Posts from — September 2009

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<h3>Health Insurance…what?</h3>

Now that you have graduated from college, you are focused on fulfilling all of your career goals and opportunities. You’ve been trained for your new vocation, but maybe no one has told you about all the things you’d need post-graduation…like health care insurance.

Most likely, you have never had to understand health care insurance before since you were covered under one of your parents’ plans. Like thousands of other new grads, you may have lost your coverage unexpectedly. Your coverage may have been cancelled upon graduation since you are no longer considered a “dependent.” If you were unaware that this could happen, you need to find out if it truly has before you find yourself without coverage right when you need it most.
<ol>
<li>1. Determine if you are still covered.

Call the number on the back of your insurance card to find out if you are still insured. Have your policy number ready when you all. Be certain to ask what your current status is and the future terms of eligibility. That’s critical since there are policies that continue coverage until a particular age or if additional education is pursued. If you are told that you are no longer covered or your coverage will end soon, then you need to obtain an individual health care insurance policy.</li>

<li>2. Know why you need health care insurance.

With all of the other expenses you have, you may be tempted to forego health care insurance. You may be asking yourself if you really need it since you are young and pretty healthy. In today’s world, you do really need your own health care insurance coverage because:
<ul>
<li>- If the unexpected happens, you couldn’t pay for all of your medical expenses.</li>

<li>- You can have peace of mind, knowing you’ll receive the care you need.</li>

<li>- The burden will not be placed on others to care for you.</li>

<li>- You can go to the medical providers and hospitals you pick.</li>

<li>- You could receive reimbursements on gym membership, massage, and sports equipment on some policies, which would help cover the cost of the policy itself.</li>

<li>- You can receive covered “Valued Added Benefits” such as discount dental, eye care, massage, chiropractic, and other expenses you are paying for on your own right now.</li>
</ul></li>
<li>3. Evaluate your current situation.

Since you know you need coverage, it may seem impossible to know where to start. There are a lot of health care insurance programs available to you and there are some things you should keep in mind as you begin the process of purchasing your own health care insurance policy. These include:
<ul>
<li>- out-of-pocket expenses</li>

<li>- monthly cost</li>

<li>- prescription drug coverage</li>

<li>- doctor networks</li>
</ul></li>
You should also examine your job outlook. If you are just beginning to look for employment or don’t have any firm prospects, it could be months until you buy coverage from your new employer. You cannot afford to go that long without health care insurance coverage. When you do find a job, you will not have insurance through your employer until their coverage comes into effect. Nowadays, the effective date is often six months to a year after your first day of employment, leaving you without coverage and in need of your own health care insurance policy.

<li>4. Wisely pick the right plan and provider.

Locating the right insurance program online can be difficult. There are so a lot of health care insurance websites that you may not pick the best one for you. Many online companies and sites don’t know or care about your personal needs or situation. Unfortunately, they just want another sale and are satisfied if they can do it without even talking to you. Getting health care insurance is a big decision and you need to talk to an expert who can help you make the best choice for your needs, budget and situation.</li>

If you pick to look at coverage from several companies, here are several things to consider or outright ask:
<ul>
<li>- Is the business licensed to sell insurance in your state?</li>

<li>- Will the business represent multiple “A” rated  insurance companies or do they only sells programs for one insurance carrier?</li>

<li>- Is the business selling you a plan based on how it meets your needs? (i.e. Is anyone listening to your needs and then recommending a specific plan that meets those needs?)</li>

<li>- Is the business resourceful and responsive by returning your calls quickly and answering all your questions?</li>

<li>- Will the business service your account throughout the lifetime of the policy?</li>
</ul></li>
</ol>
If a business is telling you that they can give you an exclusive rate, don’t believe them. Health Insurance premiums are filed with the State Department of Insurance. Regardless of whether you obtain online, from an agent or right from a health care insurance company, you’ll pay the same amount for the same plan.

Since there are so a lot of plan types and options available to you and because programs vary by state, it would be impossible to outline them in this article. To make sure you get the right health care insurance program for your needs and budget, find a trustworthy health care insurance advisor, like through www.benepath.com, who will put your best interest first and assist you through the decision-making process.

If you have recently left college you may find that you are no longer covered under your parent’s health care insurance policy and will need to find cover until you get a job and fall within your employer’s healthcare plan. Similarly, if you have just started a new job, you may find that your employer requires you to work for several weeks or months before becoming eligible to join his healthcare scheme. These are just two of the a lot of reasons that lead to a need for interim health care insurance coverage.

<h3>So what exactly is interim health care insurance coverage?</h3>

Well, as its name suggests, it is health care insurance coverage with provides health cover for a short period of time to give you the opportunity to maintain cover while moving from one permanent health care insurance program to another. Coverage is generally issued for anything from one month to one year, although a lot of companies today restrict policies to a maximum period of six months. In most cases insurers also understand that it isn’t always easy to know exactly how long you’ll need temporary cover for and so are often flexible in allowing you to extend cover past the original expiry date if necessary.

Interim health care insurance programs generally provide similar cover to that seen on permanent policies but there are some very critical differences.

Plans are generally strictly indemnity programs and will not cover you for preventive treatments, such as check-ups, and will also exclude dental and optical coverage. Pre-existing medical conditions and work-related illness or injury are also generally excluded.

Your interim health care insurance policy will generally cover you for emergency medical care, prescription drugs, hospital and intensive care treatment, laboratory and x-ray work, ambulance care and, in some cases, in-home medical care.

<h3>So, how do you go about getting interim health care insurance coverage?</h3>

Your first step should be to determinehow a lot of weeks or months you need the coverage for and when you want it to start. You then need to find yourself an agent who specializes in interim health care insurance.

Study any policies offered carefully and pay close attention to the exclusion clauses and don’t be afraid to ask questions about any concerns you may have. Review the enrollment form and make sure that all of your personal information is correct before you sign anything. Also, remember to keep a copy of all the paper work for your own files.

The cost of an interim health care insurance program will vary according to the type of coverage that you select. You can however keep the cost down by selecting to have a high deductible added to the policy (the sum of money which you must pay towards your healthcare before the policy kicks in) with a 50/50 co-insurance option (the split in payment of each bill after the deductible has been met between your insurer and yourself) rather than the more common 80/20 ratio.

Also, don’t forget that there are some extras that you may want to consider, depending on your personal circumstances. By way of example, with the high cost of prescription medicines, you may be better off purchasing the coverage rather than leaving it off.

The most critical thing is to remember to read through any interim health care insurance policy carefully and to make sure you are being offered the coverage that want and which you’ll be paying for.

If you are looking for interim health care insurance coverage or indeed any form of low cost individual health care insurance program then there’s no better place to start you search than right here online.

Most of the individuals who are shopping for major health care insurance are concerned about their budget more than the coverage. The premium quoted becomes the deciding factor while selecting health care insurance. It determines the type and extent of the health care insurance they want to purchase. The rates offered for the health care insurance program depend on the current health, habits, hobbies, and lifestyle of the person looking for insurance. Relatively healthy individuals are offered lower rates than someone who is suffering from any illness.

Indemnity and managed care health care insurance programs differ in their fundamental approach of providing coverage. Indemnity programs are preferred for the wide choice of medical providers allowed which include specialists, such as cardiologists and surgeons. They also provide a comparatively biggerrange of approved hospitals and other health care providers. Managed care programs don’t have as wide a choice as in case of indemnity policys. They generally have tie-ups with certain medical providers, hospitals, and other health care providers. This allows managed health care programs to offer a range of services to its members at reduced cost.

Health maintenance organizations or HMOs offer managed care health care insurance programs for lower rates as compared to health plans that charge a fee for the service rendered. Nonetheless, it isn’t the right choice for individuals who might want to opt for specialized insurance coverage.

Preferred Provider Organization (PPO)ss or PPO insurance is aimed at combining the lower cost of managed care with the greater range of choice found with indemnity health care insurance. A PPO health care insurance program has all the features of an Health Maintenance Organization (HMO) plan but it allows the policyholders to pick medical practitioners from a wider range.

The Point of Service (POS) or the POS plan is a lesser-known plan that attempts to combine the properties of PPO and Health Maintenance Organization (HMO). A POS plan requires the policyholders to pick a primary care doctor to monitor their health care, who has to be chosen from within the health care network. This chosen doctor becomes the Point of Service (POS) for the policyholders.

Once you’ve been diagnosed with diabetes, you will find that certain health care insurance programs can suddenly become more costly. In some cases, it can even be impossible to obtain one. That is because numerous health care insurance businesses are allowed to use an applicant’s health status as a basis for their insurance premium. In some cases, a health care insurance company can also refuse to sell policy to an individual if he has a chronic health condition.

Here are some things you ought to know about getting health care insurance when you’ve diabetes:

You should be able to show you can manage your condition.

Whether you’ve Type 1 or Type 2 diabetes, it is important that you are able to implement a sensible management plan for your diabetes. That is one of the variables that life  insurance carriers consider in order to sell you coverage and if you can show you’ve a well-regulated blood glucose, are able to lead a healthy lifestyle and do not exhibit any complications caused by diabetes, you will not only get coverage, you will also get reduce premium prices.

<h3>Look for a policy that considers your overall health.</h3>

Certain health care insurance polices do not focus on certain health conditions that you might have at the time of application. There are also those that consider your overall health.

No means no, but…

Medical Insurance businesses are not all alike. If you get rejected by one, move to the next and if you find some who will sell you a policy, make sure you compare prices and benefits.

<h3>Is it possible to be rejected by a health care insurance company if I have diabetes?</h3>

If you are employed and your employer pays for a group health care insurance program, then you do not have to worry. A company-sponsored health care insurance policy is not allowed to reject an individual by using his health status as a basis. Thus, most businesses do require new employees to undergo a physical exam or provide health information through a questionnaire before the employees are enrolled in a health care insurance plan.

If you’ve your own health care insurance policy, it is a different matter. Your insurance company is not required to provide the same kind of protection for a consumer. The majority health care insurance available for individual enrollees have what we call “medical underwriting”, where an insurance company can determinewhether or not to sell you insurance coverage.

Your application will be based on certain personal information such as your age, gender, medical history, health status and so on. Even if you do receive coverage, certain restrictions might apply, which will limit your benefits and determinethe cost of your premium.

It will also depend on which state you live. Some states, for example, do not allow medical underwriting while others provide  insurance carriers who will offer coverage regardless of their health status. Some states even restrict the sale of health care insurance programs to certain residents. To find out what your state allows, go to your local health policy agency or check your local consumer guide to see if you will qualify for health care insurance if you’ve diabetes.

<h3>What other health care insurance options do I have?</h3>

Having diabetes will make it a little hard on you to look for the kind of health care insurance coverage that is more to your liking. Thus, there are certain sources that you can tap if it seems you are going nowhere. They include Medicare, Medicaid and Medigap. If your health care insurance need came as a result of your losing a job or health coverage, you can turn to TAA tax credit or COBRA. You can also check with major pharmaceutical businesses who offer assistance programs to uninsured patients so they have access to diabetes medications.

<h3>What is the available health care insurance for a senior over the age of 65 with diabetes?</h3>

If you are eligible for Medicare and have a Medicare managed care policy or purchased a Medicare Part B coverage, you should qualify for certain diabetes supplies such as lancets, testing supplies, test strips and monitors for blood glucose and control solution to be used for calibrating meters. There are restrictions and limitations, however, so make sure to check with Medicare (MediCare.org) to see how you will qualify for which diabetes supply or service.

If you’ve diabetes and are looking for health care insurance coverage, you might find that it is a little challenging to do. Thus, it is not entirely impossible because there are options you can use that will ensure you get sufficient or at least a little coverage to help you manage your condition effectively.

Approximately 17% of all Floridians cannot afford health care insurance of any kind. Fortunately there are ways for you to stay insured or to get health care insurance if you aren’t insured now, even if you’ve little spare money each month.

Let us start with your kids. If you’ve kids 19 years of age or younger who are not covered by any health care insurance – even if one or more of them has a pre-existing medical condition – it may be possible for you to get them very affordable state-sponsored health care insurance through a program known as KidCare.

To see if your kids qualify for KidCare health coverage  go to: http://www.floridakidcare.org/

If your place of employment doesn’t offer group health care insurance then check around with any organizations that you belong to. Many times automobile clubs, fraternal organizations, even churches have some form of group health care insurance that they can offer to members at a tremendous discount over individual health care.

Group heathcare has one other advantage – they often accept pre-existing conditions that individual heathcare doesn’t .

If you own your own home-based companyand you’ve been operating for at least six months there is a special Florida law that may allow you to get group health care insurance even if you’ve no employees or if your only employee is your spouse who helps out on even a part-time basis. Check with your insurance consultant to see if you qualify.

While you are talking with your insurance consultant ask if you qualify for a multi-policy discount on your health care insurance. If you’ve more than one insurance policy with the same company you may be entitled to a break on your monthly heathcare premiums.

Also, if you’ve been with the same insurance company for at least 5 years ask if you qualify for a long-term policy discount. The majority  insurance carriers will give you one if you ask for it.

If you smoke or use any tobacco product – stop. Period. you will never get the cheapest heathcare available if you smoke, use chew or any other tobacco product.

Your weight also plays a role in how much you pay for health care insurance. Losing weight is more challenging than quitting smoking for most people, but losing even a little weight can drop you into a reduce weight and cost category and can save you hundreds of dollars each and every year in premium expenses .

Don’t participate in dangerous or extreme sports if you want to get cheap health care insurance. Obviously if you go out of your way to put your health in jeopardy you are not going to get the cheapest rate available for your health care insurance.

Consider carefully what the maximum percentage is that you can afford as a co-payment each time you see your doctor. If you can afford a 50% co-payment you will get a good break on your monthly premium. That is an extremely good idea for people who do not see their medical provider on a regular basis.

Another important question to ask is how large of a deductible can you afford to pay? Your deductible is cash that you have to pull out of your own pocket to pay for your own heathcare each year, so think about this carefully and be honest about how much you can really afford to pay. The more you can pay – the biggeryour deductible – then the less your insurance company will charge you each month in health care insurance premiums.

Now take everything you’ve learned in this article and create a health care insurance policy that is designed to save you the most money possible. Once you’ve done that then get online and find at least 3 different websites that let you make side-by-side comparisons of health care insurance programs and their prices from different insurance businesses.

If you recently lost your health coverage but had 18 months of coverage prior to losing it, you could be eligible for a different kind of affordable health care insurance in Tennessee. Inexpensive health coverage in TN can be obtained with the help of the Medical Insurance Portability and Accountability Act, or HIPAA.

HIPAA actually covers a variety of health-related topics, but if you are reading this you are most interested in one: When employees experience a change in jobs, or lose their jobs, they are entitled to keep health care insurance coverage for themselves and their families.

How does HIPAA make it possible to obtain affordablehealth coverage in TN? They do so by prohibiting any health care insurance company from implementing any “qualifiers” when the time comes to determineon your premiums. Consider this example, they stop the health care insurance businesses from using pre-existing conditions to determinehow expensive or affordable health care insurance proposals will be. Such pre-existing conditions include your current health status, your (and possibly your family’s) medical history, your genetic information, and even your disabilities. The same health situations that once made you feel it was impossible to find affordable health care insurance in Tennessee now mean nothing to your health care insurance policy as far as affordable health care insurance proposals are concerned.

As far as coverage exclusions go, HIPAA makes it challenging for any health care insurance company to place limits on your coverage of preexisting medical conditions if you are coming away from 12 straight months of health coverage from a credible insurer, i.e. Medicare, group medical programs, military-sponsored health coverage. If your previous health care insurance company isn’t considered credible or was from a foreign insurer, the new health care insurance company can deny payment for the preexisting medical condition medical care.

Medical Insurance has numerous requirements and few requirements at the same time. There are numerous circumstances that may apply to this. A healthy person would easily qualify for health care insurance, whereas someone with a medical condition or someone who has a history of certain medical conditions would find it very hard to find a health care insurance company to cover him or her. The cost of health care insurance also varies according to your degree of health and other conditions.

A person’s life style would certainly be taken into consideration when qualifying for health care insurance, for example a librarian would be much more qualified for health care insurance than a race car driver. An insurance company is a companyafter all and are about making money, that is why it will not want to qualify you for health care insurance if they think that you are at you are at a risk of becoming seriously ill or in any kind of health danger, for example smokers, or people who consume excessive amounts of alcohol would receive higher premiums. People with diseases such as cancer, AIDS, HIV, and other pre-existing conditions would find it hard or nearly impossible to get health care insurance.

Another aspect that is considered when your application for health care insurance is being processed is the area where you live. Places with environmental pollutants such as nuclear power plants, landfills, war torn areas and other places where variables in the environment may cause ill health will definitely drive your premium upwards. Age is another factor, for example a twenty year old person would get a very cost effective health care insurance package whereas a seventy old person would get an equally or less valuable package for a much greater price. Gender is also a consideration because women generally tend to live longer than men, are less likely to develop heart disease and have reduce levels of depression. Marital status is another key area in insurance as married men are apt to live longer with fewer bouts of depression whereas married women have shorter life expectancies and higher stress levels.

All these variables are called risk variables and people who score on the high end of the scale may find it challenging to find affordable health care insurance. Thus, great strides towards making heathcare available to everyone have been made and you may find an outreach program in your area that either gets you heathcare at a discount or provide it free of charge. The United States system of Medicaid and COBRA are excellent examples of a heathcare system working to keep all its citizens healthy.

This article identifies the fundamental drivers of raising medical premiums and expenses . A supplementary measure of breaking down how existing premium dollars are being used up is taken into account.

By specifying how health care insurance premiums are being used up as well as distinguishing the drivers and aspects of premium increases, this article endeavors to provide stakeholders and policymakers with information which can facilitate in directing efforts to address raising medical expenses  and enhance medical efficiency.

Outlined are some of the variables which affect the overall medical expenses :

<h3>General Inflation</h3>

General inflation is one of the variables that impacts medical expenses . The rise in the cost of medical beyond general inflation accounted 2.5% out of the 8.7% rise in health care insurance premiums.

<h3>Higher Priced Technologies</h3>

New technologies drive the increase in medical prices because they are regularly more costly than existing technologies. Older drugs as well as generic drugs tend to be replaced by newer prescription drugs. And since modern imaging technologies are being sold into the commercial market at a higher value, it has been observed that these new technology cost greatly influence the cost of health care insurance premiums.

<h3>Cost Shifting</h3>

The growth in hospital inpatient expenditure, which is the third chief constituent of health care insurance premiums, also influenced the overall premium increase. The growth in hospital inpatient spending has been alleviated by shifts and changes of services to outpatient settings, the rehabilitated introduction of disease administration programs and utilization controls programs have amplified cost sharing.

<h3>Broader-Access Networks/Provider Consolidation</h3>

The movement which was prompted by state laws and market forces towards programs in extensive provider networks has also influenced the cost of health care insurance premiums. Several programs have initiated open-access products which lessens the task of the primary care medical provider in assisting consumer access to health specialists. While various consumers have uttered an inclination for expansive provider networks, such networks apt to diminish the sum of competition in the scheme. There have been occurrences of provider consolidation which also reduced the degree of provider clash in some markets. These market directions have all contributed to health care insurance premium increases each year.

<h3>Aging Population and Increased Utilization</h3>

The most significant factor in the increase in health care insurance premiums is increased utilization. Lifestyle changes and the aging population both contribute to increased utilization. It is extensively acclaimed that the population is growing old as Baby Boomers move towards retirement. It has been established that the aging of the population registered in health plans greatly contributed to the rising cost of health care insurance premiums.

Since competition in terms of health care insurance is on the rise, it is no wonder that more and more forms of health care insurance are being designed. Among these, there are few that are popular and they are briefly described below.

Individual Insurance: Insuring a person individually is a common mode of insurance. One may be selective about what s/he wants in a plan through this process. Accordingly, one has required premium is calculated, and the insurance program takes effect.

Group Insurance: Another kind of insurance is the group arrangement. Through this kind of insurance, one is compelled to abide by what others are going for, and this is dependent on the insurance providers. They are the ones that determinewhat is feasible to include in a plan, and on that basis, a group insurance can take place.

Indemnity Plan: This plan allows one to go to any medical provider when one needs to; there are no restrictions on this, and it is believed to be more of a traditional plan. One doesn’t need permission to go to a specific heathcare provider. Thus, generally what happens is that the member pays 20% of the total fee for treatment while the insurance provider pays 80%. Additionally to this, there is a period through which one pays up in this manner, and then the company takes over paying the whole 100%.

Health Maintenance Organization (HMO): The Health Maintenance Organization (HMO) is one that allows a member to select a specific medical provider off the panel. It is these selected medical providers that will deal will with members’ problems. The selected medical provider is the one that will be approached for checkups of any kind, and if there are problems with a member that cannot be handled by him or her, the member is referred to specialists.

When a health care insurance claim is rejected, your next steps will determinewhether you win a reversal in your favor or get stuck with a big bill.

Contact your health care insurance provider. A claims adjuster should be able to review the denial and resolve the issue if there was just a simple error, such as an incorrect diagnostic code. Be certain to keep a written record of your call, including the date, time and name of the person you spoke to. If you do not get anywhere with the phone call, request to begin the process of a formal claim review.

Ask for help. Take the details to your human resources department or benefits administrator. She/he should be able to call the insurance company for you or offer advice on how to proceed. You might also want to ask your medical provider to call or write your insurance company to specifically explain why you needed the care you received.

Draft a letter. If the claim is still denied, write a letter to the claims manager and send copies to higher ups, such as regional vice presidents. Call your health care insurance company for names and proper spellings. Politely explain why your claim should be covered and request a written response by a certain date.

Apply some pressure. If you still feel that your claim is legitimate and your insurance company disagrees, file a complaint with your state insurance regulatory agency. Many states allow you to do this online. To find your state regulator, go to naic.org