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Health Insurance
The U.S. does not have a national healthcare system. Providers are networked onto panels of managed care companies which often dictate which treatments will be paid for.
If you lose your job you may need temporary health insurance to cover you
until you get another job that has health insurance benefits.
In 1987, the Consolidated Omnibus Budget Reconciliation
Act (COBRA) went into effect, which contained provisions
allowing certain former employees, spouses, and dependent
children to buy temporary health insurance at group rates.
"Employees" eligible for COBRA can be full-time or part-time
workers, agents, independent contractors, directors, and
certain self-employed individuals eligible to participate in
a group plan.
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HealthBlue.com - Health Insurance Library of Information
Medicare does cover the elderly in the U.S., but there are huge gaps in coverage. Private medigap insurance can help. Senior living facilities cover the spectrum from nursing homes to luxury condominiums, with a range of services available.
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The changing healthcare and health insurance landscape in
the United States has resulted in more individuals and
families purchasing health insurance coverage on their own.
Rather than touch on the number of reasons why this is the
case, I would like to provide individuals and families
finding themselves in this position with ten basic ideas to
assist them with getting the best health insurance policy
for their specific situation. Below is a combination of ten
questions and suggestions that will provide the tools
necessary to get a medical insurance policy that will best
work for you and your family.
1)What are your typical health and medical care expenses in
a calendar year? Most people are surprised when they go
through this exercise to learn that they would be
financially better off in most years to purchase a high
deductible health insurance plan and use the premium savings
to directly offset heath care expenses throughout the year.
2)How long do you anticipate needing the health insurance
coverage? For example, many companies sell temporary
policies that can be put in force for 1-6 months and they
are relatively inexpensive. If you are in between jobs or in
a waiting period for employer coverage, this may be your
best option.
3)What is your budget? If your budget is tight, having a
$1000, $2500 or even $5000 deductible is better than having
no coverage at all. The ability of doctors and hospitals to
save and prolong life in the United States is in many cases
extraordinary. However, their treatment is not free and
going without health insurance coverage can in some cases
result in you and/or your family losing an entire life’s
worth of savings and assets.
4)Be careful to choose a plan that covers the “big stuff”.
It is nice to have a policy that covers items such as:
physician office visits, routine physicals, outpatient
testing, and blood work. However, it is essential to have
coverage for major services such as cancer treatment,
transplants, critical illness, traumatic accidents, and
infectious diseases. Find out the lifetime maximum amount as
well as if the policy contains “internal” dollar limits.
5)Always carefully read and understand the pre-existing
condition clause and policy exclusions so that you will not
be surprised down the road if a claim is denied. This is
important whether you are purchasing a standard medical,
temporary, or student health insurance policy.
6)Does the insurance company you are considering have a
substantial network of preferred doctors and hospitals in
your area? In addition to family doctors, what type of
access will you have to specialists and the best hospitals
in the event you or a family member is diagnosed with an
illness that requires specialized care? Also, what are your
options for preferred health care providers when traveling?
7)If you need to go “out of network”, will you still have
coverage? Most insurance policies will have coverage in the
event you need to go outside of their network for care.
However, review how these out of network claims will be
paid. Will there be an additional deductible? How are
reimbursement levels determined for out of network claims?
What is your maximum out of pocket for out of network
claims?
8)Are you looking for an opportunity to reduce your taxable
income? If so, make sure your plan qualifies as a high
deductible health plan and look into all of the aspects of a
Health Savings Account. In the right situation, HSAs can be
an excellent way to pay for eligible health care expenses,
reduce your taxable income and save for retirement.
9)What are the financial ratings of the insurance company
you are considering? A.M. Best, Standard & Poor’s, and
Moody’s are organizations that rate the financial stability
of insurance companies.
10)What type of customer service will you get from your
insurance agent? Do they specialize in health insurance? Do
they have a staff that is willing and able to assist you in
the event you have a claim, billing, or other customer
service problem?
If you do not have the time or patience to look into all of
the items mentioned above, develop a relationship with an
independent insurance agent that specializes in evaluating
and servicing health insurance policies. A good independent
insurance agent will be able to save you time, money, and be
an excellent resource for evaluating all of the items
mentioned above.
About the Author
About the Author: Michael Ertel is the founder of
http://www.MedicalInsuranceNow.com . This is a
website that assists individuals and small business owners
by providing side by side comparisons of health insurance
alternatives. He can be reached at MErtel@medicalinsurancenow.com
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