I have a health insurance broker for more than a decade and every day I read more and like stories published on the Internet about health insurance companies not paying claims, refusing to cover certain diseases and the doctors do not receive compensation for medical services. Unfortunately, insurance companies are driven by profits not, people (even if it takes people to make a profit). If the insurance company can find a legal reason for not paying a claim, chances are you’ll find, and consumers will suffer. However, what most people do not realize is that there are very few “gaps” in an insurance policy providing the insurance company an unfair advantage over consumers. In fact, insurance companies go to great lengths to detail the limits of coverage, giving the insured 10 days (a period of 10 days free look) to reconsider its policy. Unfortunately, most people put their insurance card in your wallet and put your policy in a file drawer or cabinet during their 10 days free look and is usually not until receiving a “denial” letter from the insurance company to obtain policy to read.
Most people who buy their own health insurance, rely heavily on the sale of an insurance agent to explain the coverage of the political system and its benefits. That said, many people who buy their own health insurance plan can tell very little about the plan, except you pay the premiums and how much to pay to satisfy their right to vote.
For many consumers, buying an insurance policy for your own health can be a huge undertaking. Buying an insurance policy on health is not like buying a car when the buyer knows that the engine and transmission is standard, and power windows are optional. A health insurance plan is much more ambiguous and is often very difficult for consumers to determine what type of coverage is normal and what other benefits are optional. In my opinion, is the main reason the owners of most politicians do not understand that they have no coverage for a particular treatment until they receive a large hospital project stating that “the benefits denied.
Of course, we all complain about insurance companies, but we know it is a “necessary evil”. And while the purchase of health insurance can be frustrating, time consuming and difficult, there are some things you can do as a consumer to make sure you buy the kind of insurance you really need a fair price.
Treatment of small business owners and independent of the market, I realized that it is extremely difficult for people to distinguish between the type of health insurance coverage “want” and the benefits they really “need”. Recently I read many comments on various blogs defending the health plans that offer 100% coverage (no deductible and no co-insurance), and although I recognize that these types of plans have a “call pavement” Great, I can tell you from personal experience that these plans are not for everyone. Do 100 health plans offer the largest% borrowers peace of mind? Probably. But one thing is 100% health insurance plan that most consumers really need? Probably not! In my professional opinion If you buy a health plan should be a balance between the four major variables, desires, needs, risks and prices. Just as you would if you were options to buy a new car, you should weigh all variables before you spend your money. If you’re healthy, no medications and rarely go to the doctor, you really need a plan of 100%, with 5 million co-payment for prescription drugs if it costs $ 300 more per month?
Is it worth $ 200 more a month for $ 250 discount and $ 20 brand / $ 10 generic co-pay for Rx-compared to a 80/20 plan with $ 2500 rebate, which also offers $ 20 brand / $ 10generic co-payment after payment once a year, 100 million Rx rebate? Could the 80/20 plan still does not offer adequate coverage? not think it would be better than the position of $ 200 more (2,400 dollars per year) to a bank account in If you may have to pay you $ 2500 to purchase a franchise or $ 12 Amoxicillin prescription? It is wise to keep your hard earned money instead of paying higher premiums to an insurance company?
Yes, there are many ways to keep more money than you normally would for an insurance company in the form of higher monthly premiums. For example, the federal government encourages consumers to purchase HSA (Health Savings Account) qualified HDHP (high deductible Health Plans), to have more control over how their money is spent on health. Consumers who purchase an HSA qualified HDHP can save more money each year in an interest bearing account so they can use the money to pay out of pocket medical expenses. Even procedures that are usually not covered by insurance, such as Lasik eye surgery, orthodontics, and alternative medicines become 100% tax deduction. If there is no allegation that year, money deposited in the HSA can be rolled deferred tax profits for the year grow even more interesting. If there is no significant claims for several years (as happens frequently), the insured building has an account that has tax advantages similar to a traditional IRA Most HSA administrators now offer thousands of no load mutual funds for HSA to transfer your funds where you can perhaps even earn a higher rate.
In my experience, I think that people who buy health plan, based on the desires and needs do not feel cheated or ripped off “from your insurance company and / or insurance agent. In fact, I I heard the same comments for almost all business owners I speak. Comments like “I run my business, I have no time to be sick!” I think he went to the doctor twice in the last five years “and” insurance company keeps raising my rates and I do not even use my insurance! “As a businessman, I understand your frustration. Thus, a simple formula that anyone can follow to make it easier to buy health insurance? Yes! Become an informed consumer.
Every time I come into contact with a prospective client or call one of the landmarks of my client, I ask a handful of specific issues directly related to the policy of the individual today in his office drawer or dresser. You know that the policy purchased to protect them from having to declare bankruptcy because of medical debt. This policy, which bought $ 500 000 to cover transplants of organs to save lives or those of 40 chemotherapy may suffer if diagnosed with cancer.
So, what do you think happens almost 100% of the time when I ask these individuals “BASIC” questions about your insurance policy? Not know the answers! The following is a list of 10 questions I ask often a potential customer of the insurance. See how you can answer without an examination of policy.
1. The insurance company is safe and what is the name of your health insurance plan? (For example, Blue Cross Blue Shield “Basic Blue”)
2. What is the year of your franchise and you pay deductible for each family member if anyone in your family got sick at the same time? (For example, most health plans have an annual rebate per person, for example, $ 250, $ 500; $ 1000 or $ 2500. However, some programs require you to pay a maximum of 2 persons each year are deductible, even if everyone in your family needs extensive medical care.)
3. What is your coinsurance percentage and what U.S. dollar amount (stop loss), based? (For example, a good plan to cover the middle 80 / 20 will pay 20% of any dollar amount. This amount is also known as stop loss and can vary depending on the type of policy you purchase. Stop losses can be as little as $ 5,000 or $ 10,000 or less $ 20,000 or the market there are policies that have no stop loss value of the dollar).
4. What is the maximum your free pocket per year? (For example, all privileges and all coinsurance percentages plus all access charges or other fees)
5. What is the maximum benefit from the life insurance company will pay if they fall seriously ill and that his plan “from the illness” or maximum ceilings? (For example, some projects may have more than 5 million U.S. dollars, but perhaps a maximum benefit of $ 100 000 per disease. This means that we must develop many separate and independent fatal disease that costs $ 100 000 or less to receive 5 million U.S. dollars of life coverage.)
6. Your plan a project schedule, which only pays a certain amount for a specific list of procedures? (For example, Mega Life and Health and the Midwest National Life, endorsed by the National Association of Independent NASE is known to adopt plans programming) 7. Your plan have doctor co-pays and you’re limited to a series of co-payments for doctor visits a year? (For example, many plans have a limit to how many times have you gone to the doctor every year for a co-payment and often the limit is 2-4 visits.)
8. drug coverage offered by your plan and if that happens, you pay per share for their prescription, or if you must meet a separate drug deductible before receiving benefits and / or if you have a prescription discount card only? (For example, some programs you offer prescription benefits right away, other plans require you to pay a separate drug deductible before you can receive medication prescribed by a co-payment. Today, many plans do not provide options for co-payments and only give you a card with discount prescription discount gives you 10-20% of all prescription drugs).
9. Your plan have any reduction in benefits for organ transplants and if so, what is the maximum your plan to pay if needed organ transplant? (For example, some programs only pay compensation up to $ 100 000 for transplants instruments for a procedure that actually costs $ 350 – $ 500K and a maximum of $ 100 000 may also include the return of the fight against catastrophic drug .- rejection must be taken after a transplant If this happens, it will often pay for everything the anti-rejection medication out of pocket).
10. You must pay a “fee” or deductible for each hospitalization or any emergency department? (For example, some programs such as Assurant Health, the company’s Website CoreMedia “plan to have a separate entrance than 750 dollars pay the hospital for the first three days, you’re in hospital. The tax is in addition to the franchise plan. In addition, many plans have benefit “caps” or “access charge” for outpatient services such as physiotherapy, speech therapy, chemotherapy , radiation therapy, etc. Benefit “caps” could be as little as $ 500 for each outpatient, leaving you a review of access charges for the remainder. fees pay for treatment. For example, each administration of chemotherapy external patients may have to pay an “access fee” of $ 250 per treatment. So for 40 chemotherapy treatments, you have to pay $ 40 x 250 = 10.000 dollars. Again, these fees will be charged extra to your plan deductible) .
Now that you have read the list of questions that I pose a potential health insurance client, ask yourself how many questions you can answer. If you could not answer all the questions in ten, not discouraged. This does not mean you’re a smart consumer. It can only mean that you have been dealing with an insurance agent “evil.” So how can you tell if you are treated with an insurance agent “bad”? As an insurance agent “large” would have taken the time to help you understand your insurance benefits. An agent of the “big” is the time to ask questions so they can understand their insurance needs. A publicist for “big” are health plans based on four variables, desires, needs, risks and values. An agent of the “great” gives you enough information to evaluate all the options that you can make an informed buying decision. And finally, an agent of “big” look for your interest and not in the interest of the insurance company.
So how do you know if you have an agent “feature”? Easy, if you are able to answer all 10 questions that examine the health insurance policy, you are an agent of “large”. If you are unable to answer most questions you may have an official ‘good’. However, if you are able to answer some questions, chances are you an agent of evil. Insurance agents are not different from any other professional. There are insurance agents who care about customers with whom they work, and there are other agents that avoid answering questions and phone calls from the duck client when a message has been left with unpaid claims or exorbitant rates for insurance health.
Remember, the purchase of health insurance is as important as buying a house or a car, if not more important. So do not be afraid to ask your insurance agent lots of questions to ensure that you understand what your insurance covers and what not. If you do not feel comfortable with the kind of coverage that your agent suggests or if you think the price is too high, ask your agent if he / she can choose a design similar to what you can do a side by side comparison, before you buy. And most importantly, read all the fine print in the brochure to plan for your health and when you receive your policy, take the time to read your contract for 10 days free look.
If you can not understand something, or are not sure that an asterisk (*) next to the description of the benefits they really mean in terms of coverage, contact your agent or your insurer to ask for further clarification.
Furthermore, the time required to perform its own due diligence. For example, if you research MEGA Life and Health or the Midwest National Life insurance approved by the National Association for Self-employment (NASE), you will find that there were 14 shares of Appeal proceedings against these companies since 1995. So ask yourself: “Is a company hope to pay benefits for my health insurance?
Additionally, if your agent is an agent of “captive” insurance or “broker”. “Captive” agents can offer their products, an insurance company. “Independent” agents or insurance brokers can offer a variety of insurance programs for many different insurance companies. An agent of the “captivity” may propose a plan for health does not correspond exactly to their needs, because it is the only plan / he can sell. An agent “independent” or “broker” insurance can usually offer a variety of insurance products for air quality and more often to adjust a plan to meet their specific insurance needs and your budget.
Over the years I have developed strong relationships of trust with my clients because of my experience in insurance and level of personal service I provide. This is one of the main reasons I do not propose to buy health insurance on the Internet. In my opinion, there are many variables that buyers in the industry often do not take into account the Internet. I am deeply convinced that the health insurance market requires a level of knowledge and personal attention that only an insurance professional can provide. And since it does not cost a penny more to buy insurance through an agent or broker, my advice would be to use Ebay and Amazon for their purchases and less important to use an officer, ethics and credible independent broker or the most important purchases of your life …. policy for your health insurance.
Finally, if you have questions about an insurance company, please contact your insurance before buying your policy. The state insurance department can tell you if the insurance company is registered in your state and may also indicate if there was a complaint against the company have been filed by policyholders. If you suspect that your agent is trying to sell you an insurance fraud (for example, must be a member of a union to qualify for coverage) or are not honest with you, your Ministry of the State L Insurance can also check whether the agent is licensed and if any previous disciplinary action against that officer.
Finally, I hope I have given enough information so you can become a consumer of insurance. However, I remain convinced that these words of wisdom on the road again: “If it sounds too good to be true, it probably is!” And “If you buy only on price, you get what you pay!