider in their network. If a person goes to a doctor outside of that network, they will not receive coverage. This works in contrast to the PPO, another type of managed care plan. While PPOs still have a specific list of providers, a person is not restricted to them. Should they stray from the list, they will receive partial coverage for their care. Either way, both HMOs and PPOs tend to have higher deductibles and out-of-pocket expenses than group plans. But on the plus side, for self-employed individuals, these networks do offer individual coverage.
Finally, there is national health insurance, a body of plans provided through the United States government. Medicare and Medicaid are the most well-known. Medicare provides coverage to anyone over 65, while Medicaid grants insurance to disadvantaged groups. Lesser-known plans include Tricare, COBRA and high-risk insurances.
Tricare is designed for military personnel while COBRA temporarily covers people who have lost their jobs. Then there are high-risk insurances, which are designed to help people with pre-existing conditions. They offer a more affordable alternative, at least in comparison to what one might find among managed care plans.
If you need assistance in locating particular coverages at a pre-determined price, we can help you find a reduce health insurance premium today.
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Health Insurance – Terms Used
Health insurance is the adding up of some amount of money with a private or public organisation in order to meet uncertain future medical problems. People usually have to pay a small amount either monthly or annually and can avail a health insurance.
Elder Chamberlen was the first to introduce this concept in 1694. It was followed by accident insurance in the 19th century. In the US it was first offered by Franklin Health Assurance Company, in 1850. By 1856, sixty organisations were providing accident insurance.
Health insurance is basically a transaction deal set between an organisation providing health insurance and a person willing to avail such a service. The terms and conditions are first laid down to the person, then accordingly the type of insurance and policy selected. It is important that the policy holder must pay his premium or other dues on time.
Some of the common words used in insurance are:
Premium- it is the amount that the policy holder pays annually or monthly to the health insurance organisation.
Deductible- it is the minimum amount that the insured person needs to pay per year before the insurance company pays.
Co-payment- it is the minimum amount that must be paid each time along with the payment that the insurance company does.
Coinsurance- it is the percentage of the total cost that the policy holder must also pay along with the insurance company. For example 10% of the total treatment cost is paid by the policy holder, the rest 90% is taken care of by the insurance company.
Exclusions- certain services may not be insured for, the the policy holder would have to pay the full amount. For example, the insurance company would not pay if the policy holder needs to get a hair implant surgery done.
Coverage limits- this is the maximum amount of money that the insurance company pays. Any expenses exceeding this would have to be borne by the insured person himself.
Out of pocket maximus- this is the maximum amount of money, the insured person has to pay. Amount exceeding this is to be paid by the health insurance company.
Capitation- it is an amount paid by the policy holder for which the organisation provides insurance for his members usually family or business.
In Network provider- these provide discounted coinsurance or copayment to a plan member
Prior authorization- it is a certificate that is provided by an insurer prior to a medical occurring
Explanation of benefits- this is a statement provided by the insurer explaining the payment policy and procedure of the medical service.
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Health Insurance
Health policies can be divided into individual as well as group health coverage.
While an individual policy is purchased by the insured directly with the insurance company, in a group health insurance policy, the group is the master insured and the insurance company contracts with the group. Each member gets an insurance certificate which acts as the policy. Often group health insurance is less expensive than individual policies. Additionally it may also contain certain special coverage which may have been too costly for individuals.
Employer’s Insurance – Million of people obtain their insurance through employment. After meeting certain criteria, the employee is eligible to be covered under the employer’s group insurance policy. Medical insurance is also a common benefit of such a policy. The employer’s insurance policy and coverage may vary with different organizations.
Individual Insurance – Some major health insurance companies offer a broad range of coverage and options to individuals, who pay directly for the cost of the insurance. Many insurance companies require a medical examination and comprehensive details before offering coverage to the individual.
Government Sponsored Insurance – Some state governments offer affordable health insurance benefits to their residents based on their income. These plans are designed for the poorer individuals who are employed but no health care coverage is available where they work. It allows the state to protect its residents from calamitous loss due to illness, disease or accident without placing an additional burden upon its program for the extremely poor and underprivileged.
Association Sponsored Insurance – There are some health insurance benefits available to people belonging to a group or organization by virtue of membership.
Primary and Secondary Coverage
Many people have medical insurance from more than one insurance plan. To prevent double recovery or the insured making profit out of the insurance plan, the insurance company make provisions to determine how primary versus secondary coverage will be determined. Primary coverage is provided through an insurance plan of which the insured is a member or the plan under which the member has been a participant for a long duration. Secondary coverage, usually as a result of being covered as a dependent under someone else’s health insurance plan, provides reimbursement for medical expenses after exhaustion of coverage available through the primary plan.
There are several types of policies sold by insurance companies to individuals. Some of the common insurance plans include:
Major Medical Expenses
Hospital and Surgery
Hospital Confinement Indemnity
Health Maintenance Organizations (HMO) Specified Diseases
Short Term and Long Term Care
Accident Only Policy
Dental
Vision
Home-Health Care
Limited Benefit
The different types of group health coverage include:
Fully Insured Employer Group
Small Employer Group
Large Employer Group
Health Maintenance Organization (HMO)
Self-Funded ERISA
Association Group
Group Managed Care
Preferred Provider Organization
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Health Insurance – Secrets to Affordable Health Insurance
When you are seeking affordable health insurance, you want to make sure that you have great coverage at an affordable monthly payment. Here are 5 secrets that can help you save money by making your health insurance and overall healthcare costs more affordable.
1. Get a discount health plan. The way this works is simple – you pay a little every month to get 20-40% discounts on the services you are provided when they are needed. Physicians within a discount health plan network have negotiated lower prices for office visits, checkups, and other medical procedures. So for example, if you have a medical procedure that costs $500, you will only have to come out of pocket for $300-400.
2. Start a Health Savings Account. A health or medical savings account (MSA) works like a bank account allotted to take care or medical expenses. First, you choose a healthcare plan with a very high deductible. This can range from $1700 to $2650 for an individual and $3500 to $5250 for a family. With a health savings account, you or your employer can deposit up to 75% percent of your deductible amount into it. The funds are held by a bank or your insurer and this money is free of income tax. Whenever you have a medical expense, your MSA can take care of your deductible. Your MSA can also be used to cover expenses that would not usually be covered by your insurance plan, like cosmetic procedures for instance. This account can be carried over between employers and can collect interest over time. It is important to note that this money can be used for non-medical expenses, however if it is, you will have to pay tax on it.
3. Drop maternity coverage. If you are not of child bearing age, or do not plan on having children at all, you may want to consider dropping your maternity coverage. Some plans do have an insurance rider that you can add on should you become pregnant, but it is not necessary to have that coverage in your plan the entire time. Maternity coverage can cost an additional $2500 a year so if you do not foresee a pregnancy happening, you could drop this coverage to save some money.
4. Check with your church. If you are a part of a congregation and there are several of you that are uninsured, you and your church members may be eligible for a group healthcare plan. The advantage is that most times group healthcare plans are cheaper than individual plans. You may find that you are not only helping yourself save money with a group plan, but other uninsured individuals just like you that are in need of affordable health insurance can save money too.
5. Use the power of the Internet. In our technology age, the world is literally at your fingertips. You should not have to settle for any insurance plan that does not meet your needs completely. Affordable health insurance plans are out there, and many plans can be customized to fit your life and lifestyle. There are websites ready to give you personalized quotes that you can compare for the best rate. Do not feel rushed or pressured into choosing something that is not right for you.
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Health Insurance – Unwrapping Cost Savings Options
One of the most challenging expenses that families and individuals face nowadays is the skyrocketing cost of health insurance. With health care costs rising at an unprecedented rate, and more personal bankruptcies caused by health care costs than any other factor, coverage is more expensive and more important than ever. Not only is there considerable uncertainty regarding the future of health insurance in America, there is also considerable confusion about health plans, how they work, and how to save on premiums in order to keep coverage more affordable.
Most people acquire health insurance as a benefit through their employer, or their spouse’s employer. However, these numbers are dwindling as more employers either lay people off or drop coverage as a cost-saving measure. For those that purchase their insurance individually (meaning that they are not part of a group), shopping around is a great way to find the lowest premiums. Although the process can be cumbersome, online shopping has made it somewhat easier. One little known trick that the individually insured can use is to check premium rates every once in awhile. If rates ever decrease due to economic situations such as deflation, a person who is insured individually can take advantage of these lower rates.
An increasingly popular way to save on health insurance premiums is to use a non-traditional health plan. High-deductible plans that are eligible for health savings account use are becoming increasingly popular. Under these plans, a person’s deductible and out-of-pocket maximum are usually considerably higher than other plans, but the premiums offer substantial savings. Those who use these plans are also eligible to save for the increased costs through a tax-favored account known as a health savings account. Most health savings accounts are quite simple to use, and are much less cumbersome than their tax-favored cousins for use with traditional plans, flex spending accounts.
Another way to save money on health insurance premiums is to use an indemnity plan instead of a traditional plans. These plans offer varying levels of reimbursement for various services, or will offer coverage for a certain number of days or visits. While these plans are limited in what they cover, most carry a catastrophic event provision, and the premium costs are significantly lower. For young and mostly healthy people, the plans offer major risk coverage at a greatly reduced premium rate.
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Health Insurance – Comparing Health Insurance in Ireland
Irish health insurance premiums have risen by up to 45% in 2011. In March, VHI announced an average policy increase of 15% and up to 45% in some cases. Quinn healthcare also announced an increase for those renewing policies, with premiums to rise by up to 25%. While Aviva increased its premiums by 14%, which sees the cost of its most popular plan rise from €825 to €941.
The reasons for these premium rises are the costs of private beds in public hospitals, medical inflation which is running at 9% and the government imposed health insurance levy.
Customers are advised to shop around to find a better deal. A policy does not have to be expired before searching for a new policy. When somebody switches to a new, an older policy can be cancelled and the period not used has to be fully refunded. While more than 50% of the population in Ireland have health insurance, it is only a legal requirement for students from outside the EU. All people “ordinarily resident” in Ireland are entitled to basic healthcare in hospitals, but have to pay a daily charge of €75 in public hospitals.
A visit to the emergency department costs €100, however, if referred by a doctor, there is no charge. Typically a visit to a doctor costs €60.
The government provides a “medical cards” to people on low income, this card exempts holders from charges, both in hospitals and doctor visits.
Also available from all the companies are what are known as “group schemes”. These are policies aimed at companies and a group discount is applied. Under Irish law, every consumer has to be allowed buy any available policy. So, if a consumer applies for an individual policy, they are advised to ask for the price for that policy as a “group scheme”. The insurance company has to offer the group discount. This will lead to an immediate saving of approximately 10%.
Comparing the various policies on offer can be confusing. In general, the cheaper policies allow for a private bed in a public hospital. More expensive polices give a private bed in a private hospital. The more expensive the policy, the shorter waiting time for tests or treatments. Some policies also have an excess ( this is the amount of money that the customer must pay and will not be able to claim from the insurance company).
Compare4me.ie provide a live search of all available insurance products available. Simply fill in the form at see your quotes at http://www.compare4me.ie/insurance/compare-health-insurance/
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Health Insurance!
Taking a good health insurance policy is very crucial for maintaining a security for your life. It is an instrument that takes care of your all your health related needs in exchange of a reasonable premium every year. Earlier, it was indeed very difficult to find a crucial solution for all your health needs. However, with the increasing use of internet technology, you can find a good insurance policy within a few clicks. Choose a solution that helps you do adequate health checkups and treatments that generally would be impossible for you to avail due to heavy costs. Nowadays, it is very much easy for you to find a health insurance for meeting your tedious tasks.
Top three reasons for comparing the best health insurance plan:
1. Compare the quotes provided by different health companies. Get the best reason to find your reasonable policy on your terms. You should not take the policy that charges high premium rates for meeting your needs. Compare quotes and try to figure out the best option among all.
2. Choose a policy with best benefits. You can find so many options and added values. However, among all, you need to pick the best that meets all your needs with a single premium rate. At times, you can combine your needs into under one umbrella to avail the best.
3. Comparing policies is all about time saving. You can find advisers who can guide you the best option to get the one that meets your demands fully. Choose the best and stay happy forever!
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Health Insurance – How to Find a Doctor Covered by Your Policy
If you are currently covered by health insurance, or are investigating new health insurance options available to you, it is always vital to know whether your physician and hospital will accept the coverage you have or will be purchasing in the future. This is important for a number of reasons, primarily to ensure that when medical services are rendered, you will not receive reduced coverage by your health insurer, or even be required to pay the full out-of-pocket cost to a non-network provider. If you have a PPO plan (Preferred Provider Organization) type policy, but it does not cover certain types of medical procedures, or perhaps you were ridered (i.e., the plan declined pre-existing conditions coverage for a period of time), you may still at the very least qualify for network repricing, or lowering of the charges to reduced rates, if your provider does in fact accept that particular plan’s PPO network.
There is no substitute for doing a little research by reading your policy carefully and asking a good health insurance agent or broker which doctors or physician networks will accept the plan. While it is permissible to call your doctor’s office to find out if they will accept a certain plan, this is not always reliable as oftentimes the doctor’s office may not be familiar with every carriers’ plan offerings. For example, if you were to call in to your physician’s office and mention to the billing staff that you are going to be changing to Aetna health insurance, they may readily state that they are happy to accept Aetna’s plans, but in reality they may accept MOST but not necessary ALL of Aetna’s plan offerings. And so one might be unpleasantly surprised after purchasing the coverage that it is not going to be quite so acceptable after all.
A good way to ensure that this does NOT happen to you is to find out exactly which type of coverage you are considering, and more specifically, the plan’s exact name. Then you may refer to the carrier’s website where you can check to see if your physician is in the provider directory for that particular plan. An online provider directory is usually superior to a printed booklet directory in that the information is generally current and the provider list is updated frequently to reflect the providers recently joining the network, as well as to exclude providers who have recently left the network.
In some cases, especially when you have group health insurance through an employer, the carrier covering you may contract with a large independent national PPO network to provide its repricing and negotiation services. Usually this network will be shown somewhere on your health insurance ID card. In that case you may need to look up providers at that organization’s website. An example of a large national network that numerous reputable insurance companies often contract with is Multiplan. The provider directory in this instance could be found at Multiplan.com.
A question you might ask yourself in the event that you have found a plan that you would like to purchase but your doctor does not accept it is: are you willing to change providers? If you are not necessarily joined at the hip with your primary care physician or specialist, and are willing to change to other suitable providers of varying specialties that are in the plan’s network, then you may feel that it could still be a wise decision to purchase the new coverage. Or you may decide that even if the provider does not take the insurance, you will just pay that provider directly without regard to the insurance, and simply utilize your coverage for the event that a more catastrophic medical situation arises.
One other option is to purchase supplemental indemnity coverage, which can reimburse you directly a stated benefit amount for many types of medical procedures, including office visits. A big advantage to this approach is that the plan will usually reimburse you for ANY licensed physician that you choose to visit without limiting you to a certain list of doctors. This supplemental coverage may also help cover any deductibles or coinsurance that your primary health insurance plan may require you to pay.
Also if you are considering applying for medically underwritten insurance, be aware there is a chance you might be declined due to preexisting conditions. In that event you may want to explore certain guaranteed acceptance health insurance options. Again the suggestions of a good health insurance agent or broker, in addition to your own research and the advice of other friends and family members who have experience in this area may be helpful.
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Applying for Health Insurance
Applying for health insurance is easy enough once you have all the relevant information on hand. A little bit of research will give you all the required details like comparative prices of the various benefits available by the different health insurance agencies. Application can be done on or off line or even through group plans. Keep handy your documents regarding the latest policy, contact details of your doctors and details of the most recent checkup/visits as this would need to go into your application form.
Now if you are applying through your employer or enrolling as per company policies, you have to wait till the company’s open enrollment period comes up and the application process can begin but if you are a new recruit then it generally happens that most companies enroll everyone without checking for pre-existing conditions and present state of health etc.
The enrollment form would require details like social security numbers, addresses, and all relevant personal details of dependants like names, ages, date of birth and their social security numbers along with the designation of the primary insured, date of employment, type of health cover wanted etc. They would also need information about any earlier health insurance that you may have had along with the insurance company name and policy number. Generally a medical examination is not required and finally the application goes on to the benefits coordinator who completes the processing of your form.
If you are planning to apply for health insurance on your own, the process is fairly similar except that you may not have someone doing the actual processing of the paperwork. Most agencies send an agent to initiate a dialogue about the application process, help gather all the relevant information, co-ordinate medical examinations if any and collect the pre-payment amount. You need to be aware of the different policies and make an informed choice and the application process is quite easy.
In fact the very simplicity of it encourages people to apply online. Applications are available on a secure environment for many health insurance companies, fill in all the relevant details and submit it and the system does the rest. Again be aware of the various policies and be very clear as to what coverage you are looking for. But if you are uncomfortable with putting all your personal information on the Internet, then stick to the conventional method. Call for an agent and ensure that the entire deal is transparent and clearly understood by you. When it comes to paid insurance one can never be too cautious. It pays to do your research and make an informed decision.
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Posted in Insurance | Tags: Health Cover, Health Insurance, New Recruit, Open Enrollment Period, Simpl, Social Security Numbers | No Comments »