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[E188]Eligibility For Health Insurance

by Richard Keir, Ric

Shopping around for medical insurance can be a confusing business. You need to keep your wits about you and keep track of the benefits and costs of each policy and each type of policy. Too often we tend to look at the price first and the rest of the policy becomes a blur of fine print. And we're off to check the next policy.You need to carefully consider your situation. Think about these questions and note your answers:

What's the general state of your health?How old are you'Do you have any serious medical problems currently or in your medical history'Do you have any history of recurring or on-going medical needs'Do you use tobacco? How much'Do you drink? How much?Are you over- or under-weight for your height, body-type and age'Is your job hazardous'Do you participate in any activities or sports that could affect your health?Now this may be unpleasant but if there's any chance an insurance company could discover a history of drug or alcohol abuse or sexual behavior that might put you in a high risk group, you may want to be direct and upfront about it - especially if it's in the past. Having a claim denied later because you had failed to disclose medical information to the insurance company would be far more upsetting - and very expensive. The same goes for any significant medical condition. Insurance companies are in it to make a profit - at least most of them are. Paying large claims isn't their favorite activity, so they often do investigate.

If you're seeking a family policy you'll need to make the same analysis for everyone and consider carefully what kind of coverage you want.

Do you need dental, orthodontic, pregnancy, mental health, and/or drug coverage? Do you need long-term care coverage, either inpatient or in a nursing facility? Assisted living coverage? What about traveler's or international coverage'If there's a possibility that you may require - or want - in-home care as opposed to a residential nursing or assisted living facility, be sure that coverage is included and be sure you understand exactly what you can expect to receive.

Think about deductibles and what you could afford pay to reduce your insurance costs. But be very careful here, because medical expenses tend to pile up quickly and reach nearly insane levels for complex treatments or inpatient stays. Many drugs in common use are ridiculously over-priced and depending on the specifics of your insurance you may not be able to use the least expensive sources.

If you will end up with multiple sources of coverage, be clear about how they fit together and what the rules are about overlapping or combined benefits.

Once you are clear on your current situation, your (and other family member's) medical history, and your projected needs, you can begin looking in a organized way with a better sense of where you're going and what will actually meet your needs. This may seem like a tedious process, but it will serve you well in finding appropriate and affordable health insurance and making sure your health care needs can be met by the medical insurance you choose.

Take some time to work through these questions. Write down your answers. Make a chart with your desired coverages and any special conditions the policy must meet. As you look at health insurance policies, note the rules, exclusions, information about pre-existing conditions, any limitations, the dollar amounts covered and especially any deductibles.

Don't try to do too much at once. If you hurry, it'll become confusing and tiring. You may hate it (I know I do), but you really do need to read all that fine print and understand it. That's not a task to rush through. You might as well face up to it, because it's a lot better to do it BEFORE you need medical services than after you get a bill for the uncovered portion that sends you into shock.

So is it an impossible job to find health insurance that works for you? Not at all. There's a world of resources on the internet to help you find the policy you need. Just be sure to do your homework first.

Most of us are struggling financially, since our economy has changed for the worse recently. People have lost their jobs, or they are worried that they might lose their job. There is no doubt that families and individuals have cut back their spending to more sustainable levels. In short, people are looking for bargains in just about everything they buy - including health insurance plans.

What is happening in the health care business?

In 2009, approximately sixty-two percent of the plans being sold by agents in North Carolina, are health savings account plans (HSA plans). Blue Cross and Blue Shield of North Carolina has a plan called Blue Options HSA. The Blue Options HSA plan costs so much less than the traditional copay plan that it is being chosen more frequently. This was not true in previous years.

Why are people choosing health savings account type plans?

Lower Premiums:

The monthly premiums on HSA type plans are considerably less than the premiums you have to pay for the copay type plans. This is not obvious when people make quick comparisons. Most people make a mistake when they compare premiums on HSA type plans with copay plans.

They make the mistake of comparing deductible amounts between the plans in question. They make the deductibles approximately equal thinking that they are making a fair comparison — they are not.

Do The Comparison Properly:

To make a proper comparison, you have to consider the maximum out-of-pocket risk. What does that mean? Let's take an example: If you have to be hospitalized to have your gall bladder removed, you will have to pay your deductible. Most people will understand that. However, there is another factor that most people don't know about, or have forgotten about. It is called coinsurance.

You Must Consider Coinsurance

Coinsurance is the amount that you have to pay, in addition to your deductible. So, to illustrate, consider the gall bladder operation example. You must pay your deductible AND your coinsurance.

Assume that you have a $2500 deductible plan with a 70/30 coinsurance. The 70/30 describes the coinsurance. It means that you will have to pay 30%, and the insurance company will have to pay 70% of the first $10,000 of expenses. In actual numbers, this means that the patient will be out-of-pocket $2,500 plus ($10,000 X .30 = $3,000) or a sum total of $5,500.

I know that I have lost some people with the previous paragraph, but suffice it to say that with the copay plan, you will be out-of-pocket $5,500 - not $2,500. After the deductible and the coinsurance portions are paid, the insurance company will pay one-hundred percent of the balance of the covered expenses.

A Valid Comparison:

Now getting back to the comparison. If you compare a $2,500 70/30 copay plan to an HSA type plan, you need to compare it to the $5,000 deductible 100% HSA plan. Don't compare it to the $2,700 100% deductible plan HSA type plan — the risks are not approximately equal there.

Remember, we are trying to make the out-of-pocket risks similar. Do the comparison properly and you will see that you will save about 50% on your premium. The HSA type plan is always the winner.

Catastrophic Coverage:

Most HSA plans are pretty simple. You are responsible for the less minor medical expenses like medications and doctor visits, but if you have a catastrophic expense, you have to pay the deductible and the coinsurance. Then your financial obligations are complete.

Tax savings:

You cannot open up the health savings account at your local bank until you have the HSA type insurance plan. This is a savings account that you can use for any qualified medical expense. Examples of qualified medical expenses: over the counter cough medicine, doctor visits, prescription medications, chiropractors, accupuncture treatments, dental expenses, and vision expenses. This is an incomplete list...generally, any medically related expense is qualified. Here is a list of Qualified Medical Expenses for HSA plans. Since your contributions to this savings account are pre-tax, you will save money when you do your taxes. As a rule of thumb, consider that you are paying your medical expenses at half price.

What Else Does The Catastrophic (HSA) Plan Have To Offer?

* Annual physical

* Access to medical providers

* Lower monthly premiums

* Savings on taxes

Summary:

You must work with a helpful, knowledgeable health insurance agent. Ask him to help you make the comparisons. You will immediately know if he knows his insurance principles if he compares plans with equal or approximately equal out-of-product risks.

It doesn't matter which insurance company you choose, they will all have an HSA type plan — sometimes also called a high deductible health plan.

Once you have really understood the concept, you will be ready to purchase the least expensive, affordable type of health insurance plan available — the Health Savings Account (HSA) type plan.

Article Source : Low Cost Medical Insurance

About Author

Both Richard Keir & Richard Day are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.

Richard Keir has sinced written about articles on various topics from Water Garden, Online College and Free Credit Report Score. Richard is a writer, educator and consultant providing services to medical, scientific and business professionals. For more on choosing a health insurance policy or finding the best medical plan for you, visit. Richard Keir's top article generates over 90500 views. to your Favourites.

Richard Day has sinced written about articles on various topics from Internet Marketing, Health Insurance and SEO linking. Richard Day of is one of the premier health insurance agents in the southeast. He has a strong desire to educate his clients. Insurance plans. Richard Day's top article generates over 27100 views. to your Favourites.