Rule Health Insurance
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Health Insurance 101 for Individuals and Families
by: Michael H. Ertel
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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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?
- 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?
- 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.
- 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.
- 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
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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International Travel and Health Insurance
David M. Schmader
Embarking on Your Dream Vacation
Are your Plans Complete?
Your bags are packed, passport and papers in order and you couldn’t be in a
higher state of excitement preparing for travel to that wonderful, exotic location.
This is the vacation you have planned it seems forever. As you sit on the plane,
you and your partner discuss for the hundredth time the scuba diving you will
do, the awesome rock climbing and hikes into the rain forest. Everything is
perfect!
Life seldom gets better than this.
Despite all the excitement of travel, Americans do have some concerns.
According to a survey by the Chubb Group, more than 70% of Americans surveyed
said their greatest concern when traveling is suffering a medical emergency...more
than double the fear of being mugged (30.7%), three times the fear of being
injured in a terrorist attack (23.4%).
What happens if a medical emergency arises when traveling overseas?
Many people assume that while they are out of the U.S. or Canada they will be
covered by their standard medical plan. However, most traditional health insurance
plans are not designed for international travel.
According to the U.S. Department of Commerce, approximately 27 million travelers
board U.S. airlines for overseas destinations and almost 26 million foreign
travelers come to the U.S. each year. However, many are not prepared for a medical
emergency abroad.
Most traditional health insurance plans would not cover an unexpected illness
or injury during international travel. But travelers with international medical
insurance would have protection for scenarios ranging from a local ambulance
trip to an emergency evacuation for care at the nearest qualified medical facility.
Some even offer repatriation flights out of the country where the traveler is
located back to the US.
Available plans can cover individuals or groups for specific periods of time
abroad and can be in effect should they be stationed abroad for an extended
period of time. There are policies for corporations to insure their personnel,
plans to cover missionaries who are on an outreach program and for those participating
in extreme sports. International travel medical insurance should be considered
for anyone traveling or living abroad.
©David M. Schmader, Solon, Ohio January, 2005
www.brownschmader.com
About the Author
David Schmader is an independent broker agent located in the Cleveland Ohio suburb of Solon, Ohio. With over 25 years of corporate finance experience he specializes in serving the individual, professional and small business markets.
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