Don’t Get Caught Without Health Insurance Know the Facts

When it comes to preparedness, health insurance will always be your best bet. Because one cannot easily determine when he or she will need medical help, having a reliable health insurance plan will be very helpful in covering the costs of treatment and care. There are many factors one must consider before signing up for a health insurance policy. Since there are different types available, one needs to carefully assess his needs and also manage his allotted budget.

What do you need to know about health insurance? How can this help you and your family in times of need? Read on to learn about interesting facts about policies and coverage, so you can make the informed choice when buying health insurance for you and your family.

o In the United States, it has been reported that nearly 45 million Americans have no form of health insurance whatsoever. This accounts for about 15 percent of the total population as of the year 2006. As mentioned by the Centers for Disease Control and Prevention (CDC), among the total population of Hispanics, 32 percent were uninsured. This is compared to 19 percent of all African-Americans, and 10 percent of all whites who do not have health insurance coverage.

o Of all the uninsured persons in the United States, about 7 million were minors, below the age of 18. This accounts for about 10 percent of the below 18 population of the country, as reported by the CDC. According to the new health insurance plan proposed by the administration of President Barack Obama, about $87 billion of government funds will be allotted for the improvement of state insurance programs, as well as the SCHIP, or the State Children’s Health Insurance Program. This will expect to reduce the number of uninsured children in the country by up to 72 percent, giving minors better opportunities for health care.

o More on the uninsured: what percentage of the population ages 19 to 64 (non-elderly) do not have health insurance? The Kaiser Health Foundation reports that approximately 20 percent of adults in this age group are without any form of health insurance, as of the year 2007. Which states have the most number of uninsured adults? The same site reports that New Mexico and Texas top the list, with about 30 percent of people in this age group without health coverage. On the other hand, Massachusetts has the least uninsured adults, which only comprise about 10 percent of the total age group.

o Which states have the highest number of uninsured children, who are from ages 0 to 18 years old? As the Kaiser Health Foundation statistics present, Texas has about 22 percent of children without health insurance, with Florida following with 19 percent. Massachusetts also has the least percentage in this category, with only about 5 percent of children without health coverage.

o According to the Insurance Information Institute (III), about 34 percent of the nation has their own private health insurance plans, while nearly half of the population rely on government funded insurance programs. To be more specific, 19 percent are under MediCare, 15 percent under MedicAid and SCHIP, and another 12 percent from other select public insurance providers.

o The National Association of Insurance Commissioners reported in 2007 the insurance companies who have written the most premiums as of that year. Topping the list were UnitedHealth Group owning 11.7 percent of the market share, and WellPoint Inc. Group, with 9.75 percent of the market share. Kaiser Family Foundation follows in third with 7.7 percent market share in that same year. Among the oldest health insurance providers in the country, Blue Cross, is the ninth on the list, with approximately 1.72 percent of the market share.

o When comparing individual insurance plans and group insurance plans, you can expect to save more if you purchase multiple policies. However, according to some people who choose individual policies, they are able to tailor their plans to be in tune with their specific health needs. You can learn more on the pros and cons of these two types of health insurance when you consult with an insurance agent.

o During the economic recession in the United States, there were millions of people who have become unemployed. However, thanks to the new administration and the initiatives of President Obama, these employees can still reap the benefits of their health insurance plans, as the government intends to allot $25 billion. These will cover for as much as 65 percent of each employee’s health insurance premiums, according to a report by Reuters.

Before Choosing Health Insurance, Here is Critical Information You Should Know

Understanding Health Insurance

This article is written to assist consumers sift through multiple options, plans, exclusions and summaries of benefits and understand what Critical questions you should ask when researching health coverage. Finding the most beneficial health insurance plan to meet your unique and individual needs is difficult. This guide will help consumers understand the basics of health insurance and what to look for when comparing plans.

14 Costy Mistakes You’ll Want To Avoid

1-FREE – Do You Have a “30 Day FREE Look Period?” Can you get your $ back if you are not happy?

2- DEDUCTIBLES: How many deductibles do I have per year? Some plans will have more than 1 deductible per person per year!

3- NETWORK RATES: Prior to your deductible being met, will your insurance company extend their discounted network rates to you? Example: Insurance Company A – 5 stitches to finger – Total cost $2000, patient responsibility, $800, or Insurance Company B – 5 stitches to finger – Total cost $2000, patient responsibility, $2000. (no network break).

4- NEGOTIATED RATE: What is the AVERAGE negotiated rate? (Sometimes referred to Network Rate – very very important!)

5- UNCLEAR TERMS Is your $100 “co-pay” for an Emergency Room visit REALLY $100? Some companies the $100 copay is more like a fee AFTER your deductible, and you’ll still pay the co-insurance and the $100.

6- LIMITS on benefits, for example: $500 limit or $250 limit on Emergency Room expenses. $50 limit on Dr. Visits. Once the Limit is reached, YOU pay everything else out of pocket. $500 limit on hospital expenses per day (quick way to bankruptcy!)

7- PREVENTATIVE – Will you have to meet your deductible, or do you have a 1 year waiting period for preventative? Do you want to wait 1 year before you can have your female exam, or a mammogram?

8- TRAVEL – If you are out of state, are you covered for illnesses? If you eat something that doesn’t agree with you and become very sick and need a doctor, will you be covered? (Not just life threatening emergencies.)

9- RATE INCREASES – I am buying a “fixed rate”. Ask yourself if it makes sense to pay extra over the next 2 – 3 years for a fixed rate? Make sure your rate is set for at least 12 months but does it make sense to pay in advance for a fixed rate? Sometimes plans will naturally go down in price, so does it make sense to pay extra to have a fixed rate?

10- SUPPORT – After I buy this plan, MAY I CALL MY AGENT’S DIRECT LINE with billing issues, or plan questions, or technical problems, or claims questions or concerns of any kind?

11- EXCLUSIONS – Read the “Exclusions” in your plan. Are the exclusions available for you to read? Is there an exclusion that you cannot live with? For example: exclude well baby visits. Is this an exclusion that you didn’t catch in the plan details?

12- MAJOR MEDICAL plans are designed to pay for MOST of your medical expenses when you become ill or injured. You’ll want a Major Medical plan from a reputable company that has “Credible Coverage.” Discount plans or Limited Medical Plans are NOT designed to protect your losses like Major Medical plans are. They are marketed as “Insurance,” but you MUST ask, is it a Credible Coverage Major Medical plan?

13 – MATERNITY – Maternity plans. Do your homework. Does your plan have an outrageous deductible for maternity? Do you have a waiting period of 12 months, 24 months, or more? How many doctors do you get to choose from “In Network” that can deliver your baby? Are you happy with the choices of Doctors in the network that will deliver your baby? What if your doctor is not on-call the night you go in for delivery?

14- MEDICATIONS – Is there a limit on how much the insurance company will pay for medications. If you become very ill, this could be a very big problem. Do your research, ask questions. Do you have a deductible on medications?

*Did you know that key information about how coverage works is not always disclosed? *When comparing plans, is the language confusing? Why is the language confusing? *Did you know that many consumers compare prices of health insurance plans, but cannot always tell if they are comparing “apples to apples.”

How to avoid Medical Bankruptcy!

According to a Harvard Law and Harvard Medical School study, they found that ½ of all bankruptcies are caused by illnesses and medical expenses. If you are a breadwinner for yourself, or breadwinner for a family or spouse, and the breadwinner gets sick, you may loose your medical coverage, and a way to pay for your day to day expenses.

When you are shopping for a health plan to protect yourself financially from medical bills and bankruptcy, there are many things to consider. Probably the most important thing is to consider is what “Type” of plan you are getting. There are several types of health plans that are available. If you buy a plan that is not “Underwritten” and is “Guaranteed Issue” you are not buying a Major Medical Plan. Major Medical plans will go through a process called “underwriting.”

Some plans will pay a certain dollar amount for a procedure, or a certain dollar amount per day while in the hospital. IT IS CRITICAL you understand the implications financially if choosing a non Major Medical plan. Your chance for greater personal losses including Bankruptcy exist with non-Major Medical plans. If you are shopping price with health insurance, and you decide on a discount or limited liability plan, YOU HAD BETTER UNDERSTAND WHAT YOUR RISKS ARE if you end up needing to use that “insurance.”

Major medical plans are designed to cover most of your hospital expenses if you become hospitalized.

Do you have a disability plan? This type of plan will pay your day to day expenses if you loose your job due to an injury or illness. This should be a very important consideration when getting health insurance. If the breadwinner loses his/her income while injured or ill, how will the day to day expenses be paid for?

The 6 costly misconceptions about Health Insurance

1 – I don’t need medical insurance, I’m a healthy person, I eat right, exercise and take care of myself. This is risk-taking. You are gambling your financial future.

2- I’m not getting insurance because There is no benefit before my deductible. Some Major Medical Plans will A) extend their network rates to you before the deductible is met, but not all. Another benefit before your deductible is met is B) the copays for Dr. Visits and C) Copays for Prescription coverage. Again, check the individual plan.

3- If I get sick, or now that I’m pregnant I’ll get insurance. Once you are ill or pregnant, depending on the illness, you may or may not be eligible for health insurance. Certainly once pregnant, you will not be eligible for an individual plan. The insurance company will always reserve the right to underwrite your medical condition and elect to take you on as a risk, or not. You wouldn’t expect to run out and get auto insurance after you’ve banged up your car and have them pay for it. For this reason, it is important to not let your Major Medical insurance lapse for more than 63 days.

4 – I will get stuck with a bill that I thought should have been paid for, or the insurance company should have paid. Here again, you must do your homework on the plan you intend to purchase. Look for Limits, deductibles, exclusions, co-pays, and understand these details. Also, if you come into a plan with pre-existing conditions and did not have continuous “credible coverage,’ you can expect to pay for your pre-existing conditions for 1 full year.

5- I want excellent care at a cheap price. If you want Major Medical, shop between the competitors, and get the most for your money, but don’t expect the same benefits in a discount plan as in a Major Medical Plan.

6- I’m waiting for the President to take care of this mess. It is not a good idea to wait to purchase medical insurance ever!