With the ever-increasing cost of health care, procedures and medicines, it's no wonder that the cost of health insurance has also dramatically risen over the past few years. But as that's happened, insurance companies and the government have seen the potential negative impact of families and individuals without insurance. There are some things you can do if you don't have health insurance.
A federal mandate requires that all 50 states have a health insurance program for children. Each state was allowed to create a plan tailored to the needs of children in that state, but there are some things that are the same from one state to the next. The first is eligibility.
Government funded health programs typically have very stringent income guidelines. These health insurance programs have income requirements, but the criteria allow higher income than most programs.
Another criteria for participation is that the child isn't covered by any other health insurance. That differs from most programs in a very important way. Most programs say that if the family has access to insurance, they aren't eligible. That means that parents who have employer-based insurance don't qualify. But many of the employer-based plans are too expensive, and workers sometimes simply can't afford the premiums. This program is designed to help fill that gap.
These programs don't cover families - only children. But there are some great benefits for those who qualify. Some states offer mental health benefits, transportation to and from appointments and dental/vision benefits.
If your children don't qualify for this program, or if you're in the market for individual health insurance for an adult or private insurance for a family, you have some options. Even though insurance is typically very expensive, you can take some steps to control costs.
You can eliminate extras such as vision and dental coverage, and increase deductibles to lower the cost of your insurance premiums. Look for policies that don't include maternity benefits and cancer plans as more affordable general health insurance plans. Basic coverage will likely be less expensive than an all-inclusive health insurance program.
Finally, shop before you make a decision. Even if you're offered employer-based insurance, you might find a better deal elsewhere (depending on the amount of employer participation). Look to professional groups for discounts and advice.
Sunday, June 28, 2009
How To Choose A Health Insurance Plan
Are you thinking about buying health insurance? With so many different alternatives, it is difficult to know which to choose.
When choosing a health insurance plan, never base your decision solely on the monthly premium. There are many other cost factors -- deductibles, co-payments, and the like -- that will determine the true price tag of your insurance. You'll need to read the fine print of the health insurance plan, including what it does and does not cover, the in-network versus out-of-network coverage and costs, claims processing procedures, and the coverage limits.
Know Your Health Care Needs
The first step is to review the scope of your needs: coverage just for yourself, for a large family, or something in between?
Next assess the health needs for all you intend to include in your health insurance plan. Are there any pre-existing conditions to consider? Does someone need to have access to certain medical specialists or medical institutions?
Research and Compare Your Options
The answers to the above questions will give you a good starting point in your search for the right health insurance plan.
Next, you need to explore your options. If you're getting group insurance through your employer, your options will be limited to what the company offers. Otherwise, you'll need to more research and comparison shopping. At a minimum, you have to understand the difference between the 2 basic types of health insurance plans offered today: the Indemnity Plan, and the Managed Care Plan with its variants.
Indemnity Plans and Managed Care
An Indemnity Plan offers the freedom to choose when and where you will seek medical assistance. Along with this freedom usually comes higher out-of-pocket costs. For many this is a fair trade-off.
Managed Care Plans are more restrictive, and require you to utilize the medical professionals and institutions that are part of the plan's "network." Participants often need pre-approval for medical services that are beyond basic preventive care. The costs for this type of plan are usually lower than Indemnity Plans. For those who are basically healthy, don't mind who provides their medical services, and who need to control medical costs, Managed Care Plans are usually the better choice.
This is a very basic comparison of the types of health insurance plans available. It is a first step in your own data gathering and analysis process.
Select The Right Company
Once you've done your homework and know what you want, you need to choose the right health insurance company. Many companies offer health insurance, from well-known corporate giants to small independent outlets. As with any major purchase, you'll want to research these companies before making a final decision.
Also, find out which state or federal agency regulates the type of health insurance you're considering, in case you have questions or experience problems.
Each type of health care plan has advantages and disadvantages. It is in your best interest to research thoroughly, so that the health plan you choose will be the right one for you and your family. For today and for years to come.
When choosing a health insurance plan, never base your decision solely on the monthly premium. There are many other cost factors -- deductibles, co-payments, and the like -- that will determine the true price tag of your insurance. You'll need to read the fine print of the health insurance plan, including what it does and does not cover, the in-network versus out-of-network coverage and costs, claims processing procedures, and the coverage limits.
Know Your Health Care Needs
The first step is to review the scope of your needs: coverage just for yourself, for a large family, or something in between?
Next assess the health needs for all you intend to include in your health insurance plan. Are there any pre-existing conditions to consider? Does someone need to have access to certain medical specialists or medical institutions?
Research and Compare Your Options
The answers to the above questions will give you a good starting point in your search for the right health insurance plan.
Next, you need to explore your options. If you're getting group insurance through your employer, your options will be limited to what the company offers. Otherwise, you'll need to more research and comparison shopping. At a minimum, you have to understand the difference between the 2 basic types of health insurance plans offered today: the Indemnity Plan, and the Managed Care Plan with its variants.
Indemnity Plans and Managed Care
An Indemnity Plan offers the freedom to choose when and where you will seek medical assistance. Along with this freedom usually comes higher out-of-pocket costs. For many this is a fair trade-off.
Managed Care Plans are more restrictive, and require you to utilize the medical professionals and institutions that are part of the plan's "network." Participants often need pre-approval for medical services that are beyond basic preventive care. The costs for this type of plan are usually lower than Indemnity Plans. For those who are basically healthy, don't mind who provides their medical services, and who need to control medical costs, Managed Care Plans are usually the better choice.
This is a very basic comparison of the types of health insurance plans available. It is a first step in your own data gathering and analysis process.
Select The Right Company
Once you've done your homework and know what you want, you need to choose the right health insurance company. Many companies offer health insurance, from well-known corporate giants to small independent outlets. As with any major purchase, you'll want to research these companies before making a final decision.
Also, find out which state or federal agency regulates the type of health insurance you're considering, in case you have questions or experience problems.
Each type of health care plan has advantages and disadvantages. It is in your best interest to research thoroughly, so that the health plan you choose will be the right one for you and your family. For today and for years to come.
How to Shop for Individual Health Insurance
If you find yourself in the position of shopping for an individual health insurance policy, there are certain things you'll want to keep in mind. Whether you are coming out of a job that covered you before, or are at the end of your COBRA benefits, or simply have never had coverage before there are things you can do to get coverage on yourself and your loved ones.
The basic thing to know is that if you have a shot a group health insurance, whether through a job or an association you're a member of, that is usually much more affordable than buying individual health insurance on your own. First you need to figure out your health insurance goals; in other words, what are you after? If you're young, healthy as a horse, no dependents and not attempting Mt. Everest next week, you may want to opt for a policy that covers only the catastrophes, and cover the rest out-of-pocket. On the flip side of that, if you're the sole bread winner with a family to support, the scenario is different.
The basic choices you'll have are Fee-for-Service, Managed Care Plans, and Association-based health insurance. Fee-for-service is the traditional indemnity plan, harder to acquire, more expensive, but usually great coverage. Managed care plans include most HMO's and PPO's. These offer lower costs but your choices are somewhat limited. Another way to get insured is through a group or association you may already be a member of, such as professional, religious or trade organizations. Often they may offer health insurance. It's worth checking out, as sometimes you can strike gold in this vein.
Things to consider when you're looking for any policy are what's covered on this plan, how much are the monthly premiums, what is the yearly out-of-pocket, what is the deductible, how much are office visits, does it cover preventative medicine, vision, dental? And I'm sure you can come up with many of your own. Sit down before you go shopping and make a list of your needs and wants, and decide in advance what you're willing to give to get. Be aware that once you start getting quotes they can vary as much as 50% for the same person! Remember, you're shopping, and nobody's making you do anything. If one insurer isn't cutting it, move on to another. If you're coming at this cold and have no good recommendations it may be wise to use a broker who represents several companies, as he or she wil be more likely to find the best policy for you, as opposed to selling the company they work for.
Shopping for individual health insurance can be frustrating and time-consuming, but if you come armed with facts you'll be able to navigate this highly competitive and ever-changing field.
The basic thing to know is that if you have a shot a group health insurance, whether through a job or an association you're a member of, that is usually much more affordable than buying individual health insurance on your own. First you need to figure out your health insurance goals; in other words, what are you after? If you're young, healthy as a horse, no dependents and not attempting Mt. Everest next week, you may want to opt for a policy that covers only the catastrophes, and cover the rest out-of-pocket. On the flip side of that, if you're the sole bread winner with a family to support, the scenario is different.
The basic choices you'll have are Fee-for-Service, Managed Care Plans, and Association-based health insurance. Fee-for-service is the traditional indemnity plan, harder to acquire, more expensive, but usually great coverage. Managed care plans include most HMO's and PPO's. These offer lower costs but your choices are somewhat limited. Another way to get insured is through a group or association you may already be a member of, such as professional, religious or trade organizations. Often they may offer health insurance. It's worth checking out, as sometimes you can strike gold in this vein.
Things to consider when you're looking for any policy are what's covered on this plan, how much are the monthly premiums, what is the yearly out-of-pocket, what is the deductible, how much are office visits, does it cover preventative medicine, vision, dental? And I'm sure you can come up with many of your own. Sit down before you go shopping and make a list of your needs and wants, and decide in advance what you're willing to give to get. Be aware that once you start getting quotes they can vary as much as 50% for the same person! Remember, you're shopping, and nobody's making you do anything. If one insurer isn't cutting it, move on to another. If you're coming at this cold and have no good recommendations it may be wise to use a broker who represents several companies, as he or she wil be more likely to find the best policy for you, as opposed to selling the company they work for.
Shopping for individual health insurance can be frustrating and time-consuming, but if you come armed with facts you'll be able to navigate this highly competitive and ever-changing field.
Before You Look for Health Insurance
Shopping around for medical insurance can be a confusing business. You need to keep your wits about you and keep track of the benefits and costs of each policy and each type of policy. Too often we tend to look at the price first and the rest of the policy becomes a blur of fine print. And we're off to check the next policy.
Slow down. There some important things you should do before you start chasing around to get a policy. Doing these few things will make the whole process simpler and clearer - and you're much more likely to make a good decision.
You need to carefully consider your situation. Think about these questions and note your answers:
What's the general state of your health?
How old are you?
Do you have any serious medical problems currently or in your medical history?
Do you have any history of recurring or on-going medical needs?
Do you use tobacco? How much?
Do you drink? How much?
Are you over- or under-weight for your height, body-type and age?
Is your job hazardous?
Do you participate in any activities or sports that could affect your health?
Now this may be unpleasant but if there's any chance an insurance company could discover a history of drug or alcohol abuse or sexual behavior that might put you in a high risk group, you may want to be direct and upfront about it - especially if it's in the past. Having a claim denied later because you had failed to disclose medical information to the insurance company would be far more upsetting - and very expensive. The same goes for any significant medical condition. Insurance companies are in it to make a profit - at least most of them are. Paying large claims isn't their favorite activity, so they often do investigate.
If you're seeking a family policy you'll need to make the same analysis for everyone and consider carefully what kind of coverage you want.
Do you need dental, orthodontic, pregnancy, mental health, and/or drug coverage? Do you need long-term care coverage, either inpatient or in a nursing facility? Assisted living coverage? What about traveler's or international coverage?
If there's a possibility that you may require - or want - in-home care as opposed to a residential nursing or assisted living facility, be sure that coverage is included and be sure you understand exactly what you can expect to receive.
Think about deductibles and what you could afford pay to reduce your insurance costs. But be very careful here, because medical expenses tend to pile up quickly and reach nearly insane levels for complex treatments or inpatient stays. Many drugs in common use are ridiculously over-priced and depending on the specifics of your insurance you may not be able to use the least expensive sources.
If you will end up with multiple sources of coverage, be clear about how they fit together and what the rules are about overlapping or combined benefits.
Once you are clear on your current situation, your (and other family member's) medical history, and your projected needs, you can begin looking in a organized way with a better sense of where you're going and what will actually meet your needs. This may seem like a tedious process, but it will serve you well in finding appropriate and affordable health insurance and making sure your health care needs can be met by the medical insurance you choose.
Take some time to work through these questions. Write down your answers. Make a chart with your desired coverages and any special conditions the policy must meet. As you look at health insurance policies, note the rules, exclusions, information about pre-existing conditions, any limitations, the dollar amounts covered and especially any deductibles.
Don't try to do too much at once. If you hurry, it'll become confusing and tiring. You may hate it (I know I do), but you really do need to read all that fine print and understand it. That's not a task to rush through. You might as well face up to it, because it's a lot better to do it BEFORE you need medical services than after you get a bill for the uncovered portion that sends you into shock.
So is it an impossible job to find health insurance that works for you? Not at all. There's a world of resources on the internet to help you find the policy you need. Just be sure to do your homework first.
Slow down. There some important things you should do before you start chasing around to get a policy. Doing these few things will make the whole process simpler and clearer - and you're much more likely to make a good decision.
You need to carefully consider your situation. Think about these questions and note your answers:
What's the general state of your health?
How old are you?
Do you have any serious medical problems currently or in your medical history?
Do you have any history of recurring or on-going medical needs?
Do you use tobacco? How much?
Do you drink? How much?
Are you over- or under-weight for your height, body-type and age?
Is your job hazardous?
Do you participate in any activities or sports that could affect your health?
Now this may be unpleasant but if there's any chance an insurance company could discover a history of drug or alcohol abuse or sexual behavior that might put you in a high risk group, you may want to be direct and upfront about it - especially if it's in the past. Having a claim denied later because you had failed to disclose medical information to the insurance company would be far more upsetting - and very expensive. The same goes for any significant medical condition. Insurance companies are in it to make a profit - at least most of them are. Paying large claims isn't their favorite activity, so they often do investigate.
If you're seeking a family policy you'll need to make the same analysis for everyone and consider carefully what kind of coverage you want.
Do you need dental, orthodontic, pregnancy, mental health, and/or drug coverage? Do you need long-term care coverage, either inpatient or in a nursing facility? Assisted living coverage? What about traveler's or international coverage?
If there's a possibility that you may require - or want - in-home care as opposed to a residential nursing or assisted living facility, be sure that coverage is included and be sure you understand exactly what you can expect to receive.
Think about deductibles and what you could afford pay to reduce your insurance costs. But be very careful here, because medical expenses tend to pile up quickly and reach nearly insane levels for complex treatments or inpatient stays. Many drugs in common use are ridiculously over-priced and depending on the specifics of your insurance you may not be able to use the least expensive sources.
If you will end up with multiple sources of coverage, be clear about how they fit together and what the rules are about overlapping or combined benefits.
Once you are clear on your current situation, your (and other family member's) medical history, and your projected needs, you can begin looking in a organized way with a better sense of where you're going and what will actually meet your needs. This may seem like a tedious process, but it will serve you well in finding appropriate and affordable health insurance and making sure your health care needs can be met by the medical insurance you choose.
Take some time to work through these questions. Write down your answers. Make a chart with your desired coverages and any special conditions the policy must meet. As you look at health insurance policies, note the rules, exclusions, information about pre-existing conditions, any limitations, the dollar amounts covered and especially any deductibles.
Don't try to do too much at once. If you hurry, it'll become confusing and tiring. You may hate it (I know I do), but you really do need to read all that fine print and understand it. That's not a task to rush through. You might as well face up to it, because it's a lot better to do it BEFORE you need medical services than after you get a bill for the uncovered portion that sends you into shock.
So is it an impossible job to find health insurance that works for you? Not at all. There's a world of resources on the internet to help you find the policy you need. Just be sure to do your homework first.
Health Insurance and health care
Health insurance is something that everyone needs today. The rising cost of visiting a health care provider or a hospital stay makes it imperative that everyone have some type of health care coverage. Government statistics estimate that over 40 million people in America are not covered by any type of health insurance on any given day. That's an enormous number of people who really are taking a financial risk.
Even if you're on a tight, limited budget, it's very important that you pick up some kind of affordable health insurance. Even if you only have a plan that covers unexpected hospitalization, your peace of mind will be greatly enhanced. Keep in mind that a catastrophic health insurance policy can come with a high deductible before their coverage kicks in. They don't pick up the cost of preventive physician visits or emergency room visits to get a few stitches.
Some questions to ask when considering affordable health insurance.
1) Can your and/or your family afford to pay ALL your medical expenses if you're sick or injured?
2) How much is the deductible?
3) How much are the premiums?
With a little searching and comparison shopping you find the best rate for your personal affordable health insurance.
Even if you're on a tight, limited budget, it's very important that you pick up some kind of affordable health insurance. Even if you only have a plan that covers unexpected hospitalization, your peace of mind will be greatly enhanced. Keep in mind that a catastrophic health insurance policy can come with a high deductible before their coverage kicks in. They don't pick up the cost of preventive physician visits or emergency room visits to get a few stitches.
Some questions to ask when considering affordable health insurance.
1) Can your and/or your family afford to pay ALL your medical expenses if you're sick or injured?
2) How much is the deductible?
3) How much are the premiums?
With a little searching and comparison shopping you find the best rate for your personal affordable health insurance.
What to look for in good Health Insurance
Health insurance is a kind of protection that provides payment of benefits for covered sickness or injury. Included in health insurance are various types of insurance such as accident insurance, disability income insurance, medical expense insurance, and accidental death and dismemberment insurance.
Before sign the health insurance policy make sure that you have read thoroughly the benefit�s section. Take note of any health care service that is not covered by your health insurance policy. Also, pay specific attention to how the health insurance policy is worded. Sometimes, health insurance companies hide the health insurance coverage exclusions within the definitions of words.
For instance, a health insurance company may define the term �emergency� as anything that is life threatening condition that cannot be reasonably treated by a primary care physician. Whereas, your definition of �emergency� may be anything that requires quick medical attention.
Clearly, there is conflict for the two definitions. If you find yourself in an emergency situation where you incur a broker arm, for instance, your insurance company may deny coverage for emergency room treatment of a broken arm for the reason that the broken arm does not fall under the life threatening category.
Therefore, you should read over carefully the health insurance policy definitions, paying close attention to the seven key words:
medical emergency
medically necessary
accidental injury
experimental or investigational
pre certification
pre-existing condition, and
reasonable and customary
These words and any words that are open to interpretation should be regarded with wariness. Find out how your health insurance company defines each of these.
Finally, find the section describing the procedures you must follow in order for your insurance company to reimburse you. These policy conditions or prerequisites are typically worded in a positive tone. Read through each condition carefully, make notes and call your health insurance company with any questions.
You should also compare health insurance contracts before you sign one. In order to compare exclusions, take two policy contracts and find the exclusions sections. If you want to compare a number of health insurance contracts then you could use an online service.
After you obtain your free quote for the health coverage you desire, apply for it online, and you'll obtain all the information that you'll need to compare exclusions of each health insurance policy (though sometimes this will require more research.)
Before sign the health insurance policy make sure that you have read thoroughly the benefit�s section. Take note of any health care service that is not covered by your health insurance policy. Also, pay specific attention to how the health insurance policy is worded. Sometimes, health insurance companies hide the health insurance coverage exclusions within the definitions of words.
For instance, a health insurance company may define the term �emergency� as anything that is life threatening condition that cannot be reasonably treated by a primary care physician. Whereas, your definition of �emergency� may be anything that requires quick medical attention.
Clearly, there is conflict for the two definitions. If you find yourself in an emergency situation where you incur a broker arm, for instance, your insurance company may deny coverage for emergency room treatment of a broken arm for the reason that the broken arm does not fall under the life threatening category.
Therefore, you should read over carefully the health insurance policy definitions, paying close attention to the seven key words:
medical emergency
medically necessary
accidental injury
experimental or investigational
pre certification
pre-existing condition, and
reasonable and customary
These words and any words that are open to interpretation should be regarded with wariness. Find out how your health insurance company defines each of these.
Finally, find the section describing the procedures you must follow in order for your insurance company to reimburse you. These policy conditions or prerequisites are typically worded in a positive tone. Read through each condition carefully, make notes and call your health insurance company with any questions.
You should also compare health insurance contracts before you sign one. In order to compare exclusions, take two policy contracts and find the exclusions sections. If you want to compare a number of health insurance contracts then you could use an online service.
After you obtain your free quote for the health coverage you desire, apply for it online, and you'll obtain all the information that you'll need to compare exclusions of each health insurance policy (though sometimes this will require more research.)
How to Find Affordable Health Insurance ?
Affordable health insurance - it seems, especially today, those words just don't belong together in the same sentence. Health insurance monthly premiums have become the biggest single expense in our lives - surpassing even mortgage payments. In fact, if you have any permanent health problems, such as diabetes, or have had cancer at one time in your family history, your monthly cost could easily be more than the house and car payment combined.
Shopping for affordable health insurance can certainly be an eye-opener. If you have always had a health insurance benefit where you work - especially a state or federal employee - and now have to buy your own, you may not be able to afford the level of health insurance coverage you have become used to.
Affordable health insurance, however, is definitely available -if you know how and where to look.
When you are looking for affordable health insurance, you want the lowest cost per year that will fit your budget, of course. But, even more importantly, you want a company that has a good record for paying without fighting with you on every detail. Just as there is a car for just about any budget, there is also affordable health insurance. You may not be able to afford a "Cadillac" policy - but then you probably don't need all the frills anyway.
Shopping for health insurance on the internet is the easiest and best way to find affordable health insurance. Here are five reasons why.
1. You don't need a local agent to help you submit the claims for health insurance. The medical provider does it for you. You save money because the health insurance company saves money by not paying the agent commission. This could amount to an 8% to 12% savings to you.
2. All the top health insurance companies are at your fingertips on the internet. Most local agents can only quote you from the few companies that they represent. They may not offer you what is best for you financially or health-wise but only what they happen to have available.
3. Health insurance companies have to be extremely competitive because it is so quick and easy to compare them with their competitors on the internet today. In the past you would have had to visit physically eight to ten agents to do a similar comparison. Most folks just didn't have the time or desire for that.
4. You can change your coverage, deductibles, and payment options with just a few clicks rather than going through the paperwork delay with a local agent (and then finding out he/she made a mistake - more delay).
5. Charging to a credit card means you aren't going to forget a payment and be without insurance. Also, it gives you another 30 days before you actually have to pay. Also, many companies today give an additional discount for "auto-pay".
The key, however, to finding affordable health insurance is realizing that the purpose of any health insurance is to protect you from a major financial loss - not to protect you from spending small money on clinic visits and sliver removal. These small expenses may be cumbersome but they generally will not hurt you. It's the $100,000 heart operation that will break you. That's the financial disaster health insurance was originally designed to prevent.
Also, keep this in mind. Health insurance, as with any insurance, is a gamble. You are gambling that you will draw out more than you pay in. Your health insurance company is gambling they will pay out less. The odds are in their favor for two reasons. They have all the facts for millions of families to average out, so they know the risk in advance. Also, they get to set the rules and the prices. The higher you set your deductible, the more risk you take. This is not a bad thing at all. You will most likely be the winner in the long run.
Yes, finding affordable health insurance is much easier than most people think.
Taking more of the risk with higher deductibles, spending a little time on the internet comparing eight to ten different companies, and deleting coverage that you will not likely need (such as maternity for many folks) will make it very possible to find your own affordable health insurance.
by: Dr. Deepak Dutta
what is american family insurance?
American Family Insurance (aka AmFam) is a private mutual company that focuses on property, casualty and auto insurance, but also offers commercial insurance, life, health, and homeowners coverage, as well as investment and retirement-planning products. A Fortune 500 company, its revenues for 2007 were over $6.8 billion
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