Discover the Best Individual Insurance
Policy for You!
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Finding affordable health insurance is challenging, but you do have a choice. You can spend hours reading booklets and advertising materials that only provide you with what someone else thinks you want to know, or you can use our friendly, helpful service and complete our easy profile. You will be matched with the companies that have the type of product you seek. You will receive quotes usually by email or return phone calls for up to five companies. Even if you have been declined, a diligent effort will be made to find a company that will offer you insurance.
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an affordable medical health care insurance plan designed to accommodate your family's needs!
In general, personal major medical health insurance is not as cheap as coverage you may have had with an employer. That’s because your employer was paying the largest share of the cost. Also, group health insurance does not take into account your age or your health history, but rather sets a premium based on the average age of the entire group. Even health insurance companies that claim to have a “group” of members, such as companies that insure small business owners or self employed individuals, still set your premium based on your age and on the your own health history. In spite of this, there are choices and ways of lowering the high cost of individual health insurance.
Traditional Health Care Coverage is the individual health insurance most people are familiar with. Individuals can see any doctor and use any hospital without having a primary physician as a “gate-keeper.” A list of participating doctors is simply a group of physicians who have agreed to accept the insurance as payment (in addition to your copay or deductible). A non-participating doctor is one who has not agreed to accept the insurance. He may charge a higher copay, and the percentage paid by the company will usually be less, but you will be free to go there if you wish.
HMO Insurance plans are a mid 1900s invention that was supposed to lower the cost of group health insurance. People had to see a primary physician for any ailment and could only see a specialist with a referral. The doctor accepted a small, flat copay, and was paid his negotiated rate by the insurance company plus a stipend for being a participant. In some cases, doctors were paid more if they sent fewer patients to specialists. HMO policies were out of favor during the last 20 years, but have made something of a comeback, especially among those needing to buy private insurance. While choices of physicians are rather restrictive, if a person is in good health, an HMO can be a lower cost option.
Indemnity plans are plans that pay you a pre-determined amount for any covered event. They used to be primarily accident coverage, but in recent years and with so many people without insurance, companies that provide indemnity plans have expanded to offer coverage for illness or surgery as well as for accident. Indemnity plans send the money directly to you, and you can have an indemnity plan in addition to insurance. If you have a major illness, such a plan will not cover everything, but the benefit may still be worth the premium.
An indemnity plan is a low cost alternative to traditional insurance, but be aware that such plans are not considered creditable coverage. They are simply better than no coverage at all.
Catastrophic
Health Care, Cancer and other focused plans
Catastrophic plans are plans that pay only for a major event. Through the years, there have been scores of these for everything from cancer, to heart disease, to hospital intensive care. Cancer plans, accident only plans, and hospital indemnity plans will pay a benefit when the specified event has occurred. Some catastrophic plans are actually considered insurance, but most have fairly high deductibles. Still, a catastrophic plan can prevent bankruptcy if you should have a major illness.
Questions
to ask an agent
Most people have never been educated in Insurance. No company will pay benefits not covered in a policy, and the commissioner of insurance will uphold the company’s decision to decline benefits that are not specifically covered. Law suits against insurance companies are seldom won as companies are experts in making sure every detail of coverage is spelled out. Yet, the average client has never actually read an insurance policy from cover to cover. The policy arrives in the mail and is shoved into a drawer or a file box and never actually read. Bear in mind that neglecting to read the policy does not make a company liable for things you didn't understand.
That being said, you will avoid confusion and have greater peace of mind if you work with an agent who is willing to take the time to help you understand your policy. Don’t just assume your agent will do this. Many will simply send the policy in the mail and leave you to figure it out. A truly good agent from a reputable company is worth working with even if the premium is a few dollars more. When you do select an agent, you should be sure to ask the following questions.
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How long do pre-existing conditions apply? When you go from one group coverage plan to another, the pre-existing condition clause is waived. This is not true when going from group coverage to private coverage. Your new company may refuse to pay for a pre-existing condition for as long as two years. They may also look back over your entire life for that pre-existing condition. Thus, if you had cancer 15 years ago but are still taking some sort of preventive medication, you will have a waiting period even though you have been cancer free for 14 years.
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What are the exclusions? There will always be some as no company pays for everything. You need to know what they are.
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What are the anticipated rate increases? Your agent may tell you that he doesn't know as rates are approved by the commissioner on an annual basis. That much is true, but the company has charts showing what your premium would be today for any given age. They also know the average company increase rates over time. Don’t buy if they won’t provide you with that information.
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What is the lifetime maximum benefit?
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Can you reduce the premium by taking a higher deductible?
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How are co-payments determined?
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How do you get permission to go to the hospital?
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Are prescription drugs included? Is there a separate deductible? What is the copay?
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How are customer service issues handled? Can you get help from the agent?
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