When a family goes out in the market and shops around for health insurance, they normally want a comprehensive plan that includes co-pays to the doctor, Rx coverage, and maybe even preventative or vision with the plan. Having these benefits makes it look more appealing to the subscriber and seems to offer the most for the money.
But, let us think again when purchasing this benefit. Let us look a national carrier and what the cost is for a family of three with and without co-pays to the doctor. I ran a quote without a co-pay option and the cost was around $85.00 less per month than with co-pays of $30 dollars. Now, according to the national average, one goes to the doctor two times per year. So, a family of three would go six times. They have to pay the $30 copay, that is an additional $180 dollars per year, plus the extra $1020 for the copay benefit, this will cost them around $1200.00 dollars a year for this benefit.
Now, if they did not get this benefit but had a carrier that allows them to use their insurance card and get a discount when going to the doctor, that cost will vary mind you, but you are looking at anywhere from $37-$45 per visit, depending on doctor and carrier. Note, this does not cost extra and you still get a pretty good discount when going to the doctor. Let us see, six times $45 is $270 dollars per year. Wow, you just saved yourself $930 by not getting the copay benefit...... What a benefit right? No it is not and you need to realize that the insurance company is not in the business of giving something for nothing.
In conclusion, every carrier has different costs and options with the co-pays-like preventative, etc., but when you add this feature on your plan, you need to add up the cost and make sure it makes financial sense. Could you use that extra $930 dollars for a new t.v.? A new wardrobe? Start adding up before you buy.
Sunday, May 17, 2009
What is an HSA Health Insurance Plan
Choosing the right health plan can be a very confusing process to say the least. Understanding the differences between each health plan is important before deciding which plan is best for you or your family. It's difficult just to figure out which deductible amount to choose or whether to pay extra for a fixed doctor copay or not. Now there is a fairly new type of plan that is compatible with a Health Savings Account or HSA for short.
A Health Savings Account can be set up and utilized in conjunction with an HSA compatible health insurance plan. However, setting up a health savings account is not mandatory and is separate and apart from the insurance plan issued by the insurance company. Banks offer, set up and administer the Health Savings Account. Some insurance companies have agreements with banks who offer Health Savings Accounts and give you the option of signing up during the application process.
It is important to know, you can use ANY bank of your choosing for your Health Savings Account. Insurance companies cannot dictate which bank you use. Before choosing a bank, be sure to research fees and interest rates as they can vary greatly from bank to bank.
Health Savings Accounts function similar to an IRA. Both are tax deferred savings accounts and both can be used to supplement your retirement. The difference is the way funds are taxed. With an HSA, any funds withdrawn for the purpose of qualified medical expenses become tax free.
An HSA compatible plan can be very different from a PPO plan or can also be very similar. All HSA plans and some PPO plans have a deductible which all covered medical services are subject and no copays for doctor visits or emergency room services. Both PPO and H.S.A plans will offer a coinsurance percentage of coverage after the deductible has been met. These percentages of coverage can be anything from 100% to 50% depending on the plan and whether you utilize in network or out of network provider.
HSA plans have one main unique feature. All plans have ONE single deductible which needs to be met before any coverage applies. Everything goes towards the deductible, including pharmacy benefits, if provided. In the case of a single person being covered it is one single deductible. But if you are covering a family, it is still one single family deductible whether you are covering two or ten family members. For a PPO family plan you have individual deductibles that apply to each family member AND a family deductible that caps the annual deductible amounts to two or three times the individual deductibles.
HSA deductible amounts are set by the government and can change year to year. The single deductible options are lower than the family deductible options. As of 2009 the minimum single deductible is $1,150 and maximum is $2,300 for family. The maximum out of pocket amounts are $5,800 for single and $11,600 for family. The maximum out of pocket includes deductible and coinsurance amounts.
As always, be sure to keep your current coverage in place until a reputable company has approved your application and offered you acceptable coverage and premium.
A Health Savings Account can be set up and utilized in conjunction with an HSA compatible health insurance plan. However, setting up a health savings account is not mandatory and is separate and apart from the insurance plan issued by the insurance company. Banks offer, set up and administer the Health Savings Account. Some insurance companies have agreements with banks who offer Health Savings Accounts and give you the option of signing up during the application process.
It is important to know, you can use ANY bank of your choosing for your Health Savings Account. Insurance companies cannot dictate which bank you use. Before choosing a bank, be sure to research fees and interest rates as they can vary greatly from bank to bank.
Health Savings Accounts function similar to an IRA. Both are tax deferred savings accounts and both can be used to supplement your retirement. The difference is the way funds are taxed. With an HSA, any funds withdrawn for the purpose of qualified medical expenses become tax free.
An HSA compatible plan can be very different from a PPO plan or can also be very similar. All HSA plans and some PPO plans have a deductible which all covered medical services are subject and no copays for doctor visits or emergency room services. Both PPO and H.S.A plans will offer a coinsurance percentage of coverage after the deductible has been met. These percentages of coverage can be anything from 100% to 50% depending on the plan and whether you utilize in network or out of network provider.
HSA plans have one main unique feature. All plans have ONE single deductible which needs to be met before any coverage applies. Everything goes towards the deductible, including pharmacy benefits, if provided. In the case of a single person being covered it is one single deductible. But if you are covering a family, it is still one single family deductible whether you are covering two or ten family members. For a PPO family plan you have individual deductibles that apply to each family member AND a family deductible that caps the annual deductible amounts to two or three times the individual deductibles.
HSA deductible amounts are set by the government and can change year to year. The single deductible options are lower than the family deductible options. As of 2009 the minimum single deductible is $1,150 and maximum is $2,300 for family. The maximum out of pocket amounts are $5,800 for single and $11,600 for family. The maximum out of pocket includes deductible and coinsurance amounts.
As always, be sure to keep your current coverage in place until a reputable company has approved your application and offered you acceptable coverage and premium.
Health Insurance Lifetime Maximum
The Health Insurance Lifetime Maximum of your plan is the total amount of money the insurance company will pay for the entire time you have coverage under that plan. Once you reach that amount, your plan will not pay for any more of your medical expenses.
What Are The Limits?
The maximum amount that the insurance company will pay varies from policy to policy, with the typical amount being between 1 million and 5 million dollars. There are some polices though, that only contribute a total of less than 1 million dollars over the lifetime of the policy.
On a brighter note, although not as common, there are policies that have an unlimited lifetime maximum.
Why Are There Limits?
Insurance companies set these limits to keep their total possible liability for a health insurance plan as low as possible.
Keeping these limits lower also keeps the premium rates lower. All of the guidelines of the plan, including the lifetime cap come into play when insurance companies set the cost of the insurance plan. A plan richer in benefits is going to cost more.
For instance, a health insurance plan with a high deductible and a low lifetime cap will cost less than a plan with a low deductible and unlimited lifetime benefits.
Similarly, when the annual deductibles of two plans are the same, the plan with a higher lifetime maximum will cost you more.
Should You Be Concerned?
You and your family members may be in perfect health and can never foresee that any one of you could possibly incur medical bills as high as one to five million dollars. And quite frankly, I hope you never do!
But, with the rising costs of medical treatment for conditions such as open heart surgery, cancer, organ transplants and chronic illnesses, it isn't that difficult to reach those amounts in a short amount of time.
If you want to be sure to be covered for all medical expenses for the duration of your coverage under that policy, look for one with a higher lifetime limit or one with no limit. To lessen the cost of these plans, consider accepting a higher annual deductible.
P.S. Consider this ~ A coverage cap of $1 million in the 1970s would have had to grow to more than $10 million today to keep pace with inflations and costs.
What Are The Limits?
The maximum amount that the insurance company will pay varies from policy to policy, with the typical amount being between 1 million and 5 million dollars. There are some polices though, that only contribute a total of less than 1 million dollars over the lifetime of the policy.
On a brighter note, although not as common, there are policies that have an unlimited lifetime maximum.
Why Are There Limits?
Insurance companies set these limits to keep their total possible liability for a health insurance plan as low as possible.
Keeping these limits lower also keeps the premium rates lower. All of the guidelines of the plan, including the lifetime cap come into play when insurance companies set the cost of the insurance plan. A plan richer in benefits is going to cost more.
For instance, a health insurance plan with a high deductible and a low lifetime cap will cost less than a plan with a low deductible and unlimited lifetime benefits.
Similarly, when the annual deductibles of two plans are the same, the plan with a higher lifetime maximum will cost you more.
Should You Be Concerned?
You and your family members may be in perfect health and can never foresee that any one of you could possibly incur medical bills as high as one to five million dollars. And quite frankly, I hope you never do!
But, with the rising costs of medical treatment for conditions such as open heart surgery, cancer, organ transplants and chronic illnesses, it isn't that difficult to reach those amounts in a short amount of time.
If you want to be sure to be covered for all medical expenses for the duration of your coverage under that policy, look for one with a higher lifetime limit or one with no limit. To lessen the cost of these plans, consider accepting a higher annual deductible.
P.S. Consider this ~ A coverage cap of $1 million in the 1970s would have had to grow to more than $10 million today to keep pace with inflations and costs.
Why You Should Think About Cheap Health Insurance
Nowadays with ever increasing NHS waiting lists, numbers of free hospital beds reducing and waiting times to see specialists increasing it's never been a better time to look into the benefits of finding cheap health insurance in the UK.
You might think if you have never been seriously ill there is no need to get covered and it's unlikely that you will ever need cover in the immediate future. Well if you are living and enjoying a healthy lifestyle today there is even more reason why you should consider a private medical plan. People with no long term illnesses and lead an active life can find cover at a discounted rate.
Benefits of health cover
Private health cover has become more and more popular as peoples expectations of the health service are increased, the main benefits of opting for private medical cover is first and foremost - prompt treatment. Many people find themselves stuck on an NHS waiting list for months and months' finding the only way to move forward is to pay extortionate fees to companies which will enable them to be treated sooner.
Personal preference is another reason why someone would choose a cheap health insurance plan rather than go down the NHS route. In most private hospitals you are provided with a private en-suite room, TV and Radio, this makes things much more comfortable for any patient staying there.
So all in all, there are many reasons to consider health insurance, if you decide you need cover, take your time and find the plan that's right for you.
You might think if you have never been seriously ill there is no need to get covered and it's unlikely that you will ever need cover in the immediate future. Well if you are living and enjoying a healthy lifestyle today there is even more reason why you should consider a private medical plan. People with no long term illnesses and lead an active life can find cover at a discounted rate.
Benefits of health cover
Private health cover has become more and more popular as peoples expectations of the health service are increased, the main benefits of opting for private medical cover is first and foremost - prompt treatment. Many people find themselves stuck on an NHS waiting list for months and months' finding the only way to move forward is to pay extortionate fees to companies which will enable them to be treated sooner.
Personal preference is another reason why someone would choose a cheap health insurance plan rather than go down the NHS route. In most private hospitals you are provided with a private en-suite room, TV and Radio, this makes things much more comfortable for any patient staying there.
So all in all, there are many reasons to consider health insurance, if you decide you need cover, take your time and find the plan that's right for you.
Florida State Health Insurance - A Guide
What is Florida State Health Insurance?
For those people who have been denied medical insurance due to certain medical conditions, the state of Florida offers an alternative means to get insured, as directed by the Florida Legislature.
The sunny state is one of the costliest when it comes to health insurance. Moreover, the balance of power is largely in favor of insurance companies than individuals; for instance, there is no upper limit to what an insurance company can charge you for its policy. This, along with a lack of widespread competition, has helped in creating a market monopoly that has driven policy prices upwards.
To combat this, and to provide individuals denied medical insurance along with those who cannot afford insurance from a private providers, Florida came out with its "Florida State Health Insurance" scheme. The plans provided by the state under this scheme are invariably superior in terms of cost and payment than those offered by private companies.
Who is Eligible for This Scheme?
If you're a resident of Florida for over an year, you qualify for the state of Florida health insurance. Usually, if you've been denied insurance by a company on medical grounds, you will be covered by this program.
Florida also has provisions for medicaid to families from the lower income brackets who cannot afford regular health insurance from private providers. Under this program, you are required to consult your neighborhood Division of Family Services, which will provide you with all the necessary information and the requisite application forms. The application procedure involves answering certain questions about your finances and past medical history; the percentage of people approved for insurance are always quite high.
What Coverage Does the Program Offer?
This program covers all aspects of a family's health: dental care, eye care, emergency visits, and of course, doctor visits.
Additionally, children who do not get coverage through their parents' employment are also covered through a public/private program called the Florida Kids Healthy Corporation. Applications can be submitted online through their website at HealthyKids.org.
Who Else is Covered?
The Florida state health insurance program also covers "federally eligible individuals" - chiefly, those individuals who've accrued a total of 18 months of creditable coverage and have not had more than a 90 day gap between coverage - as defined by the Health Insurance Portability and Accountability Act (HIPPA). To check whether you qualify as a federally eligible individual, please consult the HIPPA website. This scheme is specifically designed for individuals who've lost their employment and thus, are without coverage.
For those people who have been denied medical insurance due to certain medical conditions, the state of Florida offers an alternative means to get insured, as directed by the Florida Legislature.
The sunny state is one of the costliest when it comes to health insurance. Moreover, the balance of power is largely in favor of insurance companies than individuals; for instance, there is no upper limit to what an insurance company can charge you for its policy. This, along with a lack of widespread competition, has helped in creating a market monopoly that has driven policy prices upwards.
To combat this, and to provide individuals denied medical insurance along with those who cannot afford insurance from a private providers, Florida came out with its "Florida State Health Insurance" scheme. The plans provided by the state under this scheme are invariably superior in terms of cost and payment than those offered by private companies.
Who is Eligible for This Scheme?
If you're a resident of Florida for over an year, you qualify for the state of Florida health insurance. Usually, if you've been denied insurance by a company on medical grounds, you will be covered by this program.
Florida also has provisions for medicaid to families from the lower income brackets who cannot afford regular health insurance from private providers. Under this program, you are required to consult your neighborhood Division of Family Services, which will provide you with all the necessary information and the requisite application forms. The application procedure involves answering certain questions about your finances and past medical history; the percentage of people approved for insurance are always quite high.
What Coverage Does the Program Offer?
This program covers all aspects of a family's health: dental care, eye care, emergency visits, and of course, doctor visits.
Additionally, children who do not get coverage through their parents' employment are also covered through a public/private program called the Florida Kids Healthy Corporation. Applications can be submitted online through their website at HealthyKids.org.
Who Else is Covered?
The Florida state health insurance program also covers "federally eligible individuals" - chiefly, those individuals who've accrued a total of 18 months of creditable coverage and have not had more than a 90 day gap between coverage - as defined by the Health Insurance Portability and Accountability Act (HIPPA). To check whether you qualify as a federally eligible individual, please consult the HIPPA website. This scheme is specifically designed for individuals who've lost their employment and thus, are without coverage.
Health Insurance - Guide For the Complete Novice
Health Insurance does not have to be complicated. If you understand the core principles behind a health insurance policy and the system itself, you are way ahead of the majority. People often get too caught up with what insurance company they believe to be superior to others or what insurance plan they believe will conquer the rest. Long story short, there is no one insurance company or plan that would make even God jealous.
Insurance premiums are regulated by the department of insurance at the state level. No one insurance company or agent can offer you discounts or a magic dream policy that will cover hospitalization 100% at 5$ a month. You will always pay the same premium for the plan listed weather you go directly to an insurance company or through an insurance agent.
In the insurance market today premiums generally increase about every year. However, there are exceptions to this general rule. Some carriers can negotiate up to a 2 year rate guarantee. This can directly provide more security to the insured. Rate guarantee plans are usually a wise choice considering the current status of our economy in 2009.
Key parts to a health insurance plan
If you become familiar with the following core parts of a health insurance policy you will be much more informed the next time you find yourself shopping the insurance market place. It is better to understand your policy now instead of when you end up in the hospital! If a plan has an extremely low premium chances are it is lacking in one of the following areas:
Deductible
This is often the first part of the health insurance policy that you will encounter when viewing or researching a plan. A deductible is the amount of money that you must pay up front before the insurance company will cover you. You start paying your deductible when you start incurring medical bills. Let's say I go to the hospital for stitches in my arm and the hospital bill ends up costing $250. If I have a health insurance policy that has a $1500 deductible I must pay the full $250; now I am left with $1250 of my deductible to satisfy before the company will start paying a Co-insurance percentage (see below) of my bill.
Out-of-pocket maximum
Out-of-pocket maximum is the most important element of a health insurance policy and basically the reason you buy it in the first place. It is the total amount of money that you can be exposed to in a given year. For example, if I have an out-of-pocket max of $4000 and I have a serious accident that leaves me with $1,000,000 in hospital bills, I will pay $4000 and the insurance company pays the rest.
Prescription Drug Coverage
People often get into some hot water if they don't take a close enough look to see how prescription drugs are covered within their policy. You may be extremely healthy and feel that you do not need medication but you would feel differently if you had a catastrophic emergency that required expensive prescription drugs only to find out later that they were not covered. The end result could leave you thousands out-of-pocket!
Some insurance companies will have plans offering generic Rx only. Again this will result in you paying full price for brand name drugs if some reason there is no generic available. Most companies will offer generic Rx, no Rx or apply a yearly maximum cap to lower the overall cost of the health plan. It is all a matter of how you weigh the risk but it is usually recommended that you purchase full prescription drug coverage. With full Rx benefits it is common to see a $35 co-pay for brand drugs and a $10 co-pay for generic. It is common to see a small brand Rx deductible applied to brand name Rx. This can range anywhere from $250 to $750.
Co-Insurance
Co-Insurance is simply the percentage that your medical bills will be covered at after you satisfy the deductible. If I have a $1000 deductible with 80/20 co-insurance and a $3,500 out-of-pocket maximum this means that once my deductible is satisfied I will be responsible for 20% per medical bill until the total cost reaches $3,500 (deductible is usually included in out-of-pocket maximum).
Co-payment
More than likely you have heard the term "Co-payment," which refers to a flat dollar amount that you pay for a specific medical service. It's common to have a co-payment for primary care and preventive care office visits. Co-pays can range anywhere from 10-50 dollars (sometimes more) depending on the service you receive and what type of policy you enroll. If you visit the doctor frequently you should enroll in a plan offering co-pays before satisfying the deductible. On the other hand, if you are very healthy and never go to the doctor it would be beneficial to enroll in a high deductible HSA compatible plan with out co-pays.
Insurance premiums are regulated by the department of insurance at the state level. No one insurance company or agent can offer you discounts or a magic dream policy that will cover hospitalization 100% at 5$ a month. You will always pay the same premium for the plan listed weather you go directly to an insurance company or through an insurance agent.
In the insurance market today premiums generally increase about every year. However, there are exceptions to this general rule. Some carriers can negotiate up to a 2 year rate guarantee. This can directly provide more security to the insured. Rate guarantee plans are usually a wise choice considering the current status of our economy in 2009.
Key parts to a health insurance plan
If you become familiar with the following core parts of a health insurance policy you will be much more informed the next time you find yourself shopping the insurance market place. It is better to understand your policy now instead of when you end up in the hospital! If a plan has an extremely low premium chances are it is lacking in one of the following areas:
Deductible
This is often the first part of the health insurance policy that you will encounter when viewing or researching a plan. A deductible is the amount of money that you must pay up front before the insurance company will cover you. You start paying your deductible when you start incurring medical bills. Let's say I go to the hospital for stitches in my arm and the hospital bill ends up costing $250. If I have a health insurance policy that has a $1500 deductible I must pay the full $250; now I am left with $1250 of my deductible to satisfy before the company will start paying a Co-insurance percentage (see below) of my bill.
Out-of-pocket maximum
Out-of-pocket maximum is the most important element of a health insurance policy and basically the reason you buy it in the first place. It is the total amount of money that you can be exposed to in a given year. For example, if I have an out-of-pocket max of $4000 and I have a serious accident that leaves me with $1,000,000 in hospital bills, I will pay $4000 and the insurance company pays the rest.
Prescription Drug Coverage
People often get into some hot water if they don't take a close enough look to see how prescription drugs are covered within their policy. You may be extremely healthy and feel that you do not need medication but you would feel differently if you had a catastrophic emergency that required expensive prescription drugs only to find out later that they were not covered. The end result could leave you thousands out-of-pocket!
Some insurance companies will have plans offering generic Rx only. Again this will result in you paying full price for brand name drugs if some reason there is no generic available. Most companies will offer generic Rx, no Rx or apply a yearly maximum cap to lower the overall cost of the health plan. It is all a matter of how you weigh the risk but it is usually recommended that you purchase full prescription drug coverage. With full Rx benefits it is common to see a $35 co-pay for brand drugs and a $10 co-pay for generic. It is common to see a small brand Rx deductible applied to brand name Rx. This can range anywhere from $250 to $750.
Co-Insurance
Co-Insurance is simply the percentage that your medical bills will be covered at after you satisfy the deductible. If I have a $1000 deductible with 80/20 co-insurance and a $3,500 out-of-pocket maximum this means that once my deductible is satisfied I will be responsible for 20% per medical bill until the total cost reaches $3,500 (deductible is usually included in out-of-pocket maximum).
Co-payment
More than likely you have heard the term "Co-payment," which refers to a flat dollar amount that you pay for a specific medical service. It's common to have a co-payment for primary care and preventive care office visits. Co-pays can range anywhere from 10-50 dollars (sometimes more) depending on the service you receive and what type of policy you enroll. If you visit the doctor frequently you should enroll in a plan offering co-pays before satisfying the deductible. On the other hand, if you are very healthy and never go to the doctor it would be beneficial to enroll in a high deductible HSA compatible plan with out co-pays.
Health Care Reform by Reconciliation Encouraged by President Obama
The talk around the federal government is saying that the health care and health insurance reform legislation may get through the Senate by using reconciliation. This is a rule which permits only certain bills which have an affect on the federal budget to be moved through by a simple majority of 51 votes. The effect of this is the minority party has no way to filibuster the bill.
This would permit the Senate Democrats to have an opportunity to pass whatever kind of health reform they orchestrated and the Republicans would have no recourse. The New York Times reported this weekend that President Obama was endorsing the use of reconciliation if the need was there.
President Obama is committed to passing the health care reform this year, reconciliation would make that a done deal. The President has more than enough support in the U.S. House of Representatives and the Senate would be part of the deal if reconciliation is used.
The Senate Republicans are very upset as you can imagine. The GOP is accusing the Democrats of not wanting to discuss all the aspects of health care reform and trying to exclude the Republicans. There are some Democrats however, who do want all involved in a full debate on this subject. One of them is Senator Max Baucus who says we need more than 60 votes, and if we jam something down somebody's throat, it won't be sustainable.
The Senator from Montana is speaking what a lot of people are thinking. The need to include everyone's ideas and issues is a reasonable request. Since the announcement of Senator Arlen Specter moving from Republican to Democrat, it might have those 60 votes, enough to keep a filibuster from happening. Of course, this assumes Democrat Al Franken will win the fight with Norm Coleman in Minnesota.
This would permit the Senate Democrats to have an opportunity to pass whatever kind of health reform they orchestrated and the Republicans would have no recourse. The New York Times reported this weekend that President Obama was endorsing the use of reconciliation if the need was there.
President Obama is committed to passing the health care reform this year, reconciliation would make that a done deal. The President has more than enough support in the U.S. House of Representatives and the Senate would be part of the deal if reconciliation is used.
The Senate Republicans are very upset as you can imagine. The GOP is accusing the Democrats of not wanting to discuss all the aspects of health care reform and trying to exclude the Republicans. There are some Democrats however, who do want all involved in a full debate on this subject. One of them is Senator Max Baucus who says we need more than 60 votes, and if we jam something down somebody's throat, it won't be sustainable.
The Senator from Montana is speaking what a lot of people are thinking. The need to include everyone's ideas and issues is a reasonable request. Since the announcement of Senator Arlen Specter moving from Republican to Democrat, it might have those 60 votes, enough to keep a filibuster from happening. Of course, this assumes Democrat Al Franken will win the fight with Norm Coleman in Minnesota.
Subscribe to:
Posts (Atom)
