Medicaid Madness – The Latest in Eligibility Requirements

November 15, 2008

Medicaid is state regulated and funded health insurance that helps
low-income persons who can’t afford medical care pay for some
and/or all of their medical bills. If you qualify and don’t have
medical insurance, Medicaid can help you stay healthy and assist
you till you find other resources. Medicaid is available only to
people with limited income and has strict limitations. In order to
qualify, you must fall into a group of persons that meet specific
criteria. Medicaid pays money directly to your health care
providers. Depending on your state’s rules, you may also be asked
to pay a small part of the cost (co-payment) for some medical
services or prescription drugs. .

Many groups of people can be covered under Medicaid that will
qualify under their own group’s specific guideline. Some examples
of group’s requirements can include your age, whether you are
pregnant, disabled, blind, or aged or your income and resources.
Resources can be cash or any item that can be sold for a
substantial amount of money, or bank accounts, or property. Another
requirement is whether you are a U.S. citizen or a lawfully
admitted immigrant. The rules for counting your income and
resources vary from state to state and from group to group, so you
should check the requirements that pertain to where you are living.

In addition, for those persons living in a nursing home or at home
with disabilities, there are specific rule and guidelines to be
met. Your dependent child or children may be eligible for coverage
if they are U.S. citizens or a lawfully admitted immigrant, even if
you are not. Eligibility for children is based on the child’s
status, not the parent’s. Also, if someone else’s child lives with
you, the child may be eligible even if you are not because your
income and resources will not count for the child.

General eligibility requirements you must meet to obtain Medicaid
in your state may vary from other states, but they are pretty mush
based on the same criteria. You must meet the income, dependent,
resources, and other various requirements asked on the application
to qualify. People who qualify are individuals over 65, blind, and
disabled for social security disability purposes. Others are
families or single parents with children under 21 year old who
either don’t make enough money, don’t have health benefits at a
reasonable cost, or are on public assistance. Single and married
persons with a temporary disability, limited income, special
circumstance, or between the ages 59-64 also can meet the criteria.
If you need to seek drug or alcohol treatment, or are the victim of
domestic violence you are eligible for Medicaid during treatment
and possibly after the crisis is over. You can also qualify if you
are caring for a child or disabled person.

When applying for Medicaid your eligibility is determined by your
income and that can come from various sources. They compare the
income and to the size of the family to determine if they qualify.
Qualifying income is, and not limited to, earned wages, interest,
dividends, social security, veterans’ benefits, pensions, child
support, and spouse or partner’s income if living with them. Types
of payments that aren’t considered countable income are public
assistance, social security benefits, food stamps, low income home
energy assistance program benefits, foster care payments, certain
housing and utility subsidies, and weatherization payments. There
are income limits of course and they are strict, if you exceed them
by a penny you don’t qualify. The limits are different depending on
the amount of family members living in the home and requesting the

You will have to have proof of your resources and family size to
determine if you have resource limits and are eligible. Different
groups of qualifiers will vary in what resources they can have.
Resource limits do not apply for those persons with children at
home and under the age of 21. Resources that are counted in
eligibility determination are cash, checking and/or saving
accounts, certificates, Christmas or vacation clubs, stocks and
bonds, some types of trust funds, life insurance, vehicles,
revocable burial funds, and non-resident property. Items that
cannot count against you when determining eligibility are your
home, burial space and marker, and one vehicle per household. If
you are a student and get federal grants and loans, those cannot be
counted either. Find out more about Medicaid Madness – The Latest in Eligibility Requirements

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.

Defining Point of Service (POS) Health Insurance

November 3, 2008

A POS or Point of Service plan is kind of like an HMO and PPO
combined type health care plan. You have more flexibility than a
regular HMO, but pay a smaller fee and deducible than a PPO. It is
perfect for those people who need more flexibility but want to pay
less. You will be asked to select a general provider that is off
the list of acceptable doctors. This will be your primary care
physician and he or she will be the one to manage what care you
receive. He or she will direct you to specialist and hospitals as
needed that are also participants in the plan. Usually there are
many providers from each specialization to choose from and
typically covers a wide geographic area. With this type of policy,
you will not have a large deducible if any, and still have a
minimal co-pay on visits and prescriptions. Of course, this is if
you stick with the preferred providers list. You also may want to
make sure what drugs are covered under this plan and if you have to
pay more for newer on not generic medications. Some doctors don’t
think about what kind of insurance you have when writing out the
prescription and you need to remind him or her if you are only
allowed to buy generic to be covered.

You will also have a choice to see out-of-network providers when
you need a specialist and they are not on the list. Most POS plans
require you get a doctor’s referral prior to seeing another doctor
or specialist. Once referred to a specialist within the network,
you will have to be prepared to pay more. If you choose to do this,
you will be billed directly and must submit the claim to the
insurance company your self. Your insurance company will pay their
flat rate for whatever you had done and you will be responsible for
the rest. You may also be responsible at the time of service to pay
the entire amount and wait to be reimbursed your self from your
insurance. If you chose to see a specialist on you own, the cost
will be higher and around 50% if you were not referred. You will be
required to pay a higher amount if you go out-of-network. So in
essence, you have the right to see whom you chose, but at your own
expense. The POS plan will only pay their flat rate for specific
medical issues and not above it, unless it is an emergency
situation. Many people like the idea of having more say in their
health care choices, while others care more about saving money and
don’t care who they go to. What you chose will depend on what you
personally want and what is more important.

The emphasis on this plan is prevention of illness or disease to
cut the cost to both the individual and the insurer. Most other
plans such as HMOs and PPOs have the same basic emphasis. You are
encouraged to take an active roll in your health and do what it
takes to remain not sick and disease free for as long as possible.
The idea is to see the doctor less so both you and your carrier
together spends less money. The idea with this plan is that if you
have to put more money into your health care you will think twice
at whether or not you really need to go. If you want to waist the
insurance companies money you have to waist your own too to do it.
Medical insurance companies are in business to make money, they
want you to stay healthy so they can collect your premium and not
have to pay it out to the health care provider. So, for those
people who do not want to pay as high as a monthly premium tends to
opt for this type of health insurance plan. This one will ensure a
low rate with out having to worry about huge deductibles or co-pays
if used more like an HMO. So, if you think that this sound like
something you are interested in, talk to several different
companies and get some policies to look at. Make sure to look at
what is covered as well as the price. Do a little research in the
various insurance policies that are available. The one that you
need to pick will depend on your priorities.

Find out more about Defining Point of Service 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.

Health Savings Accounts – A Basic Overview

October 29, 2008


Health Savings Accounts (HSAs) are becoming more and more a need
than a luxury. You must be enrolled in a health care plan to
qualify for a Health Savings Account. Since they have been around,
millions of people have qualified and gotten one of these accounts.
The trend should continue to raise as more employers and companies
offer this benefit as a bonus to their medical plans. Some
companies aren’t quite there yet but many have jumped on the
bandwagon. There are some basic rules that can help an individual
or corporation decide to enter the HSA market.

To establish an HAS, there are some rules and regulations. It is
like establishing an individual retirement account (IRA) in most
cases. In fact the documents are very similar and the procedure as
well. An HSA trustee can add terms to their agreement regarding the
effecting policy and procedure of their HSA. These terms can
include any of the following but that may not be all that is
required. Included in your agreement could be definitions, fees and
expenses, amendments, disqualifying provisions, investment options,
distributions, transfers and rollovers, reports and records,
termination and/or resignation, and liability protection. There
might be more of less of these conditions depending on the insurer.

HSA eligibility requires you to have an Internal Revenue Code to
even desire to be eligible. You must be enrolled in a
high-deductible medical care plan. So, people who don’t pay a
deductible or it is very low, do not qualify for this benefit. Some
exemptions do apply of course but you would need to contact the
right person to find out. You must not be able to be claimed as a
dependent for anyone else or on Medicare. To qualify your
deductible needs to be for an individual a minimum or $1000, and
your out of pocket expenses can’t exceed $5,100 for that year. For
a family, the deductible needs to be a minimum of $2000 and the out
of pocket portion can’t exceed $10,200 per year. There is a cost of
living deduction as well and your agent to better save you money
will adjust things. Many organizations require that you prove you
are eligible prior to a contract. It is the individual asking for
the HSA that must figure out that they qualify or might qualify.

The yearly contribution can’t exceed the deductible amount or
combination with out of pocket expenses. As long as the individual
has the high-deductible health plan they are qualifying. If you
lose this plan, you will not be eligible for that month or period
of time. If you are married and have separate high-deductible
health plan, it is the lowest deductible amount that the family as
a whole can meet. There are no combining deductibles to get a
higher benefit. If you qualify, you can establish a regular
contribution, a rollover contribution, or a transfer contribution
plan. For the money to be deductible for a specific tax year, one
must file by the deadline to receive the benefits. If an eligible
individual’s employer contributes to his or her HSA, the employer,
not the HSA owner, is entitled to a deduction.

An HSA custodian or trustee reports the contributions on IRS Form
5498-SA, HSA, Archer MSA, or Medicare Choice MSA Information.
Copies of the report are due to each participant and the IRS by May
31, 2006. The owner is responsible for reporting the contribution
amount on the proper forms to be submitted and file them with the
income taxes that year. The distributions are to be made by the
owner, if different than the participant. These will tax-free if
used to pay for, or reimburse qualifying medical expenses that
occurred after putting the plan into effect. These expenses include
and could exceed the diagnosis, cure, treatment, or prevention of
disease, prescription and certain nonprescription drugs, and
transportation and certain lodging costs primarily for and
essential to qualified medical care and certain qualified long-term
care services
. It is an HSA owner’s responsibility to determine the
taxability of an HSA distribution and whether it is legitimate. The
guidance of a tax or legal professional may be necessary to
determine whether an expense is a qualified medical expense to
avoid penalties.

Find out more about Health Savings Accounts – A Basic Overview

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.

Considering Long Term Care Insurance

October 27, 2008


Long-Term Care Insurance is still fairly new on the market and a
lot of people don’t know that it even exists or what it covers.
Even those who have heard the term don’t know always when benefits
are paid, how they are designed, and who qualifies or needs
coverage. Many people don’t think about this type of coverage until
it is too late to get a great rate and higher benefits. They wait
till they are past retirement age and closer to needing to cash in
the benefits instead of investing earlier and maximizing your
options. It is becoming more of a common practice for people to
start thinking about what will happen 30, 50, or more years ahead.
Many people invest in 401Ks, IRAs, stocks and bond, and other types
of investments to prepare for the future. Many people think this
will pay for living expenses and leisure activities once retired.
Things don’t always go according as planned.

What happens in the unfortunate incidence of an accident and you
need help with your daily living activities? Or, you get to a point
in your elder years that you require home care, as you grow older?
You may decide you would rather live in you home for a long as
possible and would need to have enough for personal home care. Some
seniors enjoy assisting living facilities that provide 24 hour
nursing care, but still let you be as independent as you can. There
are also those unfortunate instances where nursing home facilities
are need to tend to varying degrees of illness. Long-term care is
designed to provide you help with these services due to a long-term
illness or disability. The average cost of these types of care can
cost around $40-$100 thousand per year and sometimes more. It is a
very quick way to eat your saving and social security benefits. If
you think Medicaid or Medicare will help, think again. Even if and
when you qualify, your saving is now gone and they will only pay up
to 50% of the cost, someone has to come up with the rest. Long-Term
Care insurance can help with these costs in the unfortunate event
you require nursing care.

Who should consider Long Term Care Insurance? If you think you will
not qualify for Medicaid or full Medicare benefits due to a large
saving, assets, or high income, this is a program for you. You do
not want to end up having your children to pay for these expenses
while you have to have them and possibly well after your death. It
will keep you able to leave your loved ones a little something
instead of sucking all your assets dry. Also if you can afford to
pay the premiums you will likely not qualify for assistance so
would truly benefit. If you currently have chronic health issues or
have a family history of a long-term illness you would be off
purchasing now than waiting. It will be too late to get a policy
after you have already developed a long-term illness or disability.
If you think at any point you might fall into any of the categories
you might want to consider getting a plan earlier to be safe and
covered. You can purchase a policy from most large insurance
companies. As always, every state has different insurance
regulations, therefore it is best to check with your state on
specific determining factors and qualifications.

This coverage will help provide nursing-home care, home-health
care, personal or adult day care usually for individuals above the
age of 65 or with a chronic or disabling condition that needs
constant supervision. LTC insurance offers more flexibility and
options than many public assistance programs. Long-term care is
usually very expensive, which is why most people need insurance.
For example, on average, nursing facilities providing skilled care
charge $150 to $300 per day, or over $80,000 a year or more. Even
custodial home care at three visits per week, can cost over $9,000
a year. Most LTC insurance policies will cover only a specific
dollar amount for each day you spend in a nursing facility or for
each home-care visit. Thus, when considering an LTC insurance
policy, read the policies carefully and compare the benefits to
determine which policy will best meet your own needs.
Find out more about Considering Long Term Care 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.

Tips for Choosing Dental and Vision Coverage

October 22, 2008

Dental and vision coverage seem to take the back seat for many
people who can already barely afford medical insurance. They just
skip those visits all together until a really awful problem arises.
It is then that they realize it is going to cost a slight fortune
to fix. What many people don’t know is that many plans you get at
your work will cover a yearly eye exam and any emergency eye issues
to some extent. They usually offer really affordable dental
benefits, as well. It would be worth $3 per paycheck to have some
coverage for you teeth. Most times a yearly cleaning is 100%
covered. It is the tooth repair that you might have to fork some
cash over. Even then, it is much less than if you had to pay
completely out of pocket. Remember, the bigger the company you work
for the better your benefits will be and cheaper too.

Dental work can be very expensive and not easy to afford for many
people. With a decent dental plan, you can save some major amounts
of money in the long run. No matter how perfect your teeth are, it
will be a worthy investment. Most people will and do get their
dental coverage through their job and pay much less by doing so.
There are several types of plans to be had, indemnity, HMO, and PPO
plans to choose from. Ask your employer if you have more than one
plan and if not what kind they offer. Most plans typically cover a
maximum of $1000-$2000 per year on services. The rest will be up to
you to come up with. For most people this is plenty to have routine
cleanings and any cavities that come up filled. If you need some
serious work done you might have to space it out over the year.
Some people who have major teeth issues will have the top of their
mouths done one year and then the bottom done the next year. If you
exceed your limit for a year most dentists will charge you less
than if you had no insurance at all.

For vision insurance, first check to see what is offered through
your insurance at work. Most plans will only cover yearly eye exams
and emergency care. Some may offer some coverage on glasses or
contact lenses, but not many. If you are a person who has eye
problems and wants to save on contacts, laser surgery and any other
type of eye necessity than you might want to invest in a personal
plan. The cost of these plans can greatly vary depending on what
you want to be covered for. A plan that covers exams, emergencies
and corrective lenses will be cheaper than if you want to add laser
surgery or other high price options. If you have perfect vision,
then your work’s plan will be good enough and will help you keep
your eyes healthy. A vision plans features will vary depending on
the provider you chose so make sure you know your policy or shop
around for one that works for you. Benefits and features typically
discounted include: eye examinations, surgical procedures –
including Lasik procedures where available, frames and lenses,
contact lenses, and non-prescription sunglasses.

Just like choosing any other form of insurance, know what you want
and how much you can afford. Make sure you look at all your options
and get several quotes. Make sure you know what will be covered and
will not. Know the limits with in your policy and find out what
happens if you exceed those limits. Ask dentists and optometrists
which insurance providers they see the most, that can give you a
clue to what plans are most affordable and best. Talk to you care
provider and ask what the typical fees are under specific policies
so you can see which ones have the smallest co-pay. This will also
tell you how much you will be likely to spend per visit or per
specific procedure. If you haven’t been to a dentist in a long time
expect the first visit to be a bit costly even with insurance so be
prepared before going. Ask your dentist what will be done and what
it will cost so you can save up if need be. Routine visits after
that, will be nothing. Remember, a little prevention and being
prepared goes a long way when it comes to your health.
Find our more about Tips for Choosing Dental and Vision 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.

Self-Employed Should Make Health Insurance a Priority

October 17, 2008

Having enough and being able to afford health insurance, is one of
the most nagging concerns for those who run their own business.
Many small businesses don’t offer health benefits to employees if
they have less than 20. It is hard and expensive enough to work for
yourself, but having to pay high prices for health insurance can
make life much harder. If you work as a consultant, freelance
worker, and other self-employed individual you will be allowed to
deduct all of your health insurance premiums and bills off of your
taxes. It is especially valuable because it is an above the line
deduction for Adjusted Gross Income (AGI), so you can take
advantage of this deduction even if you do not you itemize your
deductions on your tax return. For those persons opening a small
business, even the cheapest plan can be too expensive to pay for.
Between the overhead and invested money to get your business off
the ground, and the fact that most businesses take years to turn a
gain, you can find your self making ends meet the first few years.
But your medical bills and premiums are deductible, too. So, get a
plan and have your taxes reduced at the end of the year, it will
save you money in the long run for sure.

How to find Self-Employed Health coverage at a price you can afford
doesn’t have to be a headache. When you leave your employer to
venture forth on your own take advantage of your COBRA rights. This
law allows you to keep your coverage for up to 18 months after
leaving at a higher rate. Most employees only pay about 28% of
their policy. This will be a shock to the system because your
employer will no longer be paying for part of your coverage so you
will be paying the whole bill yourself. So in essence, you will be
paying for a higher group rate verses the original group rate on
the job, but this will buy you some time in looking for a new plan.
COBRA will at least get you through in case you need time to look
at many policies and find one that works for you.

Lighten your financial burden before you hastily leave your current
job if you can. This will allow you to have money put aside and
have researched other health plans that you can go to right after
leaving. If you purchase your own policy before leaving your job
you will still qualify for COBRA but the rates will be lower and
something you are used to. Make sure you have paid up all your debt
so the money you have saved can be used to start your business and
pay your insurance when you leave. If you will be working from
home, save some money and designate that for your medical expenses.
Most independent contract work pays weekly so that money can be
used for bills and other things till you start to make more. If you
are going to need a lone to start your small business, make sure
you are in the green credit wise. This can up the loan amount, so
you have some extra to put aside for bills. That way you can use
the money saved from your job just for insurance.

Don’t let time slip by you and forget to find a new insurance
company if you are on COBRA. They will only cover you for 18 months
and an extra 63 days past that if you haven’t. At that point they
could up your rates and not include any previously existing
conditions and that will just make your premium higher. So, utilize
the time you have and get a cheaper plan that works for you as soon
as possible. Why shell out more money and then also forget that you
are going to be cut off. If you have a spouse or partner who works
outside the home go on their plan. They will be getting a group
rate from their employer. You might have to wait till the next
eligible entry day, but that should happen before the 18 months of
COBRA has run out. Have your partner ask his or her employer when
they would be able to add you to the policy. Find out more about
why Self-Employed Should Make Health Insurance a Priority

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.

How to Get a Group Health Insurance Rate as an Individual

October 13, 2008


Most individuals can get really good group rates through their
employers. As long as your place of business has more than 50
employees and actually offers a medical plan, you should get a
pretty good deal. The overall cost is based on how many of the
employees actually have the insurance plan. The more people who are
signed up, the cheaper the plan will be. Most people will choose
this over going with a private plan any day because it is so much
more cost friendly. That is one of the first things you should be
looking for when seeking a job, whether or not they offer insurance
benefits or not. At your interview ask to see their healthcare
providers plan and rates. If they will let you take it home. This
way you can see if the plan offers what you want and at a price you
can afford. There are some private insurance companies that have
reduced individual rates that are comparable to group ones.

When going with a private company make sure you shop around. Check
several companies and have a checklist of your definite needs and
requirements. Also know how much you are willing to pay. Plan ahead
for the future. Buying insurance at a younger age and better health
will get you that low cost deal you have been looking for. Take a
plan with a higher deductible if you can afford to pay out a few
hundred dollars here and there till it is met. This will save you
money on your monthly fee and won’t be a huge bill if you have an
emergency. Look for a HMO, PPO, or POS plan, they are cheaper than
traditional plans and tend to have very low co-pays. Don’t
over-insure your self, you don’t need anything more than normal
coverage. Most plans will pay if you get sick or injured after the
policy is bought.

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. Make sure you find out if you have a deductible and how
much it is. Most HMO’s don’t have one at all, and most basic PPOs
and POS only have a small one, usually $200 to $500 per year. 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. Usually this is because
the 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.

The best and most assured way to guarantee that you are getting the
best-reduced prices for health care benefits is to make sure you
work for a large company. The more employees there are, the cheaper
the cost out of your pocket. Find out how many employees a company
has and what the percentage is that have taken the company’s
insurance. Talk to the other employees and ask them if they like
the coverage and has it suited their needs. Also, ask them if there
have been any problems with it at all. Talking to the people who
have used the coverage that is being offered and what it has done
for or to them will let you know if this is the type of company you
want to work for. Think long term when job hunting, it isn’t just
about a paycheck. Sometimes a few dollars less per hour is better
to take if the insurance plan is a gem. You also need to think
about what will happen if you are ill and can’t be at work and how
to pay for these expenses. Look for a job that pays well and has
great medical coverage, you will be much better off in the future.
Not to mention you never know when you might get sick or injured
and need coverage for those expenses.  Find out more about
How to Get a Group Health Insurance Rate as an Individual

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.

Helpful Hints when Shopping for Individual Health Insurance

October 8, 2008


Make sure when deciding on an individual health policy, you shop
around and get many options to consider. Policies can range in what
they cover and cost dramatically, so make sure you get the best
plan that fits your needs for the best price. Don’t get suckered
into all these extras that you don’t need because it will cost you
some serious cash. Make sure to contact several groups and are able
to sit with an agent and compare all of them. The policy should
protect you from large medical costs like hospitalization and
emergency treatment. Understand the policy thoroughly and make
sure it is what you need. You don’t want to find out later that it
didn’t cover something you needed. Make sure you check to see when
the policy starts paying and what is covered and excluded. Always
check to see if there is “free look” clause that allows you some
time to review the policy at home and make sure it fits your needs.
That way, if you decide it isn’t what you want you can return it
and get refunded your premium. Make sure to watch out for single
disease policies, these are very disease specific and not needed if
you have a regular medical plan. Most major medical plans cover all
diseases that are acquired after the purchase of the insurance.

Always remember to read your application, especially if the
insurance representative completed the application for you. This
allows you to make sure all the information is correct and exactly
what is being submitted. The company can decline the policy if
information was not disclosed on the application that was required.
All health plans have a provision titled “Exclusions and
Limitations.” Make sure you read that section over carefully for
your policy so you know what to expect. If it doesn’t cover some
things you know you might need or want coverage on, then don’t buy
this policy and keep searching. If a benefit or service is limited
or excluded, you will not be covered even though treatment may be
considered medically necessary.

In addition, before an insurance company will accept you as a
potential policyholder, the company may want to know if you have
any pre-existing illnesses that require constant treatment and
care. They might want to place an exclusionary rider on your policy
for a specified condition. If the policy is issued with an
exclusionary rider you will be responsible for the cost of any
medical care received for the treatment of the excluded condition.
This can pose a problem if that is why you want the policy, so be
sure they will cover any already existing medical needs you might
have. Individual policies generally pay benefits for your spouse,
and on your dependent children up to the age specified in the
policy. However, your insurance company cannot terminate coverage
for dependent children who lack other means of support due to
mental or physical handicaps.

Some individual policies contain both In-Network And Out-of-Network
benefits at different percentages (In Network 90% vs.
Out-of-Network 60%). The insurer is not required to pay the
Out-of-Network provider at a higher percentage and it will be your
job to pay this if you chose to go outside of your network. Use
caution when making the decision to utilize an Out-of-Network
provider for medical care and Treatment. You may find yourself
paying more than you anticipated. Most groups have an array of
medical persons in all branches to choose from or are referred to.
It is a good idea to look at the handbook of providers in your area
to make sure there are plenty of doctor available in your area. It
would also be a good idea to see if they accepting new patients
with the insurance you are considering purchasing. Buying a policy
would not be a good idea if none of the doctors are taking new
clients at the moment and you have to travel completely out your
town to find a doctor who can see you. Make sure that you know
whether or not your particular plan requires referrals to other
care providers from your general practitioner. If you choose to see
another doctor with out a referral you can find you will be paying
that bill completely.  Find more Helpful Hints when Shopping for Individual 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.

Health Insurance Options for your Significant Other

October 3, 2008


In many places today, health insurance is not just limited to
married persons and one’s dependants anymore. An individual with a
domestic partner can be covered, as well. This includes persons of
the opposite sex as well in many states persons of the same sex.
This allows those people who have chose to not be married to
provide health care benefits to their partners. This can be very
hard in some states that refuse to recognize any other type of
relationship other than marriage between a man and a woman. But now
laws are being passed that will either allow same sex couples to
get legally married or allow them to be recognized and get the same
benefits under the term domestic partner. Many people choose to not
get legally married, but should still have the right to have the
same type of benefits as married couples. There are some cities and
states that have laws that ensure that this coverage is available
to the people in those communities. You will want to contact your
local government and ask if any laws in this regard apply to you
and your living arrangement. Make sure to find out if the policies
are for just same sex partners or also include partners of the
opposite sex.

Obtaining one of these insurance policies might prove to be a
daunting task. Most work related insurance policies don’t offer
this extension of benefits to their employees. So far it is not
required for employers to do this either. So you will need to look
for private companies with in your state and see if and which ones
offer this benefit and it is at a decent cost. Some states actually
do have laws in place to ensure domestic partners are covered and
employers must offer this to all employees as long as they have
over 50 people working for them. Smaller companies with less than
50 employees sometimes choose to not even carry insurance as a
benefit. They don’t get the reduced rates because their employee
numbers are too low. The best option is private companies for most
people in this situation. Remember insurance is a business and
broadening its market base bring the company more money, so more
than likely they will find something for you.

If you do find a policy, make sure you look it over carefully. Know
what the policy covers and doesn’t before buying it. Make sure that
if you need any specific criteria met prior to purchase that you
have done so and have proof. Some policies require that you live
together and have been together for a minimum time period. They
also might want to know if you are fully supporting this person
and/or if they qualify for health benefits through somewhere else.
Sometime a joint bank account is also required to prove that you
are mutually sharing living expenses and have access to each
other’s money. You want to make sure that the policy works for you
and your partner and will cover all the needs you both have. Make
sure that the plan is affordable as well. If the price is
outrageous and the plan stinks, then it would be better to just
purchase a single plan that just covers the other person.

This is not an easy task for most people. Even states that require
employers and private insurance companies to provide domestic
insurance still try to find loopholes to not have to. What
people are failing to see is that morality and ethics are not
supposed to keep a person from obtaining medical coverage for
themselves and their partner, regardless of whether or not they are
married or the same sex. Last time I checked that was
discrimination. What is going to happen as society keeps broadening
its horizons on what constitutes a relationship is many companies
are going to find themselves in lawsuits. One would think it would
be cheaper just to offer the insurance plan. Once the realization
that our country is changing its perspective has set in one would
hope the intelligent people will make sure that all people can get
affordable health care benefits that fit their families needs. The
point of health care is to keep you healthy, not keep you legally
married.  Find out more about Health Insurance Options for your Significant Other…

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.

Traveling Internationally? Get Your Health Insurance Together

September 30, 2008


When traveling abroad not only should you make sure that you have
had all the vaccines required for where you will be going, remember
to find out what kind of medical coverage you have when leaving the
country. Some insurance plans are only good in the country where
they were purchased, while others have some sort of coverage for
traveling abroad. It is possible to have a medical emergency while
traveling and you will need to have your medical information with
you at the time of service. Since January 1, 2006 it is now
required for all persons traveling in Europe to have a European
Health Insurance Card
(EHIC) to be able to receive medical
treatment while visiting an European Economic Area (EEA) or
Switzerland. So, make sure you find out if the country in which you
are traveling even accepts your insurance and if not what you will
need, such as an EHIC card or something else similar.

The EHIC is valid for three to five years. It covers any medical
treatment that becomes necessary during your trip, due to either
illness or an accident. This can be very handy especially when
traveling with the family. The card gives you and your family
access to state-provided medical treatment and you’ll be treated on
the same basis as an ‘insured’ person living in the country you’re
visiting. Depending on what country you are visiting, you might
have a co-pay or fee depending on the type of treatment. Each
country has its own uses for the card, so be sure to know the usage
and limitations of each country you are visiting. Flare-ups of
chronic diseases and pre-existing conditions is also covered under
EHIC, such as dyalisis or diabetes. Make sure you have all you
medical issues cleared up before traveling abroad to reduce the
risk of needing medical assistance. But having the protection in
case of an emegency is much better than getting stuck with a huge

EHIC will not cover you if getting medical treatment is the main
purpose of your trip. If you have scheduled a surgical procedure
abroad then you won’t be able to use EHIC and should have made the
arrangements with your private insurance to handle that. Make sure
when scheduling a medical procedure in another country your private
insurance is a form that is accepted. EHIC is for people who have
no known health issues or minor health problems. This will enable
them to be covered in cases of emergency or falling ill while
traveling. This keeps the individual from have to spend all their
money in medical treatment. You should take out comprehensive
private insurance as well for visits to all countries, regardless
of whether you are covered by your EHIC. For women traveling abroad
during pregnancy EHIC should cover any routine visit you might
need. They will also cover an emergency birth, but other paper work
might have to filled out at the time. If your sole purpose is to
give birth in another country you will not be able to use EHIC. You
will have to fill out other types of paper work that you can obtain
from the government of the country you are seeking to birth in.

Apply for the European Health Insurance Card if you:
Plan to go on holiday to another EU / EEA country or Switzerland
Regularly visit any of these countries on business, as a transport
worker or for leisure
Plan to go to any of these countries to look for work
Are being sent by your employer to work in any of these countries
Intend to go to school in any of these countries Intend to visit
any of these countries for any other type of temporary stay where
healthcare in itself is not the aim of the visit

Having a European Health Insurance Card will allow you to get
reduced cost or free medical assistance while traveling in European
Economic Area
countries, and Switzerland. The European Economic Are
includes the European Union, including Iceland and also
Liechtenstein and Norway. Switzerland also participates but has a
slightly different policy than some of the other countries. Make
sure you know where you will be staying and what the policy is for
each country.

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.