Eligibility Requirements Vary on Health Insurance for Dependents

May 11, 2009

To meet eligibility on requirements for health insurance, the main
or primary applicant will have to be at least 183 days old or half
a year, and under sixty four and a half years old. The applicant
cannot at the time be insured by another health care coverage. The
applicant will have to be a citizen of the US or a foreign
resident, whom has resided in the US for a minimum of two years,
while on a visa of permanent status. Any dependants of the
applicant will have to be a minimum of six weeks old. The
application will be individually underwritten, with health history
and any dependants in mind. To have this application successfully
underwritten, the insurance company will have to obtain as much of
your medical history as you can give them. This process will be
dealt with by a medical questionnaire, with perhaps a telephone
interview. The underwriter may also set up further questionnaires
and interviews as required.

If you satisfy a portion of the current coverage that is ongoing, a
credit for past and prior deductibles may be awarded, provided it
remains in the same calendar year. The proof of deductible will be
required by way of E.O.B or explanation of benefits. Time you incur
with the prior plan may or may not be used as credit for your new
plan. State law, and you own unique circumstances, may indeed
dictate what if any will be credible points to your new plan. If
and when you decide to stop our coverage, the said credits will
then be transferred to other insurance coverage. There may be a
waiting period, with the new company and their policies, this
should be found out before you outright terminate your current
policy. You may have to show the new underwriter proof of current
policy, to get the ball rolling with the new company. Any
pre-existing medical conditions such as an injury, or illness,
which has been diagnosed, must have had proof of treatment, or at
the very most proof of continual conditions of said preexisting
conditions within twelve months, prior to new policy.

If the guidelines of the new companies policies have been met, the
company will have no problem giving full coverage, for the
condition. Not only is it illegal, but also it is not beneficial to
you not to disclose any preexisting conditions when making a claim,
or starting a new policy. Guidelines are in place to help you, and
to prevent fraud, other than that if all requirements are met,
again full coverage will follow. There is a twelve-month wait
period, for coverage on any undisclosed preexisting conditions,
provided the company does not seek to close out the policy, on
grounds of misinformation. You may opt to go the term life
insurance route, where there is a beneficiary installed, to receive
compensation by the policy if the primary dies. Between the ages of
eighteen and sixty four and a half, the maximum amount allowable is
$25,000 anyone that is in the age bracket of six months to
seventeen years of age the cap is $10,000. On the schedule page of
your policy, you will find the dates of when the policy starts and
stops, provided all premiums are met on a timely fashion.

Coverage stops as: · Maximum lifetime benefit has been met
· You do not upkeep with your premiums
· You are no longer a dependant
· You leave the US for residency elsewhere
· The main policy becomes terminated

This policy can be canceled with sixty days notice commencing on he
first of any month. When a policy is set up, the company has a team
of medical advisors that review each and every case, to determine
the best action to be followed. The team consists of psychiatrists,
surgeons and general practitioners. This team can advise you on
appropriate questions for treatment with your specialist, as well
as discuss with them any possible alternatives to treatment. Should
you require a second opinion, this will be covered, by the policy.
Please keep in mind, any final decision on treatment and care,
shall always be within the right of you and your general
fractioned. All non-notifying treatments will result in a 20%
exclusion from coverage. No benefit will be paid out if he
treatment is deemed non medical, or not necessary, and you will
receive a certificate of non-acceptance on said treatment.

DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.

Find out more about
Eligibility Requirements Vary on Health Insurance for Dependents


Single? Don’t Skimp on Disability Insurance

March 26, 2009

You are throwing away money when buying the cheapest policy on the
market. The odds of getting paid a monthly benefit under that
contract may be extremely lower than receiving benefits from a
quality contract. Individual disability insurance is designed to
replace anywhere from 45-60% of your gross income. This is designed
on a tax-free basis should a sickness or illness prevent you from
earning an income in your current occupation. Every disability
insurance plan has a different definition of total disability in
the policy. There are three basic types:

Own-Occupation Disability Insurance

If are deemed incapable to perform the duties of your regular
occupation, the company will pay the claim. You are even allowed to
get another job in a different field and still be paid. This is the
only plan that does not penalize somebody for going back to work in
a different occupation while on a claim.

Income Replacement Insurance

This is the most common definition of total disability in the last
few years. Most insurance carrier has moved to an income
replacement definition, if they stopped offering own-occupation
disability insurance. You will be penalized or lose the benefit if
you work while on a claim.

Gainful Occupation Coverage

This is a very common definition in an employer sponsored long-term
disability policy. This is also very popular with property and
casualty insurance companies who have decided to release a
disability insurance policy to offer more options to their clients
and put a foot in the market. This is the worst possible definition
and leaves whether you are disabled or not up to the insurance
company itself.

The first aspect of any disability insurance policy one needs to
understand is the renew ability feature. Non-Cancelable and
Guaranteed Renewable guarantees you that after you purchased the
policy there will be no changes to your premium schedule, monthly
benefits, or policy benefits to age 65 or whatever age you elected.
The insurance company legally cannot change anything concerning
your policy unless you want them to. A Guaranteed Renewable plan
states that an insurance company will probably not change anything
about the policy, but they can if they choose to at anytime. A
Conditionally Renewable plan is a policy that offers you virtually
no guarantees for your disability insurance policy. Stay away from
these policies; you will get burned. Next you will need to know
what you can expect if you get disabled.

There will be a period of time from the on set of your disability
till you receive a benefit check. This is called the elimination
period. The industry has made the most common offer a 90-day
elimination period for an individual disability insurance policy.
You can expect a high charge if you choose to go with a shorter
elimination period of 30, or 60 days. Most companies will also give
you a price break if you can go longer than 90 days. Now once the
checks star coming you have moved into your benefit period.
Choosing this is most important. You don’t want to be left with out
money to live on if you are disabled forever and picked a five-year
policy. This is time frame you will be getting a check, think
long-term, if you don’t need it than who cares, you might sometime
later. Once the elimination period has been satisfied, monthly
benefit checks will begin to come in at the end of each month. Your
benefits will stop when you return to work in your occupation, or
another occupation making the same income. The most popular choice
for a disability insurance policy is to age 65. Some people prefer
to go with lifetime with a higher premium.

A Cost of Living Adjustment is a rider that kicks in if you
actually go on a disability insurance claim, it will increase your
monthly benefit every year while you are on a claim along with the
CPI up to the maximum you elected. You have to be disabled for more
than a year to use it. A Future Increase Option is a rider locks in
your insurability for a certain period of time (normally to age
55). So, as you increase in age, and increase your income level,
you can increase your monthly benefit regardless of any health
changes. An Automatic Increase Rider increases your total monthly
benefit each year for about five years. Your premium will go up
with this rider each year because you are buying more disability
insurance coverage. Make sure you look at these carefully and pick
one that is best for you if you want the extra coverage.

DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.

Single? Don’t Skimp on Disability Insurance

Tips to Shop for Health Insurance Online

March 17, 2009

Looking for and/or buying a health insurance plan for you or your
family is easier than ever now due to the Internet. You can find
tons of site willing to dish out information and give you quotes on
their best plans. Most companies have crazy slogans and sites
filled with mumbo-jumbo to entice you to buy. Well, purchasing
health insurance is not like ordering a new book online, it takes a
lot of research and digging to make sure that what you are getting
is legitimate and what you truly want. Remember to find a plan you
will have to divulge very personal information to cyber space and
have no idea who might be taking this information on the other
side. You must make sure you know that this company is real and
reputable and that any information sent is sent on a secure site so
no third-party can get a hold of it. So, here on some tips for
playing it safe and shopping smart with your computer.

Make sure you shop with a licensed agent only or the company
directly. Don’t fall for some unknown company because it swears to
give you a plan at 75% cheaper than any other company. Making a
connection with selection and assistance is extremely important.
There are tons of insurance companies that sell their policies
directly to individuals as well through agents. Don’t limit your
self to a single company; you will limit your options. Make sure
you get several quotes from several different companies and agents.
This will enable you to contrast and compare the information you
receive and make the right decision for you based on what you have
in front of you. You will also get to see what each plan has for
benefits and what the price range is, you always want to get more
for your money.

A legally licensed agent is able to sell plans from many different
companies and is a good source of information. They can offer
personal advice and assistance in helping you find the best policy
and advocate on your behalf to get it approved faster. There are
plenty of agents to chose from for help. Some work individually
with you or you could have a small team that work to find a plan
for you based on the criteria given. Licensed agents must follow
strict guidelines set by the companies they represent the state
department of insurance. Buying a policy though an agent doesn’t
cost any more than right with the company itself. You just a more
personal touch and are more likely to get all your questions and
concerns answered. Be sure to get access to any online agents
license number so you can make sure they are legitimate.

Make sure they have quality phone support in case you need to call
agent. Even if you think you will never need it, make sure you have
the number where you can get in touch with a live person if you get
in a bind. No reputable agent will refuse to give out his or her
number or put it in the fine print, that is a red flag. Not to
mention bad business. They might not have it on their home page but
it should be one of the choices to choose from in the contact
section. Many people feel more secure talking directly to their
agent on the phone while others would prefer the net. Make sure
this agent will be available for you after your purchase has been
made as well as helping you shop. An agent who is courteous,
helpful, and easy to reach is a good sign that the company is a
quality health insurance partner.

Look for seals of approval or quality ratings on their web page.
Most reputable agents are proud and willing to share their
approvals and high ratings to their prospective clients and
consumers. Look for logos from the Better Business Bureau, TRUSTe,
or A.M.; these will indicate that you have found a good agent. Also
run the company or agents name through the Better Business Bureau
Online database. It will show you any thing that comes up bad or
good about this person or company that has been reported to them.
The agent should always have the approval of an Internet privacy
protection organization like TRUSTe, to know you are dealing with a
person who will protect your right to privacy and have a secure

DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.

Tips to Shop for Health Insurance Online

Five Ways to Cut your Health Insurance Costs

February 19, 2009

Nearly one-third of all health-insurance premiums increased to 30
percent or more. At that rate, the average cost of health insurance
per employee will exceed $3,000. Seventy-three percent of senior
executives believe health-care costs will continue to increase 20
percent or more each year for the next three years. The message
here is clear: If you haven’t already gotten serious about cutting
your company’s health-insurance costs, now is the time. It can be
done. The first thing you should do is learn how the system
works–or doesn’t work. Most small employers spend fewer than four
hours a year thinking about their company health plans. Learn what
your options are. Your insurance agent can help you shop for
cheaper plans. But don’t stop there. Compare plan benefits,
insurance-company records, and service guarantees.

Consider Blue Cross and Blue Shield plans and HMOs
(health-maintenance organizations), even if your agent doesn’t
handle them. The Blues in some areas, offer clear advantages to
small companies. Experts regard HMOs as the best buys in health
care. Find out if your company is eligible for new, low-cost health
insurance plans now available in five states. In addition,
foundation-funded pilot projects in several parts of the country
are demonstrating that it is possible to cut health-coverage costs
30 to 40 percent. In short, health insurance isn’t as simple as it
used to be. And the pace of change is accelerating, offering new
hope for a truce in the business battle with exploding health-care
costs. The next couple of years present as much potential for
change as at any time in the past 20 years. You can be part of that
change by putting at least some of the following 5 ideas to work
for your company.

1) Increase Cost Sharing By Employees This recommendation is at the
top of every consultant’s list. Small companies tend to pay far
more of their workers’ total health-care bill than large companies
do. Yet research shows that insulating employees from the costs of
care encourages unnecessary use of health services. Fifty-two
percent of the companies responding to the Nation’s Business health
survey said they pay 100 percent of their employees’
health-insurance premiums. But 45 percent said they intended to
implement or increase employee contributions to these premiums. An
equal number said they plan to increase employee deductibles.
Insurance companies first attached $100 deductibles to
major-medical plans in the early 1950s. But 40 percent of employers
still set deductibles at $100 or less. Raising a $100 deductible to
$250 would cut premium costs for single coverage by about 11
percent. A $500 deductible would cut costs by about one-fourth. A
$1,000 deductible would save about one-third.

2) Allow Employees To Pay For Health Premiums With Tax-Free Dollars
Set up a so-called flexible spending account, which allows your
employees to pay their share of health-insurance premiums and
un-reimbursed health-care expenses with pretax dollars. A flexible
spending account could save employees 20 cents to 35 cents on the
dollar, because state and federal income taxes and Social Security
taxes are not imposed. Moreover, the company saves by reducing the
employee’s base salary on which it pays Social Security and other
taxes. Hire an outside payroll accounting firm to handle the
paperwork. You can pay the service fee and still come out with a
net savings. The monthly administration fee would run between $2
and $5 per employee.

3) Transfer High-Risk Employees To The State’s High-Risk Pool
Insurance premiums soar whenever someone in a small-group plan
becomes very ill–with cancer or heart disease, for example. As an
employer, you should explore the possibility of moving employees
with serious health problems into a state high-risk pool and then
negotiating a lower premium for the healthy members of your group.

4) Switches To An Open-Enrollment Blue Cross And Blue Shield Plan
Blue Cross and Blue Shield plans operate as de facto high-risk
pools in a number of states by providing “open enrollment” periods
during which any group can buy insurance. Among the 74 Blue Cross
and Blue Shield organizations nationwide, 21 offer open enrollment.
All the Blues once used community rating to set premium levels. But
that began to change in the 1960s when commercial insurers started
to lure away firms with low risks by offering them cheaper health

5) Replace Your Traditional Health Plan With An HMO Unlike
traditional health insurance, HMOs cover all medical needs,
including routine preventive care, for a flat monthly fee that
typically is less expensive than traditional health insurance.
Moreover, two types of HMOs, the staff and the group models, have
proven to be more effective at controlling costs than any other
form of health-care delivery. Staff models employ physicians
directly and put them on salary.

DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.

Five Ways to Cut your Health Insurance Costs

Know your Health Insurance Rights during a Lay-off

February 9, 2009

Providing health coverage for laid-off workers is good health
policy for all employers. This can take away some of the sting from
being out of work and COBRA payments. Tax credits for laid-off
workers are also available and can be a valuable element of a
phased-in national strategy to assist the uninsured. Laid-off
workers can receive effective, temporary “bridge” coverage between
jobs using the COBRA law. These benefits will be the same as with
their employer but at a higher cost. There are advantages in
targeting this on this group for helping. Providing health
insurance to persons becoming unemployed will help keep these
people on the map so to speak. One of the biggest problems with
American health insurance after unemployment is the disappearance
of it. Most uninsured Americans had health coverage at some recent
point but then lost it, typically because of unemployment, or some
other reasons, such as aging out of a parent’s policy or wage
in-creases that exceed public program limits.

Targeting these people for aid or assistance in lower premium
insurance will help reduce the number of uninsured. And as
suggested by many American public opinion polls, there is more than
90 percent public support for helping laid-off workers. This
addresses an important worry in the 165 million Americans under age
65 who have employer-based insurance. They too are afraid that a
pink slip could end their health insurance. Helping laid-off
workers obtain health coverage, regard-Less of the cause of their
unemployment, would also remedy an inequity created by the Trade
Act. It is hard to justify covering unemployed workers whose
lay-offs result from foreign competition while denying help to
equally needy and hard-working Americans who are laid-off for other

Moreover, a simple tax credit targeted to those who lose who lose
their jobs due to layoff would not risk unraveling or jacking up an
employer’s group coverage. Some policymakers fear that such tax
credits to assist the employed uninsured could cause some
businesses to drop coverage. Also young, healthy workers could take
up credits, leaving employers responsible for the higher-cost group
left behind. If credits were limited to laid-off workers and not
include working persons refusing health care plans, this would be
anything to worry about. One national survey found that 52 percent
of uninsured adults lost health coverage because they or a spouse
lost their job. No other single cause of insurance loss was
re-ported by more than 12 percent of uninsured adults. The only
thing these people have to turn to is COBRA, which when unemployed
can sometimes be impossible to pay for.

The federal Consolidated Omnibus Budget Reconciliation Act (COBRA)
is for workers who lost health benefits through voluntary or
involuntary job loss, reduction in work hours, or transition
between jobs. This gives them the right to continue group health
benefits through their current plan. COBRA requires that employers
with 20 or more employees that offer group health plans must offer
a temporary extension of health benefits. Under COBRA, employees,
their spouses and dependent children are eligible to continue
coverage for up to 18 months following lay-off or reduction in work
hours. Employers are not required to pay for continuing coverage as
the did when the person was employed with the company. The workers
are responsible for the full price of the plan and may be required
to pay up to 102% of the cost of the health plan

If your spouse or domestic partner is covered under employer-based
coverage you and your dependent children may be eligible through
that plan’s dependent coverage. Again, employers are not required
to pay for such coverage, and you may be required to pay the full
cost of the health plan. For more information, contact your spouse
or domestic partner’s employer. The only problem with this option
can be that you may have to wait till open enrollment to be able to
change the policy. Some employers will only let changes to be made
if there is a birth, death, divorce or marriage taken place. Other
than that most have to wait 12-18 months for the next opportunity
to add new people or change their benefits.

Private Health Insurance may be purchased by anyone directly from
any company that deals with health plans. However, individual
policies are generally priced higher than those through a group
plan, and insurers can ask about your health history and may
exclude “preexisting medical conditions,” deny coverage, or charge
less than healthy people a higher rate than they charge healthy
people. For more information contact the health plan or insurance
broker of your choice listed in the Yellow Pages under “Health
Plans” and “Insurance.” When deciding on a policy it is best to
speak directly with an agent. Make sure you get several different
opinions before deciding on a plan.

Know your Health Insurance Rights during a Lay-off

DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.

Discount Plans vs. Health Insurance

January 29, 2009

A woman from Las Vegas thought she was buying health insurance. It
looked and sounded like health insurance. The Las Vegas woman is
not 65 yet, which means she can’t get Medicare. So, she went online
looking for health insurance. She ended up finding something called
Healthcare Advantage, and signed up after paying $100. Come to find
out, this was not medical insurance at all and the sales
representative never told this poor lady. She found that out when
her cards arrived in the mail. In tiny writing at the bottom, it
read, “not an HMO, PPO insurance or managed care company”. This was
a discount plan. These plans do not have the same coverage as a
full medical health insurance policy. Make sure you know what you
are getting and if it fits your needs.

So what is a discount plan? The plans claims to save people money
by offering discounts on physician visits, prescription drugs,
dental work, eye care and other treatments for a monthly fee.
Unlike normal health insurance, which is very costly and very
selective about who it covers, a discount health plan accepts
everyone, no matter what health conditions they may have. You will
use a list of doctors that are willing to charge discounted rates
to the subscriber. Discount is not the same as coverage, and so you
will pay more for visits and other services that you wouldn’t with
a regular medical plan. The average savings is only 25% that could
be very expensive if you have to see a specialist or require
surgery. These networks claim to have as many as 400,000 doctors
and 50,000 hospitals available to choose from, but what if none of
them are near you? You can get a savings of up to 30% on both
generic and brand name drugs, which can also be costly if you have
multiple prescriptions or they are costly ones. So if you have a
health plan already but have a high deductible, this extra plan may
help save you some money. But to use as a complete health plan, it
really isn’t designed for that and will cost you more than a great

HMOs and other medical plans can offer full medical coverage at
great rates. Managed care plans are the way to go for those who are
limited on funds. They offer the best policies for the least amount
of money. Most of these plans are available to anyone and can save
you a ton of cash. You can make the plan even more affordable by
asking for a deductible, which will lower your monthly expense.
Most HMO’s do not have one at all but, you can request one, and
most basic PPOs and POS only have a small one, usually $200 to $500
per year, which you can also asked to raised. The co-pays are also
very reasonable with these types of plans. If you choose to
purchase an HMO, expect to pay about $5-$10 per office visit and
per prescription. With PPOs and POSs you will have a 20% co-pay
with both visits and medications. The differences are how strict
they are and you pay more of a co-pay to have extra flexibility.
Usually a PPO or POS plan is less expensive and you have more
freedom to see whom you want so the insurer makes you more
responsible for payment. HMOs tend to be the least expensive and
best policies for people with fixed incomes.

Make sure you know what your needs are and double-check what you
are getting. If you need full medical coverage with low co-pay then
a discount plan will not work for you. If you are already covered
by a medical group but have a large deductible then you might
benefit from the extra savings a discount plan can offer. Also, ask
whether the plan is insurance that covers your treatment, or is a
discount plan that still requires you to pay all medical bills
yourself. Beware of slippery sales pitches. Make sure you know
what’s being offered. Discount health plans may only sell you
access to a large mailing list of medical providers that it
purchased commercially. Don’t assume you’re getting access to a
large provider network just because your discount card displays the
network’s name and logo. If you plan to use a specific listed
doctor, hospital, pharmacy or other provider, ask a few questions
before you sign up.

Discount Plans vs. Health Insurance

DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.

The Long and Short on Short Term Health Insurance

January 24, 2009

Sometimes, short-term health insurance is just plain needed. If you
have just graduated from school, or left a job, or need to get your
own insurance on a temporary basis while you job hunt, this might
be the answer for you. This can also be very helpful while waiting
for your employer’s group health insurances waiting period to end.
Many employers require you be with the company at least 90 days
before you can even think about wanting insurance, and then it can
be the first of the next month before they kick in. If you can get
short-term coverage where you live these are good times to consider
this type of health insurance. As the name states, short-term
health insurance is health insurance that is top be used for the
short-term. For usually 30 days to 180 days though some plans will
offer coverage for up to 12 months. If you haven’t found what you
are looking for yet at the end of the period you can always renew,
if the company offers that possibility. You shouldn’t try to rely
on short-term health coverage for more than a year some companies
don’t allow renewal, and in fact, most don’t.

Usually you will receive many the same benefits as you would with a
regular health plan, the outline is very similar. It is just the
time you have on the plan that is different and what type of
procedures are most likely to come up that are mostly covered. You
will have the same limitations, freedoms, co-pays, and deductibles
as you would with any other private insurance. In most situations
you can pick out your own providers such as doctors, hospitals and
other medical professionals covered under your plan. You probably
won’t need a physical and your coverage will most likely start
immediately after receiving the first payment. You can also expect
previously existing conditions to probably not be covered. This
keeps the cost down and makes you look to more long-term policies
for your needs. The point of this policy is to protect from those
unexpected accidents, illnesses, and emergencies, not provide
routine care that would only be done once in a year and can come
out of pocket. The point of this plan is to be inexpensive and keep
you from the big money pinches.

Many short-term plans don’t offer some of the same benefits as
regular plans, this helps reduce its cost. They are more concerned
about what will be covered in the short-term basis then any normal
routine things that might come up during that period that you can
cover yourself. There is a good chance that you will not be covered
for regular check ups, pregnancy and childbirth costs, dental,
vision, or preventative exams. Your coverage will most be likely to
include illness and emergency care which would cost you the most
out of pocket. So you will definitely want to get a new plan
through work or privately as soon as you find one that suits your
needs and budget. Having a permanent health package is much more
suitable and economical. Short-term plans are meant to bridge you
through till you get a new plan that has long-term coverage.

Short-term health insurance is exempt from the Health Insurance
Portability and Accountability Act. In other words, you will not
qualify for COBRA if you only have this type of coverage at your
job and not a normal health care plan. As a result, most carriers
don’t have to guarantee to renew you when your time frame is over.
They also don’t have to waive pre-existing conditions, even when
other plans would. They only have to help out with those rare
occasions you might get sick or if there is an emergency. Let’s
face it; you won’t be likely to have too many emergencies in a
year, so the company is making a profit. It is much better and
economical to get a regular plan as soon as you can to avoid paying
out too much money in routine costs. You would not want to keep
this type of plan if your employer offers medical benefits. If,
and/or when, you leave this job you want to be able to qualify for
COBRA and have all the necessary benefits, instead of pay more for

The Long and Short on Short Term Health Insurance
DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.

Interpreting Health Insurance Hieroglyphics

January 5, 2009

Trying to figure out everything that is on your insurance policy
can feel like trying to read a new language. Having an illness or
non-work related injury is devastating enough, trying to figure out
what is covered and what is not can be a whole other picnic.
Especially when prices on health care have raised so much. Even
though managed care can really save people some serious money, you
have to know what each term means and how it works in you specific
plan. If you have a group plan from your employer you are
definitely paying much less than if on your own, but do you really
know what that plan really says or what it offers? Some people are
better off and covered more for their own private plan once they
figure out the medical lingo.

The whole point of health insurance is to pay for the accumulating
cost of exams, diagnostics, and treatments of any particular issue
you may have. There are several coverage options when it comes to
what kind of health care plan you have or want. Try to pick a plan
that best meets you needs and budget, this will help you save
money. Also, don’t feel dumb if you have no clue what your agent
says. You can ask them what things mean if you don’t know. You are
better able to understand what you are covered for than be
surprised when you get the bill. It is better to know what is
available to you in health benefits on all fronts. Become familiar
with the types of plans available and know their specific
advantages and disadvantages so you can best determine what works
for you.


?Indemnity Policies (Traditional Fee-for-Service Insurance)
?Preferred Provider Organizations (PPOs)
?Health Maintenance Organizations (HMOs or Managed Care)
?Self-Insured Health Plans (Single Employer Self-Insured Plans)
?Multiple Employer Welfare Arrangements (MEWAs)


Assignment of Benefits: Your signed authorization to give your
doctor or hospital (medical provider) direct payment to them for
your medical treatment. This means you do not see the money and
don’t have to pay at the time of service more than your co-pay.

Business Day: Every day that insurance companies are open for
business, which excludes Saturday, Sunday, and state and federal
holidays. These tend to be from Monday to Friday from 8-9 AM to 4-5
PM their local time.

Calendar Day: Every day of the calendar month, which includes
Saturday, Sunday, and state and federal holidays. If something
happens on a Saturday, Sunday, or holiday you will be able to call
in a claim but it will not be recorded till the next business day.

Certificate of Coverage: The document you get that tells you that
you are a member of the group and hold a policy.

Certificate of Creditable Coverage: A written statement from your
previous insurance company and/or health plan stating the length of
time you were covered with them.

Claim: A notification to your insurance company that payment is due
under the policy provisions.

Co-payment – The portion of charges you pay to your provider for
covered health care services in addition to any deductible.

Coverage: The actual details of protection provided by an insurance

Denial: An insurance company’s decision to withhold a claim payment
or demand a preauthorization. A denial may be made because the
medical service is not covered, not medically necessary, or
experimental or investigational.

Deductible: A set amount of money paid by the insured for medical
costs before benefits kick in and pay.

Exclusions and/or Limitations: Conditions or circumstances spelled
out in an insurance policy that limit or exclude coverage benefits.
It is important to read all exclusion, limitation, and reduction
clauses in your health insurance policy or certificate of coverage
to determine which expenses are not covered.

Experimental and/or Investigational Medical Services: A drug,
device, procedure, treatment plan, or other therapy, which is
currently not within the accepted standards of medical care. These
items are more than likely not covered.

Grace Period: A specified period immediately following the premium
due date during which a payment can be made to continue a policy
without interruption. This applies only to Life and Health
policies. Check your policy to be sure that a grace period is
offered and how many days, if any, are allowed.

Independent Medical Review: A process where expert medical
professionals who have no relationship to your health insurance
company or health plan review specific medical decisions made by
the insurance company.

Medically Necessary: A drug, device, procedure, treatment, or other
therapy that is covered under your health insurance policy and that
your doctor, hospital, or provider has determined essential for
your medical well-being, specific illness, or underlying condition.

Policy: The written contract between an individual or group
policyholder and an insurance company. The policy outlines the
duties, obligations, and responsibilities of both the policyholder
and the insurance company. A policy may include any application,
endorsement, certificate, or any other document that can describe,
limit, or exclude coverage benefits under the policy.

Visit us for more information on Interpreting Health Insurance Hieroglyphics
DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.

Tips for Small Business Owners Shopping for Health Insurance

December 9, 2008

When going into business on your own, it is hard to look past the
overhead cost you have just sunk into it. There several other
issues that needs to be on the forefront of your business now. As
you hire people to work for you, what are you going to be able to
offer them? In today’s market employers must offer competitive
wages and benefits to attract and keep good employees. Small
business owners who have less than 20 employees are not required to
provide medical insurance but if you want high quality workers, you
better get it. There is a high demand for small business owners to
provide health care benefits. With the rising cost of medical
treatment, most people cannot afford to not have health insurance
and will gladly leave a job that doesn’t off it. Some people prefer
to have a slightly lower wage than not have benefits. When you
offer your employees benefits that save them long-term money, it
makes them want to stay with you and not go somewhere else.

The new trend in the job market is that the low-wage hourly
workers, the people most like to be uninsured, are now being
offered medical plans in their budget ranges. Small restaurant
owners, day care providers, and other small businesses are
realizing that to get good people to stay, they need to offer them
an incentive. Almost all people expect heath benefits today to be
in their benefit packages. This can be costly to you, the small
business owner, because the best group rates are for large
companies with lots of employees. You might find yourself forced to
give a higher premium to your employees, but having the benefit is
better than nothing. Plus even though they pay a higher premium, it
is still much less expensive than a private rate for them. You need
to stay competitive though and not offer something that is truly
different than all other businesses, including large ones. If the
overall cost to the employee is so high, then they might just
decide to go work somewhere else.

Find out what your employees need the most and purchase plans that
fulfill those needs and not a bunch of things they are not
interested in. Most basic plans can cover routine doctor visits,
sick visits, hospitalizations, medications, and emergencies and
still be a reasonable price. You might want to look at what larger
companies offer and see if you can make some of that work for you
and your employees. The playing field is not fair for the small
business owners; premiums are higher and more expensive than for
larger places. But there are many ways to get a good package that
is still reasonable in cost. Make sure you know what types of
coverage is mandatory and what is not. Some states have
requirements on such things like fertility treatments that even
though your employees might not need are a necessity. These types
of necessities are what make it so hard for the small business
owner to provide affordable health coverage.

Don’t despair, there is still hope. There’s no question about it
that small businesses are in a tough spot. You are not powerless
though by any means. There are several options including having the
employee pay more of their own premium, having higher co-pays for
employees, making sure you have an HMO verses a PPO, and also
having the plans be just for the employee rather than offering a
family plan. You can also save money in what type of prescription
drug plan you are going to offer. Many doctors are offering more
medical treatments for correcting diseases and disorders verses
more costly invasive procedures. With higher drug costs and most of
that cost having to be passed to the employee, it might be better
to offer a drug plan then to have that included in the health
package. The employee will pay a very small premium for this
benefit and save 50% or more on their prescriptions. If you decide
to include prescriptions in your over all plan, think about having
higher co-pay at the pharmacy. So, instead of a smaller $5-$10
co-pay you might have it raised to $20-$30 to save money on the
monthly premium.

DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.

Tips for Small Business Owners Shopping for Health Insurance

Stay Healthy and Keep your Insurance Premiums Down

December 4, 2008

Stay healthy, so you can switch plans. All health insurance plans
have rate increases, and you have even seen premiums jump on some
HSA plans. If a rate increase happens to you, you can switch to a
different insurance company – but only if you pass their
underwriting requirements. If chronic disease develops, you may be
stuck with your current plan, and its accompanying rate increases,
for eternity. Or at least it may seem that long. If you pay
attention to the pharmaceutical commercials, you learn lifestyle
really has nothing to do with disease, and it is natural and
healthy to be on many medications for the rest of your life, which
will then solve your health problems. If you pay attention to the
science, you know the truth is quite different. It appears
lifestyle is probably 95% of the picture, and you know the
occurrence of degenerative disease can be dramatically reduced and
even prevented.

Fortunately, many customers are interested in wellness, and disease
prevention. After all, they’re paying for their own doctor visits
if they do get sick. It is because HSA owners are “forward
thinking” people, and like to plan for their future – both
financial and physical. You can improve your odds of excellent
health with just a few key habits: Eat very high quantities of
fresh vegetables and fruits. Shoot for 35% of your calories. This
will lower your risk for diabetes, high blood pressure, heart
disease, cancer, and more. Limit your intake of sugar and starchy
carbohydrates like bread and pasta. The majority of health problems
in the U.S. are related to metabolic diseases that involve insulin
resistance. Exercise and lift weights. Exercise guru Jack La Lanne
just turned 92 on September 26, and he says if you have muscles you
never feel old.

Life Quote Is About Life. Better Health Means Lower Insurance
Rates. Most people get nervous about their health and how it can
affect their insurance rates. Your health is key in how much you’ll
pay for Life Insurance.

Life Insurance Facts:

Cigarette smokers pay at least double the premium for life
insurance than non-smokers. People, who are overweight, have high
blood pressure or high cholesterol could pay more for life
insurance. A family history of heart disease, cancer, stroke,
diabetes or other chronic diseases will make your insurance rates
increase. Having chronic diseases yourself can increase your Life
Insurance Premiums.

Life Insurance companies classify people by different categories
that essentially determine their risk of dying. The best category
and lowest price is “Super Preferred”, followed by “Preferred.”
Prices keep rising with “Standard” and “Special Class”. To be
honest, only the healthiest people in America are rated Super
Preferred. The average person will qualify for a standard rate. The
classifications vary from company to company the point is you do
have control over lifestyle choices that can hurt your health. You
should take a proactive approach and work at staying healthy, at
the gym and at the doctors’ office. Insurance companies will reward
you for it! Which is why it’s a good idea to shop around.

Tips to Improve your Insurance Health:

Regular medical treatments to monitor and stabilize chronic
diseases can influence insurance companies to offer you reasonable
rates. Heart disease, cancer, diabetes and stroke are no longer
uninsurable conditions. Insurance companies just want to see proof
that you’re improving your health. Lowering your weight and
controlling your cholesterol or blood pressure with a low fat diet,
regular exercise or medicines can result in a reduction in
insurance premiums. You can’t change your family’s medical history
but you can certainly take care of your own with regular check-ups
and by practicing healthy habits. Your clean bill of health counts
with insurance companies too. If you smoke, the surgeon general
says quit. Insurance companies judge smoking as a critical risk
factor in determining your premium. Do yourself a favor kick the
habit. For your life, as well as your life insurance.

If you quit smoking now, your rates will drop significantly if you
re-submit your “healthier” non-smoker status to insurance companies
a year later. If this doesn’t motivate you who knows what will. How
about saving some money on your life insurance policy? If you end
up paying more, don’t get mad at the insurance companies. Get mad
at yourself! For lifestyle tips and medical information to get you
started, check out some of the leaders in the business of making
you healthy–your doctor!

Stay Healthy and Keep your Insurance Premiums Down

DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.