The United States does not have socialized medical care. If you have no health insurance coverage, you have to pay for health care out of your own finances at the time of service. This can run into many thousands of dollars for serious illnesses.

You buy health insurance for the same reason you buy other kinds of insurance: to protect yourself financially. With health insurance, you protect yourself and your family in case you need medical care that could be very expensive.

You cannot predict what your medical bills will be. In a good year, your costs may be low. But if you become ill, your bills could be very high. If you have health insurance, many of your costs are covered by a third-party payer, not by you. A third-party payer can be an insurance company or, in some cases, it can be your employer.

Many people in the United States are enrolled in some sort of managed care health insurance plan. This is an organized way of both providing services and paying for them. Different types of managed care plans work differently and include preferred provider organizations (PPOs), health maintenance organizations (HMOs), point-of-service (POS) plans and fee-for-service plans.

Individuals enrolled in health care plans pay a monthly or quarterly fee as insurance for the time when they will need medical attention. At the time when a service is provided, the health insurance organization pays part or all of the fee, minimizing the amount you have to pay at the time you receive the service.

The information presented here will help you choose a health insurance plan that is right for you. If you are married or single, have children or no children, this information will help you to find out how to choose a health insurance plan that best meets your needs and your financial circumstances. Definitions of the health insurance terms used are included in the section called Understanding Health Insurance Terms.

Understanding Health Insurance Terms

Coinsurance

The amount you are required to pay for medical care in a fee-for-service plan after you have met your deductible. The coinsurance rate is usually expressed as a percentage. For example, if the health insurance company pays 80 percent of the claim, you pay 20 percent.

Coordination of Benefits
A system to eliminate duplication of benefits when you are covered under more than one group plan. Benefits under the two plans usually are limited to no more than 100 percent of the claim.

Co-payment

Another way of sharing medical costs. You pay a flat fee every time you receive a medical service (for example, $5 for every visit to the doctor). The health insurance company pays the rest.

Covered Expenses
Most health insurance plans, whether they are fee-for-service, HMOs, or PPOs, do not pay for all services. Some may not pay for prescription drugs. Others may not pay for mental health care. Covered services are those medical procedures the insurer agrees to pay for. They are listed in the health insurance policy.

Customary Fee
Most health insurance plans will pay only what they call a reasonable and customary fee for a particular service. If your doctor charges $1,000 for a hernia repair while most doctors in your area charge only $600, you will be billed for the $400 difference. This is in addition to the deductible and coinsurance you would be expected to pay. To avoid this additional cost, ask your doctor to accept your health insurance company’s payment as full payment. Or shop around to find a doctor who will. Otherwise you will have to pay the rest yourself.

Deductible
The amount of money you must pay each year to cover your medical care expenses before your health insurance policy starts paying.

Exclusions
Specific conditions or circumstances for which the policy will not provide benefits.

HMO (Health Maintenance Organization)
Prepaid health plans. You pay a monthly premium and the HMO covers your doctors’ visits, hospital stays, emergency care, surgery, checkups, lab tests, x-rays, and therapy. You must use the doctors and hospitals designated by the HMO.

Managed Care

Ways to manage costs, use, and quality of the health care system. All HMOs and PPOs, and many fee-for-service plans, have managed care.

Maximum Out-of-Pocket Expenses
The most money you will be required pay a year for deductibles and coinsurance. It is a stated dollar amount set by the health insurance company, in addition to regular premiums.

Non-cancellable Policy
A policy that guarantees you can receive health insurance, as long as you pay the premium. It is also called a guaranteed renewable policy.

PPO (Preferred Provider Organization)
A combination of traditional fee-for-service and an HMO. When you use the doctors and hospitals that are part of the PPO, you can have a larger part of your medical bills covered. You can use other doctors, but at a higher cost.

Pre-existing Condition
A health problem that existed before the date your health insurance became effective.

Premium
The amount you or your employer pays in exchange for health insurance coverage. Primary Care Doctor
Usually your first contact for health care. This is often a family physician or internist, but some women use their gynecologist. A primary care doctor monitors your health and diagnoses and treats minor health problems, and refers you to specialists if another level of care is needed. In many health insurance plans, care by specialists is only paid for if your are referred by your primary care doctor. An HMO or a POS plan will provide you with a list of doctors from which you will choose your primary care doctor (usually a family physician, internists, obstetrician-gynecologist, or pedicatrician). This could mean you might have to choose a new primary care doctor if your current one does not belong to the plan. PPOs allow members to use primary care doctors outside the PPO network (at a higher cost). Indemnity plans allow any doctor to be used. Provider
Any person (doctor, nurse, dentist) or institution (hospital or clinic) that provides medical care.

Third-Party Payer
Any payer for health care services other than you. This can be an insurance company, an HMO, a PPO, or the Federal Government

5 com

Health Insurance has gained high importance in the present scenario, since it safeguards health of you and your dependents against financial crisis arising on account of medical emergency. Basically, it covers the overall risk and emergencies of healthcare expenses and develops a regularized structure of finance such as a monthly premium or annual tax to the insurance company. This process ensures that money is available to pay for the healthcare benefits specified in the insurance agreement. It also includes insurance covering disability or long-term nursing or custodial healthcare needs. Therefore, having your health insured on a plan helps you to get timely coverage and better medical care while uninsured people tend to face delays in the times of urgency and receive inadequate health care.

Basic benefits covered in Health Insurance:

• Health Insurance is also known as Mediclaim or Medical Insurance. Some of the best Health Insurance companies cover the material consequences of a disease. The chief benefits paid by the Health Insurance companies include sickness coverage, hospital allowance and additional facilities that may differ per plan.

• In cases of severe accidents and surgeries, health insurers not only pay for the medical expenses but also take care of the hospitalization costs.

• Hospital charges consist of costs arising from the treatments taken in the particular hospital, which requires at least one night’s stay in the respective hospital.

• At times, even those expenses are covered by the Insurance Company if by accident the concerned physician, doctor or a medical practitioner has given a wrong or incomplete treatment, therapy.

Guidelines to choose the best Health Insurance:

• The major concern while selecting a health insurance plan is the factor of the ability to afford.

• Health care plans that are reasonable yet provide maximum benefits become the utmost priority. Preferably, the plans that cover cashless hospitalization at numerous hospitals and healthcare centers provide quick options to buy or renew the plans online at your convenience and avail you with better services like tax benefits compared to other plans should be the topmost priority.

• It is true that people buy insurance for different reasons but some of the best health plans that comprehend the additional needs are of much significance. For instance, you may get free coupons that help you to save your money when you go for a health check-up.

• Also, there are certain benefits of expanding the coverage by renewing the plans. There is a belief that Medicare is easily accessible but it has certain barriers. Safety-net care from hospitals and clinics provides facilities to have such an access but cannot be a substitute for Health Insurance.

• Therefore, with health insurance you can be at peace since it provides you valuable coverage in cases of normal or extreme emergencies. At ICICI Lombard General insurance, our aim is to provide best health insurance and thus, we offer variety of plans such as Health Advantage Plus Insurance, Family Floater Plan and Personal Accident Insurance Plan that secure health of you and your family.

none

Even at the outset, it must be made clear that only businesses with 2-50 employees are eligible for small business health insurance. If you are self-employed and no one else works for you, then you should look into health insurance schemes meant for self-employed individuals.

If you own or a part of a business organization having 2 to 50 employees you will qualify for and benefit from a group health insurance plan. Small business health insurance holds a lot of benefits. Besides providing medical care for business owner and the employees, a small business health insurance plan is designed in a way that the financial risk is spread among all the members resulting in lower premiums and more extensive coverage for everyone in the company.

Further, small business health insurance has certain unique tax benefits. Employer contributions to a small business health insurance plans are 100% exempted from tax and employees will also save on their payroll taxes. As per law, no insurance company in any state can refuse to sell the small business health insurance as long as you meet the state’s minimum requirements concerning the type of organization you are insuring and the number of employees getting covered.

To get a precise quote on a small business health insurance policy, you will have to furnish the right information about the type of coverage you want and the relevant particulars of all the employees who have to be insured, including the number of dependents each one has.

To get a precise online quote for a small business health insurance policy, you will have to furnish the right information about the type of coverage you want and the relevant particulars of all the employees who have to be insured, including the number of dependents each one has. Please bear in mind that the accuracy of the online quote you get will largely depend on the correctness of information you provide.

Before obtaining an online quote, it is advisable to visit eHealthInsurance, the web’s largest health insurance marketplace. For small businesses, eHealthInsurance will offer instant online quotes. As soon as you enter all the basic information about your company and your employees, online quotes — customized for your company — will be immediately generated for you. You will be able to know the amount each individual employee will be required to pay toward his or her health insurance coverage, as well as the company’s contribution to each employee’s coverage.

Several health care companies present their small business clients with a portfolio of options. Within the portfolio is an assortment of policy choices regarding how the employer contributes, and what plan options the employee will have. The employees decide what sort of plan they would like to have and what they can afford. The health plans range from a standard HMO to comprehensive PPO coverage.

Either reducing coverage or asking the employees to contribute more to the plan is the obvious step to reducing small business health insurance costs. But this attitude of the employer will prove unpopular with workers. Small business health insurance may take a huge chunk out of business revenue, but insurance benefits will attract better employees and also help retain talented and skilled workers. Satisfied, healthy employees are more likely to help your business grow.

Health insurance is a well spread out business, so seeking online quotes from different providers could reduce the small business health insurance costs. Start by searching the Internet and also ask other owners of small businesses what they pay for health insurance.

one

Do Not Read This Unless You are Making a lot of Money!:

If you would like to know how you can save up to 47% on your current Health Insurance Coverage read on… this is going to be one of the most informative messages you will ever read. After reading this message you will never going to have words; expensive and health insurance in the same sentence.

As you already know health insurance costs are at highest they have ever been and there is no sign of them slowing down. More and more Americans are forced to cancel their coverage simply just because they cannot afford it.

Who are the uninsured?

• Approximately 46 million Americans, or 15.7 percent of the population, were without health insurance in 2004 (the latest government data available).

• The number of uninsured rose 800,000 between 2003 and 2004 and has increased by 6 million since 2000.

• The increase in the number of uninsured in 2004 was focused among working age adults. The percentage of working adults (18 to 64) who had no health coverage climbed from 18.6 percent in 2003 to 19.0 percent in 2004. An increase of over 750,000 in 2004.

• Nearly 82 million people – about one-third of the population below the age of 65 spent a portion of either 2002 or 2003 without health coverage.

• The number of uninsured children in 2004 was 8.3 million – or 11.2 percent of all children in the U.S. (1).

You might say that I have great coverage that I am happy with… that’s totally fine.

For past sever years average rate increase for health insurance was 16.2% and what if it keeps on going? If you are right now paying $500 per month for your health insurance in three years from now you would expect to pay over $780 for the same plan. Wait… we all know that insurance companies consistently decrease their benefits and increase co-pays and deductible. Therefore you will pay more for less coverage. By the way if you keep same plan for over five years you will pay over $1000 a month just for your medical coverage. What if you use your Health Insurance?… Chances are if it is not for a regular doctor visits or a check ups it would be considered pre-existing condition. That means your chances of changing to a more affordable coverage in the future will be nearly impossible. That is one of the main reasons people cancel their health insurance because they were diagnosed with something or taking a prescription medication and the insurance company kept raising their rate until they could not qualify for any other coverage and could not afford the one they had.

Now you are saying I do not need coverage my spouse works for a company and I have group coverage… Great.

What would happen if your spouse left that job or the company stopped providing benefits? Probably the most obvious things that you can see how much that group coverage is really costing you. Next time check how much is deducted out of the paycheck for health coverage, especially for dependents. Group plans do cost more money because by law they are what are called “guaranteed issue”. That means you can have serious medical conditions and still get coverage. Insurance companies have to follow the law and they know they have to accept everyone who works for a large company, therefore they do charge more money for coverage. The biggest problem is not the cost of group health insurance it is what happens if some one, while on the group plan, is diagnosed with a condition or starts to take prescriptions medications. We get back to same issues as mentioned before, unable to qualify for health insurance in the future. There are people that want to leave their job but they cannot because they are going through treatment and cannot to pay for it on their own.

There is another solution… Some might save, so what is the point of even having health insurance. Once you diagnosed with something and insurance company is going to keep raising rates to the point where I am going to have to cancel it anyway. Especially if something does happen and I have to use my coverage I might not be working and I might not have income. Is my insurance company is still going to keep raising my rates? YES.

Before you think about cancelling your coverage consider this. Here are some statistics

• A recent study by Harvard University researchers found that the average out-of-pocket medical debt for those who filed for bankruptcy was $12,000. In addition, the study found that 50 percent of all bankruptcy filings were partly the result of medical expenses. Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem.

• Illness and medical bills caused half of the 1,458,000 personal bankruptcies in 2001, according to a study published by the journal Health Affairs.

• Average day in the hospital is $7500 per day.

How can you save up to 47% on your health insurance? Simple… You probably already heard of Health Saving Accounts. They are becoming more and more popular everyday. With the way health insurance prices are moving today Health Saving Accounts are the only way to keep your coverage, save hundreds per month on your health insurance and still have a peace of mind.

To this day I was not able to hear a good definition that everyone can understand. I will do everything I can to make it simple to understand. The easiest way to understand Health Saving Accounts is to think of them as Roth IRA or your Company’s 401k plan. Instead of giving your money away to insurance company you get to keep it more of it for yourself. The way HSA plans work is there health insurance combined with savings account which works in a similar way to your retirement account. There tremendous benefits to have HSA qualified health plan. First all the money that you put in to your HSA account is 100% tax deductible and it is your money that rolls over year after year. At the age of 65 and up if you have not used up all of your HSA money you can roll it over in to your retirement account. Second your health insurance costs are going to be cut almost in half. For example if you had Health Insurance plan with $2500 deductible now and it is costing you $300 per month the same plans with HSA qualified plan, now will cost you only about $160 per month. The reason you save so much money with HSA qualified health plan is because HSA qualified plans do not cover anything until the deductible is met. There are exceptions depending on the Health Insurance Company. Some insurance companies will pay for your once a year physical before you meet your deductible.

Let take an example of how HSA qualified plan could benefit you. Let take some actual numbers from actual health insurance company. In this example I am going to use HSA plans from company called Assurant Health. Assurant Health is leader in Health Saving Accounts and they one of the first companies to implement them. The main reason is that Assurant Health is part of the world’s largest financial company that sets up retirement accounts. In this example I am going to use a family of four, husband 46, wife 42, kids are 12 and 16. On a regular family plan with $2500 deductible, maximum out of pocket of $5500, co-insurance of 80% and doctor visits covered with $35 co-pay, they are going to pay $676.40. Something to keep in mind that all of the regular PPO plans that are available on the market today have family deductible which is double of individual deductible. That means that if you have a plan with $2500 deductible and $5500 maximum out of pocket that means that your family deductible is $5000 and your family maximum out of pocket is $11,000. When we are comparing HSA qualified health plans there is only one deductible, once you meet it you are covered at 100% on the most plans. There are some companies and plans that you still might be responsible for the percent age of the bill until you reach your maximum out of pocket. Most HSA plans do not have maximum out of pocket that meant once you met your deductible you are covered at 100%, it’s that simple. The same plan with $5700 deductible for the entire family with HSA qualified health plans will only be $491.64 per month. For the total monthly savings of 184.76 per month. Also your maximum out of pocket will decrease from $11,000 on a regular plan to $5700 with HSA health plan. That’s yearly savings of $2,217.12 and additional savings of $5300 on the maximum out of pocket. (that’s if you have had to use the plan for emergencies) The main reason for starting HSA health insurance is for Saving Account and being able to put money in to account, at your discretion, tax free. You can put money in to HSA qualified account up to your deductible and you do not have to put any money in to that account if you do not want to. Health Saving Accounts are as flexible as you would want them to be. TO get more information on HSA accounts and get quotes for HSA qualified health coverage see my bio.

none

Do you ever feel like you know just enough about Health Insurance to be dangerous? Let’s see if we can fill in some of the gaps with the latest info from Health Insurance experts.

Health insurance is something that most people don’t think about very often and yet it is something that when comes foremost to mind when a loved one is sick. Health Insurance coverage varies across the world, even across the different states in the United States of America.

Health insurance is a very specific type of insurance. With this type of insurance the insurer pays the medical costs of the insured if the insured becomes sick due to covered causes, or due to accidents. The insurer may be a private organization or a government agency. Health Insurance can protect a family from financial devastation in case of serious illness.

Today, according to statistics from the US Census Bureau, many Americans, approximately 85%, have some form of health insurance. Many people, about 60%, are insured through their place of employment or through health insurance acquired personally. For about a quarter of the population, federal or state government agencies provide the insurance. These agencies may include Medicare and Medicaid as well as various state funded health insurance plans.

I trust that what you’ve read so far has been informative. The following section should go a long way toward clearing up any uncertainty that may remain.

Today, health insurance costs are rising, which is a concern to many people. Because of ongoing advances in medical care and in technology, medical treatment is more expensive. These advances help people to live longer. Today there are more senior citizens than ever before – our population is aging. The elderly population is more frail and prone to illness thus requiring more medical care than a younger population that is healthier. This also causes an increase in the price of health insurance.

Health insurance costs are also rising due to personal health choices made by individuals. Poor eating habits, smoking, drug and alcohol abuse, a lack of exercise, obesity are some of these poor health choices. In addition, there are still rural areas where there is a lack of health professionals including doctors.

Today, health insurers offer discounts and incentives to people who love a healthy lifestyle. Often, a person will provide health information and a personal medical history when buying health insurance. This history may address questions such as smoking, weight, drug use, and disease history. The incentives offered by health insurance companies today may encourage individuals to quit smoking or make other positive changes in their lifestyle. Many times, heath insurers will not insure pre-existing medical conditions. The medical history provided will screen out such applicants.

Because of the concern over pre-existing medical conditions, there are now state and federal laws that help ensure that those individuals with pre-existing conditions can acquire or maintain health insurance, even if they need to change plans or providers. The Health Insurance Portability and Accountability Act (HIPAA) is a federal law ensuring that all health insurance plans nationally have a common set of standards. In addition, states can also have laws regulating health plans including group health insurance and individual health insurance. This means that the laws regulating your health insurance protections may vary from state to state. Keep in mind, that even with these laws, access to health insurance may not be protected in all situations.

COBRA continuation coverage can help you if you leave of change your job. Under COBRA, you may be able to remain in your old group health plan for a certain length of time. This can assist you in those times when you are between jobs or waiting for a new health insurance plan to cover your pre-existing condition. Under COBRA, there are limits to what you will need to pay to continue your coverage.

When word gets around about your command of Health Insurance facts, others who need to know about Health Insurance will start to actively seek you out.

one

When you buy Utah health insurance, you are making a purchase that will give you peace of mind as well as making a positive contribution to your health. This is because without Utah health insurance you could find yourself unable to afford the care you need when you have a major illness. Even if you are eventually able to afford that care, it may come too late if you haven’t purchased Utah health insurance in advance.

By purchasing Utah health insurance, you are also helping your future financial situation. The lack of Utah health insurance could result in such massive medical bills that you may even find yourself facing bankruptcy. It is essential therefore that you and your family take advantage of the coverage available.

Utah health insurance can be bought on either a group or individual basis. Group insurance, bought by an organization to cover its employees, requires you to pay regular premiums that keep your Utah health insurance up to date and protect you from unforeseen medical expenses. It is well worth the cost of those premiums to have the advantage of knowing you won’t be hit by crippling bills in the event of an accident or unexpected health problems. After purchasing your Utah health insurance, you can relax in the knowledge that you have taken all possible steps to guard yourself and your family from costs resulting from unexpected health issues.

If a group plan is available to you, it has the advantage of costing less than an individual plan. This is because the employer pays a proportion of the cost. In addition, under a group plan, your Utah health insurance usually has the extra benefit of covering you for pre-existing conditions without increasing the costs.

If you are self-employed, you should organize your own Utah health insurance as soon as possible. There is no benefit in waiting until you develop a medical condition before trying to purchase Utah health insurance. An insurance company is often unwilling to cover an individual with a pre-existing condition, so it doesn’t make sense to wait until a health problem arises before buying individual Utah health insurance. You need to take advantage of your good health now and purchase Utah health insurance while you can, so you will be protected against anything that happens in the future,

For some people looking to purchase Utah health insurance, there are particular advantages to short-term policies. Available through private health insurance providers, short-term policies provide individual and family coverage for periods of between one and six months. You may, for example, be between jobs or working part-time. You may have lost your coverage because of a divorce; you could be a student who is no longer covered by your parents’ policies, or you might be an early retiree. These are just some of the scenarios that would make short-term Utah health insurance a benefit for you until you can establish a more permanent plan.

Even if, for some reason, you are refused major Utah health insurance, you can take advantage of a mini-med or “defined benefit” health plan. Whether or not you have a pre-existing condition, you can purchase one of these guaranteed-issue Utah health insurance plans. Insurance companies can afford to provide such plans because the policies have limits on their coverage. These plans have the advantage of being easy to understand and are available for anyone between the ages of eighteen and sixty-five. Like other Utah health insurance plans, they have the benefit of providing affordable health protection for you and your family, no matter what your individual needs or situation may be.

2 com