Maximum or Catastrophic Health Coverage
June 6, 2008 on 4:41 am | In Health Insurance | No CommentsI’ve heard it said that hospitals have to treat you whether you have insurance or not. That’s not true. An emergency room has a legal obligation to stabilize you and that’s all. Having an insurance card can make the difference between life and death.
That being said, I’d like to devote the rest of this article to exploring the question of whether one should purchase the most comprehensive health care policy or purchase only cheaper catastrophic coverage. There is an valid argument supporting each position.
Because of the nature of our system, insurance companies will continue to raise your rates until they have priced themselves out of your budget and are forced into either joining the nation’s 47 million uninsured, or back into the market to shop for a new company.
It’s been speculated that insurance companies do this because they have determined statistically that you are more likely to use your policy after a certain number of years with them then you would have in the initial time of coverage.. Whether or not that’s true is open for debate. Whether or not they will continuously raise your rates, is not. They will
If they raise your rates to the point where you can not afford to insure with them any longer and the rates for other companies seem appealing, be aware that if you have used your insurance for any major health condition, from heart problems to cancer, to even depression, you may not be insurable with another company. You may not be able to switch to another company no matter how much your present insurer may increase its rates.
If you choose to make your initial purchase based on price, with perhaps a high deductible, co-payments, or minimal coverage, you may be stuck with this forever. Quite a few people who chose basic coverage over comprehensive coverage, have found, to their chagrin, that having once used their policy, that they have fewer options.
On the other hand, just having insurance, however minimal, is far better than having none at all. If you can show an insurance card, to any doctor or hospital, you will find, if it’s within “network”, that you’ll be given a substantial discount, and in most cases, offered services, and billed later.
This author had been paying an exorbitant amount of money for health insurance. When the last increase letter was received I switched to a catastrophic only policy. In doing so I saved close to $800 a month. Several months into my new policy I had need of serious medical care. I spent two days in the hospital for which I was build $17,000. Before the claim was submitted to my insurance company the hospital and doctors involved (about 20 of them) all applied my network discount. My final bill, from all 20 combined was reduced to just over $2000. The insurance company with which I had a $5,000 deductible, paid nothing. I paid to $2000 and in so doing was already better off, after less than three months, than had I continued to pay on the more comprehensive policy.
Whether it’s best to purchase the best coverage, or only the least expensive, catastrophic-only coverage, is up for debate. What is not up for debate what is immutable fact, is that in America in the 21st century you must have health insurance of some kind.
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Jeff Wild is an independent health insurance agent and a representative of some of the highest rated insurers in the United States. His Web Site, Simple Health Coverage was created to educate, inform and connect consumers with the best carriers, policies agents and choices in their geographic area.
Health Insurance Hopping
June 6, 2008 on 4:32 am | In Health Insurance | No CommentsAs the cost of your health insurance keeps rising, before you consider canceling and joining the 47 million Americans who uninsured, consider just changing carriers.
Health insurance companies calculate financial risk by determining who is most likely to actually use their services and costs them money. They have found that you are more likely to use their services after you’ve had them for many years then and during the initial years. Somehow statistically that makes sense. As a result your insurance policy continues to raise an average of 15% per year. It has less to do with your history, or even your age than it has to do with how long you’ve been insured with that company
The way to deal with this situation is to change policies to change companies every few years. Many insurance agents I know make their living helping people doing this. It helps the agent earned top commission and it helps the consumer can get better rates.
Before you take this leap however, there are a few things you need to consider, one of which is that if you have developed a condition during the years in which you’ve been insured with one company, that condition may not be covered by the new company, – at least not for a number of years.
Whatever you do, do not cancel your old policy until you’ve acquired a new one, and don’t shop around on your own. Find a reputable broker., or independent agent, one who represents a variety of companies. He or she will be able to tell you, without conflict of interest, if one particular carrier may be better for your particular circumstances than another, or that you might be better off staying with what you have, or even seeing if you can piggyback on your spouses group policy.
There are even ways to save money by having several policies, each covering one aspect of your health needs. Carriers are offering alternatives to comprehensive coverage, some of which are quite creative and may hit your target. On the other hand, some of these alternative methods, though pulling less out-of-pocket in the short run, could lead to greater exposure and less true coverage under certain circumstances. Having a broker you trust, to whom you can address questions, is a very good idea.
The health-insurance industry is in a constant flux. Prices are changing all the time. Coverage is also changing all the time. Research online. Find a website with a quoting engine and spend some time comparing the various prices and coverage available in your area. Then discuss them with your independent agent.
The world of health insurance is complicated and confusing, but do not join the 47 million Americans will be unprotected in an emergency.
The Real Reasons For The Rising Cost of Health Insurance
June 6, 2008 on 4:24 am | In Health Insurance | No CommentsWhy does health insurance cost so much in America? Obviously there are a variety of factors contributing to the ever escalating cost of insuring the average American. The first and foremost is the nature of the system. Health insurance companies, like all business entities, consider the bottom line first. Corporations are, above all, responsible to earn profits for their stockholders. If they can increase profits by raising prices, then they are obligated to do so. This is the nature of our system of capitalism.
While most Americans enjoy and appreciate our capitalist system, many believe that some things do not belong in that game. The most advanced countries have eliminated health-care from their list of entrepreneurial avenues. And whether or not you concur, or disagree, there is no doubt that profit is a contributing factor to the rising cost of health care.
The lack of uniformity is another contributor. Every state has its own set of rules. Every state has its own licensing regulations. In addition rates vary by the area in which you live and the geographic areas in which you wish to be covered.
The absence of preventative medical treatment is also a factor. Consider how many serious ailments might have been averted had they been discovered in the earliest phases. An increased availability of less expensive diagnostic and preventative treatments, could greatly reduce health care costs in America.
The continuously rising costs of health care in itself has led to the increase of health insurance premiums. New treatments, new discoveries, new tools and new regulations have all caused our basic health care ticket to rise dramatically, forcing insurers to increase rates accordingly.
Fraud, litigation, a degrading environment, improper diet, lifestyle choices, and stress are all factors leading to an increase in health care conditions and the rising costs.
We seem to be in an endless circle. The more effective and expensive a treatment, the more people will default on their payments, forcing an increase in the costs for those who are able to pay. As the costs of treatment increases, so does the cost to the insurer and thus the insurance premium. As insurance premiums increase, fewer people are able to afford coverage, resulting in more people defaulting on their medical payments, again leading to further increases in treatment and coverage, and so on and so on and so on.
While it’s easy to exclusively blame the insurance carriers, it would be wrong, for they’re just playing their part in the game. They’re no worse than the officers of any successful corporation. No worse than the oil companies. It’s the nature of the business, not the individual, that has them profiting from suffering. The agents, the general agents, the carriers, the re-insurers are all just doing their part, keeping the ball rolling. If the ball seems to be flat, don’t blame those keeping it in play, repair the hole, or get a new ball.
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Jeff Wild is an independent health insurance agent and a representative of some of the highest rated insurers in the United States. His Web Site, Simple Health Coverage was created to educate, inform and connect consumers with the best carriers, policies agents and choices in their geographic area.
How To Buy Health Insurance Online
June 6, 2008 on 4:20 am | In Health Insurance | No CommentsIt would be wonderful if health insurance policies had some consistency. It would be wonderful if you could just make one phone call and have “ health insurance”, know you’re covered and be able to relax. But that’s not the case in America. There are thousands of policies hundreds of insurance companies and each one is different and each one holds its own little surprises.
Some policies don’t cover doctor visits, while others only partially cover a limited number of visits per year. Some policies won’t pay out dime-one until after you’ve exhausted a high deductible. Some family policies won’t cover one family member until two or more of your family members have exhausted their high deductible.
Some policies won’t cover prescriptions and others will with the co-pay, but only after a separate deductible. Some policies will cover, with a co-pay only the cheapest of prescriptions leaving you on your own for more recent, expensive formulas.
Some policies will make you go through hoops and get permission from a primary physician before you can consult a specialist. Others will partially cover physicians visits, but will not cover any of the procedures, or tests he may require you to take.
Some policies will cover most of your hospital treatment but little or none of your follow-up outpatient treatment, where most of your expenses will be incurred
All policies have limits to what they’re willing to pay out over the lifetime of your insurance. Some policies limit how much money they’re willing to cover towards specific treatments.
Some policies have deductibles so high that you’d have to experience a serious illness before you can avail yourself of any of the covered remedies of which you’d dearly paid each monthly.
Know what you’re getting before or you buy. Read the fine print. There’s lots of fine print. Don’t trust anyone. Don’t take anyone’s word for anything.
Insurance companies are in it for profit. No matter how nice their commercials they are not in it for charity. Caveat emptor, let the buyer beware, and beware you should be.
Go online, search for an independent agent in your area. Finding an independent agent is essential because they represent a variety of insurance companies. While there is no guarantee that they will not steer you in the direction of the company with which they will make the most profit, their licenses expressly forbid that and, in most cases, they’ll have options enough so they won’t have to.
Find an online quoting engine. Many independent agents will have one on their website. The quoting engine can offer price comparison between the most competitive insurance companies and policies available in your area. Type in your particulars, press the button and then after reviewing the results, request a call from your choice of agents.
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Jeff Wild is an independent health insurance agent and a representative of some of the highest rated insurers in the United States. His Web Site, Simple Health Coverage was created to educate, inform and connect consumers with the best carriers, policies agents and choices in their geographic area.
Health Insurance for the Self Employed
June 6, 2008 on 4:14 am | In Health Insurance | No CommentsOne the most difficult things about being self-employed is having to find and pay for your own insurance. When you have a job with a benefits package that includes health insurance it’s easy to become “spoiled”. Rates are often far better and coverage usually far more comprehensive than for individual and family insurance.
When your employer offers health insurance, pretty much the only decision you need to make is whether or not to accept it. When you’re on your own, having to research all the options and decide what is most appropriate for you you may be overwhelmed by the choices and costs.
In your employer’s plan everyone in the company paid the same rates. Now you’re faced with more decisions than Baskin Robbins has flavors, but unlike buying ice cream, your decision has consequences.
The first thing you’ll discover is that every state has a different set of rules and laws that govern and regulate the insurance industry for that state. Prices vary, not only from state to state, but zip code to zip code. There are dozens of insurance carriers to choose from, including names familiar to you from television, which may or may not offer you the best deal.
You’re going to have to do some investigating and you’re going to be shocked, especially coming from group health policies, where pretty much everything is covered, from doctor visits to prescriptions, and everyone is acccepted by the very nature of group coverage.
You are going to find that individual and family and insurance is quite selective. Pre-existing conditions will either be excluded, not covered at all or be a cause for your rejection altogether. It is important before you apply for any insurance policy to know what the restrictions are. One of the worst things that could happen is for you to be rejected because of a medical condition. Rejection by one carrier will raise a red flag and possibly cause you to be either rejected, out of hand, or forced to pay a higher premium with other carriers.
You should also make certain when buying a policy that you’re guaranteed not to raise your premium for at least 12 months. Insurance companies often offer a teaser rate to get you to sign up with them and then raise your rates soon after. All of the companies going to consistently raise your rates, just make sure you’re rates are locked in for a least a year.
Make sure you’re with a reputable firm. Some of the offerings sound great but unless you’re an expert you may not see the loopholes which render the policy useless to your needs. Your best bet is to consult with a health insurance professional, a broker, an independent agent, one who represents a multiple insurance companies. Such a person knows the business, can answer questions and lead you in the right direction.
Another option is to consult an online quoting engine, available through the Web Sites of many independent agents. Here you can compare a variety of health insurance policies and companies, and note the variety of prices and options of coverage.
Quoting engines are nice, but do not forget that they only display the “preferred” rates, which may not necessarily reflect your actual rate. They also lack the ability to advise you about loopholes, and potential pitfalls. For that you need a trained and licensed health insurance agent.
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Jeff Wild is an independent health insurance agent and a representative of some of the highest rated insurers in the United States. His Web Site, Simple Health Coverage was created to educate, inform and connect consumers with the best carriers, policies agents and choices in their geographic area.
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