What Your Age and Habits Could Mean in Obtaining a Health Insurance Quote

August 30, 2008

 

Many people don’t start to think about life insurance until they
have gotten older, married, had children, or have settled down.
There are many risks to waiting that long. The older you are and
the more you have put yourself through over the years can come back
to haunt you. A single person in their 20s who doesn’t smoke and is
in perfect health can get a much larger policy at a better cost
than the same person in their 50s, or someone who smokes and abuses
drugs or alcohol. Age and lifestyle habits play a big role in how
much coverage you will get and at what price you will pay. Many
people think they can keep this hidden. Not only is that not always
the case, you can get dropped and in some cases sued if you lied.
Many companies have you get an exam and have all your previous
records sent to them before determining your eligibility.

Most insurance companies want you to be in the best health. This
means you will pay more over time and have less need to use it. So
the company makes a big profit off of you. There are typically
three types of premiums, standard, preferred, and preferred plus.
If you have not had a cigarette in more than five years of never
had one your premiums will be lower than if you have had one in the
last five years or are currently smoking, this would be the
preferred plus program. Being an averagely healthy person and not
smoking in the last three years will buy you the next best rate,
preferred, at a lower cost than many. The standard is for those
individuals who might have some health issues and have not smoked
in at least 12 months, they are still pretty good rates as well.

Then, you have the rate for smokers, which is about three times
higher than those who haven’t smoked or in the last 12 months. This
is what makes many people lie about whether they smoke or not. But
you have to think if you are being treated for multiple bouts of
bronchitis, pneumonia, and upper respiratory infections each year,
they will get suspicious. Plus, your doctor will be able to smell
it on you and has to inform the company if they think you smoke or
live with a smoker. Some insurance companies will require a urine
sample to see if you have nicotine in your system. It is harder
than you think to lie to them. It is possible to cheat if you stop
smoking for 72 plus hours before your urine sample is taken,
nicotine is gone by then. But you never know when they will ask for
another sample unannounced. There of plenty of insurance companies
that don’t care if you start smoking after you got the policy as
much as lying to get it.

Alcohol is another reason your insurance premium can go
skyrocketing out of control. Even just moderate drinking can cause
some companies to up your cost or deny you a plan. Some insurance
companies
don’t care how much you indulge as long as you don’t need
treatment or sought treatment for alcoholism. Alcohol abuse can
cause many health issues and reduce a person’s life by a minimum of
10-15 years or more in some cases. The insurance companies will
also want to know great lengths about your medical history and
probably demand records as well. This can give them plenty of
insight to your alcohol use. They will be looking for specific
alcohol related diseases that you might be treated for. They will
also look at your driving record to see if there is any alcohol
related incidents, which would bump you to a higher premium.

As far as age is concerned, usually people under 60 in very good
health can get a good policy for a great price. The prices tend to
go up as people age due to the fact that they are not expected to
live as long and the company won’t make as much money. If you have
other health issues or bad habits that can make the plan rise in
cost too. Now, there are several insurance companies that cater to
the older groups of people for a decent price and all right
coverage. You want to look at several companies to find out what
you need and what works for you.

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.

Advertisements

Disability Insurance – Why You Need It Now More than Ever

August 25, 2008

 

Disability insurance is very important for many people and even for
the people who don’t need it. One never knows what can happen, so
to have this available is extremely important. A non-cancelable
disability contract guarantees that your policy cannot be canceled
or have the rates change as long as you continue to pay on time.
Another type, a guaranteed renewable contract, ensures that the
terms of your policy stay the same, but the cost can change over
time. The last kind of disability contract is an optionally
renewable policy. This policy can be canceled by the company at
renewal time and require exams. These types of policies help those
with disabilities obtain and keep medical coverage. There can be a
grace or waiting period but usually you will be reimbursed for
anything accrued at that time.

The waiting period is the time from your first claim to the day you
get your first disability check. Your insurance premium will be
based on your benefit amount, the more you get each month the
higher your premium will be. The longer you collect disability the
higher your premium will be as time goes on. A doctor to determine
eligibility will obtain your current health status and medical
history. If you have any pre-existing conditions or injuries, it
doesn’t mean you are not going to get it. You need for it now
relies on what happened to make you disabled.

You are defined as disabled when the condition that is keeping you
from being able to work is defined and in your employee manual.
This definition will also tell you what you qualify for and how to
obtain it. It will also inform you of whether or not you are
entitled to a new job till you are better or have to be out of work
completely. Some companies offer easier jobs that pay the same
instead of losing an employee and having to pay. Everyone should
have some disability coverage. If you get hurt on the job and can’t
continue your current position you need to have protection that
will keep you from not being able to live. You want to make sure
you know what your business’s policy is in case you need it at some
point. Many companies have group policies that cover all employees
that are working there. One would need to find out if the policy
covers injury and illness or just injury. Also what the time frame
is and will you possibly require more. Most of these will only
cover you if you are injured at work and for a minimal time period.
Some companies don’t even have this type of insurance and you would
be out of luck if injured, while others have several types of
disability, including long and short term.

If you do get injured on the job the first step is to be seen by
your employer’s doctor. This is whom you will be seeing for as long
as you are disabled and collecting disability. You will be examined
and told what is wrong as will your employer. A determination will
be made as to what needs to happen and who is responsible. If you
are declared injured and cannot return to your normal job, another
position must be found for you or you will be paid while on leave,
if this is in the company’s guidelines. Not all employers will pay
so make sure you are working for a company that has extensive
disability insurance that covers both short and long-term issues.
Also see if they cover illness and injury that is not work related.
Many people lose their jobs because they cannot go back to work for
a long time after an injury and the injury didn’t happen at work.

Your coverage will begin after you have been examined and given a
diagnosis. Once all the necessary documents have been filed and
what you are required to do has been set, a new position or payment
will be assigned at that time. You must make sure that if you are
going to be out of work for a long term disability you must pay the
agreed premium to keep the benefits coming and make all
appointments and requirements set by your employer. To breech any
of this could terminate your claim. Make sure you know what is in
store at your job in case of illness and injury you may need it
someday.

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 Six Top Things to Look for in a Health Insurance Plan

August 21, 2008

 

When deciding on health insurance, one needs to be aware of his or
her needs first and foremost. Many plans are similar but slight
variations in coverage and expense. Most insurance companies offer
similar deductibles and cover all the standard routine issues that
arise in health. Some plans are more expensive and make the insured
responsible for more expense but offer a wider range of control.
Some plans are designed for the budget consciences individual and
has more restrictions but costs less. So look at what type of
health needs you have and think about how often you need to visit a
doctor. Make sure your doctor is cooperative in giving referrals
when needed as well. Here are some things to think about when
deciding what plan is best for you.

1) What plan benefits are offered to the insured? Most plans
provide normal medical coverage. But see what other services you
may need and if they are available easily or at all. Make sure that
you are aware of any additional fees that might be placed on you if
you see certain types of doctors or other medical professionals.
Does this plan have restrictions on pre-existing conditions or
chronic illnesses that can cause a premium increase or higher
co-pay in the future. Know what you are getting and make sure that
it works for you. If you aren’t sure call the company directly and
speak to someone who can answer all your questions.

2) Physical exams and health screenings as a form of entry into a
plan. Does this work for you or not, and do you not want to
disclose your medical issues prior to getting a quote. Many
insurance companies want to have you seen by one of their
physicians to make sure you won’t cost them money by having any
chronic illnesses. If you have some medical conditions that require
frequent visits and treatments you may not want to look at these
providers for help with coverage.

3) Care by specialists. If you require the care of specialists,
such as a cardiologist, nutritionist for diabetes or obesity, or
any other type, you want to make sure this is fully covered on your
chosen plan. You don’t want to just sign up for a plan that is in
your price range and then find out you can’t see the doctors you
need to. Be sure to see all the information on added coverage above
and beyond just basic needs.

4) Hospitalization and emergency care. Most HMOs require a referral
from your primary care doctor before you may go to the hospital.
Some insurance companies will not pay for hospital visits on the
weekends unless the doctor was called and gave the referral prior
to you going. Some will even require that you wait till the next
available business day to see your doctor first if it isn’t a life
or death emergency. If you have conditions that might require a
trip to the hospital, be sure that your policy works for you. In
the middle of a panic attack is not a good time to wait for the
“on-call” to call you back, give permission, and call the hospital
for you. You need to know that are safe to call and get emergency
care and get the referral the next business day.

5) Prescription drugs and what will the company pay for? You might
want to take into account how many prescriptions you need and what
the cost of each one is. If you are used to small co-pay, it can be
a slap in the face to find out you have to pay 20% of a $150
prescription. Many people who require some or lots of daily
medications will benefit more from a HMO that has a small fee like
$5 or $10 per prescription and/or a small deductible.

6) Vision care and dental services. Find out if these are included
in your plan or whether you need to purchase one or both
separately. Many plans will include yearly and emergency eye exams
and visits. Also many offer some coverage on eyewear to some
extent. Most dental plans are separate and require a separate
insurance or slightly higher monthly fee to be added.

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 Great Debate – PPO vs. HMO

August 18, 2008

 

Both HMOs and PPOs have benefits and downfalls. This will be
dependent on what you are looking for and what kind of coverage
that best suits your needs. Many people swear by one or the other
and have no desire for the opposing insurance. But they are very
similar in many cases and the things that make them different, are
where the benefit or deficit lies for the individual.

A HMO is a collection of health professionals, doctors, hospitals,
mental healthcare workers, and other specialists, who work for a
set fee. There are independent HMOs in where all the staff members
that work there work directly for that private HMO. A broader
spectrum of doctors and other health care workers can agree to a
set fee for service with many different HMO plan companies and are
not actually owned by the HMO itself. HMOs are designed to save
people money while getting the entire healthcare they need. Co-pays
for visits and prescriptions are usually very low and there is no
deductible to be met. However, HMOs do have their downside. HMOs
are in business to make money and so if you have many health care
issues
, you may not be accepted or have to pay more. If you have a
chronic medical condition that requires many visits, tests, and
treatment you will cost the HMO lots of money. They balance this
out by keeping a tight hold on your health care. They must approve
all visits prior to you going.

HMOs are usually extremely restrictive and have lots of rules that
must be followed if you want them to pay. You can only see the
doctors on your HMO list, and you must see your primary care doctor
first, no matter what is wrong with you. If you have to go to the
hospital you must have your primary doctor’s permission prior to
going. Many people find that way too restricting and choose to not
go with HMOs for that very reason. When and if you need to see
specialist, you must have seen your doctor first to make sure they
can’t treat you instead of going to a more expensive doctor. The
HMO makes sure it is their doctor who has control over all your
medical needs, not you. Most doctors are excellent and will hand
out referrals and most doctors these days are enrolled in HMO plans
so this isn’t a problem for many people. If you are not one of the
lucky ones, getting the care you need could be difficult or
non-existent. HMOs can also be a bit fussy about you wanting to
change your primary doctor. So be sure that you like your doctor
and you have spoken to other people who are patients of him or her.

Most HMOs also have a patient quota that the doctor has to comply
with. He or she must see a set number of patients per day to avoid
penalization or being removed from the group. This is why there is
never enough time to talk with your doctor past your examination
point. They need to keep it short so they can see more patients.
There is also the concept of Capitation that gives contracted
doctors a set amount of money for each patient each month. This is
given no matter if the patient is sick or well. Lastly you must
make sure any labs or tests you need are covered with your plan or
they won’t be covered. But for most people who have HMOs this is
not a problem and their doctors are great, so they don’t have any
problems at all.

A PPO is a collection of private-practice doctors, labs, cares
facilities, and hospitals that contract with insurance companies
and receive an agreed set rate for their services. These plans have
much less restriction but cost more to the patients. The patient
has more control over their own medical needs and doesn’t need a
referral as long as the doctor they are seeing is a member of the
PPO. The co-payment is higher because the plan only covers usually
80% of the fees. So that makes you the insured responsible for 20%
of all your fees from all medical treatment including hospital
stays. You may also have a deductible to meet before your coverage
starts each year. PPOs hire nurses and medical professionals to
handle patient cases and make decisions about hospital visits and
diagnostic tests. You have more freedom, but you end up filling out
claim forms.

PPOs are great for people who have the money and want to have more
freedom in their healthcare choices. If you are a person with many
health issues that require several different opinions, extensive
tests or treatment, and need specialists, this plan gives you a
better choice and fewer restrictions on what you can do. You won’t
have to wait months to see the specialist; you will be able to just
go. It will cost you more money, but you ill have your needs met
faster.

So which type of insurance do you choose and is one better than the
other. HMOs can be a lifesaver to many people who need insurance
but don’t have a lot of money. But for many people it is just a
personal preference based on their own needs and the needs of your
family. So, one needs to take a look at all options and make an
informed decision. Neither one of the plans is perfect, so pick the
one that best suits you.

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.


Your Choices in Health Care Plans Explained

August 14, 2008

 

Choosing between health plans can be difficult and confusing for
many people. Trying to find a plan that best fits you and your
families needs is not task. Most plans differ in the way they work
and how much you pay as a premium and co-pay. You will find that
some plans will pay for some services more than others and need to
look at what your individual needs are. Most plans today focus most
of their benefits to preventing illness and reducing the need of
medical attention by providing most of their coverage on
preventative visits and treatments. Many companies also require a
health screening and won’t pick you up if you have pre-existing
conditions. Check to see if premiums are higher for people with
chronic illnesses, such as diabetes or hepatitis, or for smokers.
There are two different types of coverage available, indemnity or
fee-for-service, and managed care.

The Indemnity Plan allows you to use any medical provider you want
to and not need to get any referrals when seeking specialized
treatment or care. You can also go to any hospital that you want
and not have to worry if you are covered. These plans tend to have
a deductible that needs to be met each year before they start
actually paying for some of the medical expenses. These deductibles
can range depending on the plan you need and are usually between
$200 and $1000 per year. The company will then start to pay a
portion of the bill; usually 80% is the standard. You would then be
responsible for the other 20%. Depending on your doctor you might
be responsible for this payment at the time of treatment. Some
doctors will bill you at a later date, but that is rare. Usually
these types of plans will pay for treatment and prescriptions but
not very preventative friendly. You might find you have to pay for
routine physicals and the like with type of plan.

Managed care is the plans most people are used to seeing and hear
most about. There usually are the choices of a Preferred Provider
Organization (PPO), a Health Maintenance Organization (HMO), or a
Point-of-Service Plan (POS). These have some very similar benefits
and you should read carefully through each one to see the
differences and figure out which one would be best for you and your
family.

Preferred Provider Organization (PPO)

A PPO is very similar to an indemnity plan. It has arrangements
with doctors, hospitals, and other providers who have agreed to
accept lower fees from the insurer for their services. As a result,
going to any of the doctors listed on the plan as accepting this
type of insurance, you lower your cost. With PPO if you want to see
a doctor outside the network then you will need to get a referral
from a doctor with in the network first. That is where PPO differs
from indemnity plans. You will pay small co-pay whenever you go to
the doctor and for prescriptions. But you are covered when it comes
to physicals. When you do go outside the network you will be
responsible for the co-pay and extra money that doctor charges, so
your portion will be higher.

Health Maintenance Organization (HMO)

HMOs are the oldest form of managed care plan and been around a
long time. They offer a range of health benefits, including
preventive care, for a set monthly fee, co-pay on prescriptions,
and no deductible. There are several types of HMOs. There is the
type of HMOs offer at most jobs that is a staff or group model HMO.
Some HMOs contract with physician groups or individual doctors who
have private offices, called individual practice associations
(IPAs) or networks. You will be given a list of doctors to choose
from and will pick one as your primary care physician. This doctor
sees you whenever you have a health issue and for yearly check-ups.
If you need to see a specialist or other doctor he/she will give
you a referral. You will also need a referral to go to the
emergency room in some cases. With most HMOs you will pay nothing
to see your doctor, but some do have a very small co-pay of $5-$10
per visit. You must get a referral to go out of the network or be
required to pay for the visit in full. In some cases you might be
required to pay in full if there is a network doctor available and
you refuse to see that one.

What is a Point-of-Service (POS) Plan?

Some HMOs offer an indemnity-type option known as a POS plan. In
this type of HMO, a POS plan, members can refer themselves outside
the plan and still get some coverage. If your personal doctor
refers you to a doctor out side of the network you will be fully
covered by the plan.

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 Tips to Trim your Medical Expenses and Save

August 7, 2008

 

With the rising cost of healthcare, medications, and insurance, it
isn’t surprising that people are trying to figure out ways to avoid
getting sick and choosing a better lifestyle to lower insurance
costs. There is actually quite a bit one can do to help save same
cash. It is just a matter of tweaking ones lifestyle choices and
preventing health issues from arising or keeping the immune system
up so you just don’t get as sick as much. For those people who are
seriously sick of high medical premiums and paying out the nose
year round for doctor’s visits and medications, this should be a
great thing. Small things make a world of difference when it comes
to your health.

1) Stop smoking is the biggest one. Not only do you get sicker than
the average person, it is worse. Many smokers are treated for
several bouts of bronchitis and pneumonia each year. Smoking also
makes you susceptible to colds and other infection. You will also
pay a higher premium on your insurance and in some cases won’t get
covered in full for cigarette related illnesses or diseases. Plus
the money you save from quitting can go to bigger and better things
than your medical issues.

2) Avoid excessive alcohol use, it lowers the immune system. People
who consume more than 3-4 alcoholic beverages in a week are at far
greatest risk of catching a viral or bacterial infection. Even if
you do most of your drinking at home where you are safe from others
germs, you still are very susceptible. Once the immune system has
lowered its defenses you are risk anywhere you have to go and even
in your home if you live with others who leave the house. Drinking
excess alcohol can also lead to other very expensive health issues,
such as liver disease or alcoholism. To be diagnosed and treated
for chronic liver problems can and does cost deep in the pocket.
Not to mention once you have this getting medical insurance with
another company will be very hard and costly for a pre-existing
condition. Plus current insurance premiums could rise now that you
have a chronic condition.

3) Eat a healthy and nutritious diet to maintain your body’s
strength and vitality. The type of foods one puts in their mouth
can be the difference between life and death in some cases. Eating
right and getting all the nutrients and vitamins can severely
reduce the risk of many diseases. Cutting out fatty, fried foods
can keep your heart and circulatory system strong and healthy, and
lower your risk of a heart attack and/or stroke. Many vitamins and
minerals found in food also promote a strong immune system, which
can help keep you infection free more often. Just adding more zinc
to your diet can help boost your immune system enough to prevent
catching colds and flues.

4) Get plenty of exercise. The better tone and condition your body
is in the less likely you are to get sick or have weight related
health issues. It is very important to get exercise to keep your
body happy and healthy, and prevent your money from going to
undesired medical treatments. Regular and consistent exercise can
help prevent heart related health problems later on in life. It
promotes a better circulatory system and stronger heart muscle.
Exercise also promotes better oxygen intake, which helps the lungs
become more efficient. Also increased oxygen aids in better
metabolism and can keep weight in check and reduce other illnesses
like asthma and diabetes.

5) Make sure you have time or make time for rest and relaxation.
Keeping healthy also includes staying happy. Reduce your stress,
get plenty of sleep each night, and have leisure time. It is
important to enjoy life and do things that ease tension and promote
happiness. Proper rest and fun can cut down the risk of developing
mental issues such as depression or anxiety that can cost much
money in treatment and control of the disorder. Having that balance
in ones life can really promote great mental health and clarity.
Being burnt out or stressed out is associated with many disorders
such as depression, anxiety, ulcers and other stomach issues,
headaches, and insomnia. All of these ailments that can be
prevented will save you tons of money on doctors visits, tests and
treatments.

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.