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Health Insurance is a insurance which insures over illness or body injury. Health insurance covers medicines, hospital stays, visits to the doctor or emergency room and other medical expenses. Most commonly used Health Insurance Policy types are:

More Details for Health Insurance

Family Health Insurance: The family health insurance provides the medical coverage for all members in a family.

 

Group Health Insurance: The Group Health Insurance policies are purchased by an employer and offers for qualifying employees and family members. This insurance policy offered as part of a benefits package working for a certain company.

 

Student Health Insurance: The Student Health Insurance provides the medical expenses for full or part-time college students until finishing their studies.

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Short-term Health Insurance: The Shot-term Health Insurance coverage options fill gaps between traditional insurance policies.

 

Individual Health Insurance: The individual Health Insurance covers all the medical Expenses, who purchased this policy.

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Health Insurance is a insurance which insures over illness or body injury. Health insurance covers medicines, hospital stays, visits to the doctor or emergency room and other medical expenses. Most commonly used Health Insurance Policy types are:

 

Family Health Insurance: The family health insurance provides the medical coverage for all members in a family.

 

Group Health Insurance: The Group Health Insurance policies are purchased by an employer and offers for qualifying employees and family members. This insurance policy offered as part of a benefits package working for a certain company.

 

Student Health Insurance: The Student Health Insurance provides the medical expenses for full or part-time college students until finishing their studies.

 

Short-term Health Insurance: The Shot-term Health Insurance coverage options fill gaps between traditional insurance policies.

 

Individual Health Insurance: The individual Health Insurance covers all the medical Expenses, who purchased this policy.

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A health insurance plan is a legal agreement entered into by an insurance company and an individual or an organization. Once signed, the insurance company is legally bound to pay a specified amount of medical expenses arising during the contract period in exchange for paying a pre-determined monthly premium.  The medical services covered by your insurance provider purely depend on the premium amount and the type of Health Insurance policy that you or your company chooses.

Before you decide on the exact type of health insurance plan you or your organization requires, it is important to know the different coverage options in market. It is good to know what you are eligible for as well as the various benefits that health insurance plans offer.  Understanding your options allows you or your company to select the very best insurance plan for the money.

Below is a short overview illustrating the distinction between individual and group health insurance:

Individual Health Insurance: Individual health insurance plans are designed for unemployed or self-employed people who pay a premium directly to the medical insurance company in exchange for health insurance coverage. Individual health insurance plans are generally more expensive than group health insurance.  Because the cost involved in medical expenses is very high, the narrow spread of risk makes the risk factor of the insurance company higher and passes that higher risk on to the individual in the form of a higher premium.  The individual who purchases health insurance also needs to go through certain medical tests (as per the insurance company) in order to qualify for the health insurance plan.  Under individual health insurance you can also cover your spouse or children under the same plan.

In relation with the high cost of individual health insurance, the insurance company usually lets you choose an appropriate Health Insurance plan that meets your needs, adjusting for your budget.  You can also renew your individual health insurance plan annually and at that time you have the opportunity to make modifications to the plan as needed.

Group Health Insurance: Group health insurance plans are designed for a large number of people associated with a single organization or company. Group health insurance is usually purchased by the company or organization on behalf of employees as an added benefit for the employee. Since the insurance premium amount is usually paid by the company or organization, the vast majority of individuals get their insurance through their employer.

With group health insurance, the insurance company covers everyone under a single group plan.  This distributes the cost and risk across the entire organization while also reducing the risk for the insurance carrier.  As a result, group plans generally do not require a medical exam to qualify and previous medical conditions are covered.

The potential downside to group medical plans is the fact that the company or organization providing the plan selects the amount of coverage to be offered their employees, the plan options and deductable amounts.  These options, though available to individuals buying plans on their own, are not available to employees.

In the end, every individual should have a health insurance plan. You might be in good health or rarely visit a doctor but nobody can predict what is going to happen tomorrow. One illness or even an accident can result in high medical expense which can significantly impact your financial situation. Although the cost of medical coverage is growing every year, the security and assurance you gain as a result of paying the increasingly high premiums far outweighs the cost.

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Today shopping for individual private health insurance online is fairly simple. Simply type the keywords “health insurance” on any major search engine such as Google, Yahoo, or MSN and you are virtually guaranteed to come across a multitude of websites with designer custom made plans. However, too often consumers who are simply weighing their options forget the bigger picture. It’s called medical underwriting. Medical underwriting is a process in which an insurer will evaluate under what terms and provisions they will insure an applicant if at all. Many times shoppers spend months trying to find the perfect benefit plan for the best price only to find out the plan they applied for came back after they submitted the application with a much higher price than anticipated or worse, they were declined coverage altogether and now cant get individual health insurance because they passed up what their employer offered.

 

Getting approved for individual health insurance coverage is not so easy.

 

If you had group insurance offered by your employer for most of the time you had coverage and this is the first time shopping for individual private health insurance, do your self a favor don’t just shop to get a feel for the market, take the next step and apply. Applying for coverage is the only real way you will really know what offer will be given to you and under what terms or price. Consult with a knowledgably licensed insurance agent who is familiar with the medical underwriting guidelines of the major medical insurance carriers offering the coverage you seek and begin to initiate the application process. All insurance carriers on the individual market will require an application to be complete with the first month’s premium deposit for consideration. The reason why insurers request this deposit is to ensure the applicant is serious about applying since they will incur administrative cost to determine if they will insure you or not, however some insurers will only withdraw funds if your approved while others will take the first months premium deposit and refund you if you decline their offer or if you are declined coverage altogether. Basically the entire process is two fold while you are considering them they are considering you. 

 

There are many reasons why an insurer will come back with a much higher price than anticipated in regards to the benefits you apply for or decline the application altogether. Here are just a few common examples.

 

Height and Weight: The physical condition of a proposed insured is of basic significance in underwriting. One of the determinants of physical condition is build. Build includes height, weight, and distribution of the weight. Experience has shown that being overweight increases the likelihood of death or sickness at all ages so for an insurer to justify the cost they will raise your rate accordingly if accepted. 

 

High Blood Pressure: Hypertension or High Blood Pressure is an intermittent or sustained elevation of diastolic or systolic blood pressure. Hypertension is a major cause of stroke, cardiac disease, and renal failure. Complications occur late in the disease and can attack any organ system. Cardiac complications include coronary artery disease, angina, myocardial infarction, heart failure, arrhythmias, and sudden death. Neurologic complications include cerebral infarctions and hypertensive encephalopathy. Hypertensive retinopathy can cause blindness or glaucoma. Reno vascular hypertension can lead to renal failure. Just because it is controlled does not mean an insurer will accept you, also any combination of High Blood Pressure, High Cholesterol, and Obesity almost always result in a decline with most carriers or at least a very high premium. The reason for all of this is from the insures point of view at very best you will create medical expenses in the form of diagnostic test, assessments, treatment, medication or at worst heart attacks and kidney transplants costing lots of money. 

 

Smoking: When an individual uses tobacco in any form, whether it involves chewing, dipping, or smoking cigarettes, cigars, and a pipe, is an important risk factor by itself. In the past smoking or other tobacco use was considered in underwriting, but only rarely as a factor of importance by itself. For example, if a person had a respiratory problem and smoked, the underwriting decision might be less favorable than for an otherwise similarly situated non smoker. Smoking unaccompanied by any other negative factor however, was not a cause for a less favorable rating and continues to be ignored as a factor in many markets worldwide. Insurers now understand that smoking and any other tobacco use, even in the absence of any other negative factor, causes expected mortality and morbidity to be worse than average and the degree of variation is of such significance as to warrant separate classification. So important is this factor that the average female smoker can be expected to pay almost double the rate of the same non smoking male of the same age. 

 

Occupation: Occupational hazards are not as important today as they were in the past, although in certain cases they can be. They may increase the risk in at least three different ways. First, the occupation may present an environmental hazard, such as exposure to violence, irregular living, or a temptation to experiment with drugs or overindulge in alcohol. Second, the physical conditions surrounding an occupation can have a bearing upon health and longevity, as in the case of persons who work in close, dusty, or poorly ventilated quarters or are exposed to chemical toxins. Finally there is the risk from accident, such as is faced by professional automobile racers, crop dusters, and scuba divers. An individual who has recently changed from a hazardous occupation to a safer form of employment must be underwriting carefully, as he or she may still retain ill effects from the earlier job or because the change may have been prompted by a health factor. It is common to see increased premium rates for bartenders, telemarketers, tattoo artist, truck drivers, actors, singers, artist, and servers to name a few if they get accepted at all. 

 

Alcohol and Drugs: Information is usually sought regarding the proposed insured’s use of habit forming drugs and intoxicating beverages. Excessive alcohol use is associated with higher than standard mortality and morbidity meaning increased likelihood of death or sickness. If the individual applying for coverage uses alcoholic beverages in large amounts, he or she may be declined or offered substandard insurance while having to pay more to receive benefits, depending on the degree of usage. Use of alcohol in moderation is considered normal. Use of drugs not prescribed by a physician or drug abuse may call for a declination depending on the type of drug. A history of misuse or unsupervised use may require an extra rate increase depending upon the length of time since the drug or drugs were used, the nature of the treatment given, and whether there has been participation in a continuing support program such as Alcoholics Anonymous

 

Hazardous Sports and Avocations: Persons with a higher standard of living and searching for new ways to spend their leisure time often resort to hobbies and avocations. Such activities as scuba diving, mountain climbing, competitive racing, hand gliding, and sky diving clearly can involve a significant additional hazard to be considered in the underwriting process. If a hazard causes increased expected mortality and the individual is insurable on some basis, he or she usually is charged a flat extra premium commensurate with the risk. A rider excluding death or hospital expenditures resulting from participation in the hazardous activity may be employed occasionally. Also, riders excluding coverage for accidental injuries caused by football, basketball, or baseball players are not uncommon. 

 

Anything: For those that think you are perfectly healthy, you are in for a big surprise. Even if you were never officially diagnosed with an uninsurable medical condition and by the way the list is endless, if you have not had coverage for some period of time a paramedical examination will have to be performed and insurers will be evaluating the test results very closely. Special attention will be given to the liver enzymes such as bilirubin, certain pressures in the kidneys such as the glomerular filtration rate which measures the rate of clearance of waste toxins you are capable of removing from your body and certain proteins in the body such as albumin. There really is not enough room within the scope of this writing to cover everything but it is important that you understand the reasons an insurer will decline your application or make you pay much more than anticipated is unlimited. 

 

As a final note: The best advice I could give to consumers considering individual health insurance coverage is to avoid trying to do it yourself and instead seek the services of a licensed professional insurance agent who is not a captive agent working primarily with one carrier but is appointed with many carriers so he or she can place you with the carrier who will issue the coverage you seek with the price you can afford. Just remember you really don’t know what you get until you apply. If you are accepted and you don’t like the offer the insurer offered you, you can simply refuse and get refunded your fist month’s premium as long as you are within your free look period as mandated by applicable state and federal law. 

 

For those of you still not ready to apply but need more questions answered please feel free to login to our website at health insurance questions and register your information and one of our consultants will be happy to assist you even if you are not yet ready to apply. At the very least by speaking with one of our consultants you will have a more accurate picture of what will happen whenever you are ready to initiate the health insurance application process with the insurance carrier you select.

Today shopping for individual private health insurance online is fairly simple. Simply type the keywords “health insurance” on any major search engine such as Google, Yahoo, or MSN and you are virtually guaranteed to come across a multitude of websites with designer custom made plans. However, too often consumers who are simply weighing their options forget the bigger picture. It’s called medical underwriting. Medical underwriting is a process in which an insurer will evaluate under what terms and provisions they will insure an applicant if at all. Many times shoppers spend months trying to find the perfect benefit plan for the best price only to find out the plan they applied for came back after they submitted the application with a much higher price than anticipated or worse, they were declined coverage altogether and now cant get individual health insurance because they passed up what their employer offered. Getting approved for individual health insurance coverage is not so easy. If you had group insurance offered by your employer for most of the time you had coverage and this is the first time shopping for individual private health insurance, do your self a favor don’t just shop to get a feel for the market, take the next step and apply. Applying for coverage is the only real way you will really know what offer will be given to you and under what terms or price. Consult with a knowledgably licensed insurance agent who is familiar with the medical underwriting guidelines of the major medical insurance carriers offering the coverage you seek and begin to initiate the application process. All insurance carriers on the individual market will require an application to be complete with the first month’s premium deposit for consideration. The reason why insurers request this deposit is to ensure the applicant is serious about applying since they will incur administrative cost to determine if they will insure you or not, however some insurers will only withdraw funds if your approved while others will take the first months premium deposit and refund you if you decline their offer or if you are declined coverage altogether. Basically the entire process is two fold while you are considering them they are considering you.  There are many reasons why an insurer will come back with a much higher price than anticipated in regards to the benefits you apply for or decline the application altogether. Here are just a few common examples. Height and Weight: The physical condition of a proposed insured is of basic significance in underwriting. One of the determinants of physical condition is build. Build includes height, weight, and distribution of the weight. Experience has shown that being overweight increases the likelihood of death or sickness at all ages so for an insurer to justify the cost they will raise your rate accordingly if accepted.  High Blood Pressure: Hypertension or High Blood Pressure is an intermittent or sustained elevation of diastolic or systolic blood pressure. Hypertension is a major cause of stroke, cardiac disease, and renal failure. Complications occur late in the disease and can attack any organ system. Cardiac complications include coronary artery disease, angina, myocardial infarction, heart failure, arrhythmias, and sudden death. Neurologic complications include cerebral infarctions and hypertensive encephalopathy. Hypertensive retinopathy can cause blindness or glaucoma. Reno vascular hypertension can lead to renal failure. Just because it is controlled does not mean an insurer will accept you, also any combination of High Blood Pressure, High Cholesterol, and Obesity almost always result in a decline with most carriers or at least a very high premium. The reason for all of this is from the insures point of view at very best you will create medical expenses in the form of diagnostic test, assessments, treatment, medication or at worst heart attacks and kidney transplants costing lots of money.  Smoking: When an individual uses tobacco in any form, whether it involves chewing, dipping, or smoking cigarettes, cigars, and a pipe, is an important risk factor by itself. In the past smoking or other tobacco use was considered in underwriting, but only rarely as a factor of importance by itself. For example, if a person had a respiratory problem and smoked, the underwriting decision might be less favorable than for an otherwise similarly situated non smoker. Smoking unaccompanied by any other negative factor however, was not a cause for a less favorable rating and continues to be ignored as a factor in many markets worldwide. Insurers now understand that smoking and any other tobacco use, even in the absence of any other negative factor, causes expected mortality and morbidity to be worse than average and the degree of variation is of such significance as to warrant separate classification. So important is this factor that the average female smoker can be expected to pay almost double the rate of the same non smoking male of the same age.  Occupation: Occupational hazards are not as important today as they were in the past, although in certain cases they can be. They may increase the risk in at least three different ways. First, the occupation may present an environmental hazard, such as exposure to violence, irregular living, or a temptation to experiment with drugs or overindulge in alcohol. Second, the physical conditions surrounding an occupation can have a bearing upon health and longevity, as in the case of persons who work in close, dusty, or poorly ventilated quarters or are exposed to chemical toxins. Finally there is the risk from accident, such as is faced by professional automobile racers, crop dusters, and scuba divers. An individual who has recently changed from a hazardous occupation to a safer form of employment must be underwriting carefully, as he or she may still retain ill effects from the earlier job or because the change may have been prompted by a health factor. It is common to see increased premium rates for bartenders, telemarketers, tattoo artist, truck drivers, actors, singers, artist, and servers to name a few if they get accepted at all.  Alcohol and Drugs: Information is usually sought regarding the proposed insured’s use of habit forming drugs and intoxicating beverages. Excessive alcohol use is associated with higher than standard mortality and morbidity meaning increased likelihood of death or sickness. If the individual applying for coverage uses alcoholic beverages in large amounts, he or she may be declined or offered substandard insurance while having to pay more to receive benefits, depending on the degree of usage. Use of alcohol in moderation is considered normal. Use of drugs not prescribed by a physician or drug abuse may call for a declination depending on the type of drug. A history of misuse or unsupervised use may require an extra rate increase depending upon the length of time since the drug or drugs were used, the nature of the treatment given, and whether there has been participation in a continuing support program such as Alcoholics Anonymous Hazardous Sports and Avocations: Persons with a higher standard of living and searching for new ways to spend their leisure time often resort to hobbies and avocations. Such activities as scuba diving, mountain climbing, competitive racing, hand gliding, and sky diving clearly can involve a significant additional hazard to be considered in the underwriting process. If a hazard causes increased expected mortality and the individual is insurable on some basis, he or she usually is charged a flat extra premium commensurate with the risk. A rider excluding death or hospital expenditures resulting from participation in the hazardous activity may be employed occasionally. Also, riders excluding coverage for accidental injuries caused by football, basketball, or baseball players are not uncommon.  Anything: For those that think you are perfectly healthy, you are in for a big surprise. Even if you were never officially diagnosed with an uninsurable medical condition and by the way the list is endless, if you have not had coverage for some period of time a paramedical examination will have to be performed and insurers will be evaluating the test results very closely. Special attention will be given to the liver enzymes such as bilirubin, certain pressures in the kidneys such as the glomerular filtration rate which measures the rate of clearance of waste toxins you are capable of removing from your body and certain proteins in the body such as albumin. There really is not enough room within the scope of this writing to cover everything but it is important that you understand the reasons an insurer will decline your application or make you pay much more than anticipated is unlimited.  As a final note: The best advice I could give to consumers considering individual health insurance coverage is to avoid trying to do it yourself and instead seek the services of a licensed professional insurance agent who is not a captive agent working primarily with one carrier but is appointed with many carriers so he or she can place you with the carrier who will issue the coverage you seek with the price you can afford. Just remember you really don’t know what you get until you apply. If you are accepted and you don’t like the offer the insurer offered you, you can simply refuse and get refunded your fist month’s premium as long as you are within your free look period as mandated by applicable state and federal law.  For those of you still not ready to apply but need more questions answered please feel free to login to our website at health insurance questions and register your information and one of our consultants will be happy to assist you even if you are not yet ready to apply. At the very least by speaking with one of our consultants you will have a more accurate picture of what will happen whenever you are ready to initiate the health insurance application process with the insurance carrier you select.

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Getting your hands on the best Colorado health insurance you can afford may seem like a daunting task, but it doesn’t have to be when you know what you’re doing. Read on for some tips to help you find the best Colorado health insurance plan for your budget.

Know your options

To obtain a plan, you can either buy individual health insurance or you can get group health insurance through your employer. There are several kinds of plans to choose from. Here is a brief primer.

FFS (Fee-for-Service) – A fee-for-service plan will pay a specific amount for each service rendered by your health care provider. There are limits, called “allowable amounts”, that the plan can pay. You should clarify these limits and other details with your insurance company. FFS plans are not very common in Colorado because, in general, we have good access to PPO and HMO networks.  As such, you can usually get a better value by opting for a PPO or HMO plan.
HMO (Health Maintenance Organization) – In this plan type, you are limited to the health care providers within the HMO network and often times are assigned to a primary care physician (PCP). Your PCP helps to “manage your healthcare”.
PPO (Preferred-Provider Organization) – This plan resembles that of an HMO, except that you may use providers outside of the network, although at lesser rates and benefits than any of the preferred providers. In addition, with a PPO you generally have the flexibility to see any specialist without first having to get a referral from your PCP.
HSA (Health Savings Account) – A Health Savings Account (HSA) is a tax advantaged savings account that allows you to set aside money for health care. This savings account is paired with a high deductible health insurance plan — the result being affordable yet comprehensive health coverage.

 

Study and compare plans

Given that you have a wide variety of plans to select from, don’t just get what your neighbor, co-worker, or best friend got. Each person has different needs and your insurance should be capable of meeting those needs when the time comes. Ideally, you should base your choice on these criteria:

the quality of the medical care you will receive
the coverage of your plan
how much your premiums will cost

 

Consider all these factors and weigh the cost with the benefits. Don’t shortchange yourself by getting affordable help insurance but with mediocre coverage – when the worst happens, you’ll be the one left holding the bag.

Look for alternatives

Having a hard time getting insured? Getting adequate health insurance in Colorado depends in some way on your current health, family, and employment status. If you find that you have been denied or can’t afford health insurance, don’t despair. There are several programs you can turn to.

Medicaid – You may qualify for this if you already have a pre-existing disability and are in a low income bracket. Find out if you are eligible for Medicaid by contacting the Colorado Medicaid Program at 1.800.221.3943 or 1.800.659.2656.
Child Health Plan Plus (CHP+) — Colorado provides plans for children from low income families through the CHP+. There are several rules pertaining to income brackets and family sizes, so go to www.insurekidsnow.gov to learn more on how to avail of this coverage.
Medicare – Another program you can turn to if you have a pre-existing disability. Normally you would have to be 65 years of age or older to qualify, but you still can if you have a disability that is expected to last more than one year or is considered fatal. You can find out more about Medicare at www.medicare.gov.
CoverColorado — This is a state-run program thath sells health insurance to a select number of high-risk individuals–people turned down by other Colorado health insurance companies due to a serious medical condition or disability. You can find out more about this service from www.covercolorado.org.

 

Get Expert Advice

Let’s face it—health insurance policies can be hard to comprehend without some guidance. In Colorado, as anywhere, the right advice can give you the coverage you want while saving you hundreds (or thousands) of dollars a year. You can get advice from two sources: a good agent or a health insurance website.

You can source a good agent from friends and family members. As a criteria, a good agent won’t just help you find the right policy; they will provide service before, during, and after the policy has been sold. That means helping you helping you update your plan, being upfront about the rules and limits of your coverage, and helping you sort out claims issues if and when the need arises. In addition, a good agent will monitor your policy over the years to ensure that you are still getting the best value for your premium investment.

Understandably, some people don’t have time to go from agent to agent. If that’s the case, a health insurance website is the way to go. Look for an insurance website that is backed by a well-established insurance agency that offers a variety of services, and are tried and tested experts on Colorado health insurance. At Sage Benefit Advisors, for example, we offer free consultations, updates on the health insurance industry, online quotes for individual or group health insurance in Colorado, and access to Anthem Blue Cross Blue Shield, Humana, PacifiCare, United Healthcare, Cigna, and more.

Read Your Policies

In the end, its all about know what you’re owning. Don’t rely on blind faith that you’re getting the right health plan for your money. If you’re not sure about the terms, clauses and limits in the document, talk to an expert about it. And finally, don’t be afraid to say no. As Warren Buffett said, “If you don’t feel comfortable owning something for 10 years, then don’t own it for 10 minutes.”

Chosen well, your health insurance can save your life and preserve your family’s standard of living. It’s worth doing and it’s worth doing right.

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