Health Insurance – Is Some Better Than None?

About 50 years ago, health insurance started to be an attractive incentive offered by employers to attract and keep good employees. Overall, group plans tended to be inexpensive for employers, with employees contributing a small amount of money or none at all to secure health insurance for themselves and their families.

It was more expensive for individuals to pay for non-group policies, but coverage was fairly affordable. Then medical costs started to rise, people started to live longer and the medical profession became adept at curing various diseases and saving and prolonging the lives of people with serious injuries and life-threatening illnesses. Health care and insurance prices started rising much more quickly than annual incomes and premiums began taxing both employers, who were paying the lion?s share of premiums, and for employees, to whom businesses often passed on costs through larger deductibles, greater out of pocket expenses and higher premiums.

According to a recent report by the MSNBC News Service, 41 percent of Americans whose income ranges from moderate to middle had no health insurance for at least part of 2005. In 2001, that number was much lower?28 percent. Additionally, more than 50 percent of uninsured Americans in 2005 found it difficult to pay their medical bills. Another alarming statistic?28 percent of Americans in 2005 had no health insurance, while 24 percent had none in 2001.

So, what should a person do if they don?t have any health insurance or if they have a choice between a cheap discount plan that does not cover core expenses and an affordable plan that may cost a bit more but also provides much better coverage? According to data from the U.S. Centers for Disease Control and Prevention, the majority of people who are not covered for important screening tests, such as a mammogram, colon cancer screening or a PSA test, will not undergo those exams. Also, close to 60 percent of people without health insurance missed treatment or did not buy medicine needed for a chronic condition.

All of these figures point to one thing?people who lack health coverage for essential services are often unable to pay for those services, putting them at greater risk for developing new or exacerbating existent health conditions.

What should you look for in a health insurance plan, especially when cost is an issue? It?s important that you get the best coverage you can afford. Skimping on premiums can save you money upfront, but the result can prove to be penny-wise and pound-foolish. Sometimes people can?t afford coverage and sometimes they believe because they are healthy that they simply don?t need it. However, healthy people get ill or are involved in serious accidents all the time. You never know when you?ll need coverage.

Some people opt for ?catastrophic? insurance, which usually covers only major medical and hospital expenses above a specific deductible. Under such a plan, the insured pays for routine doctor visits and prescription drugs. With this type of plan, you?ll pay a low monthly premium but will also have a high deductible and limited coverage. Deductibles start at %500 per year but can be considerably more. If you purchase an inexpensive policy with a %10,000 deductible and you undergo surgery that costs %8,000, you must pay that %8,000. If your surgery costs %12,000, you would owe %10,000.

One insurance company offers a plan that costs %29 per month for a 21 year-old, non-smoking female. There?s a yearly %250 deductible and %2,500 in out of pocket expenses that the insured must pay before the policy kicks in. Hospital, surgical and x-ray expenses are covered but other costs, such as doctor visits, prescription drugs, maternity care and mental healthcare are not included. There?s a lifetime maximum of %1 million.

It?s certainly a bargain, if you don?t plan on going to the doctor very often. To enroll in a plan that will cover doctor visits, prescriptions, maternity expenses and more could easily cost %400 per month?a jump of %371 every 30 days for a total cost of %4,800 per year!

Group health insurance plans, which you can usually enroll in through your employer, union or guild, are the best buy. Individual plans, especially those that offer comprehensive coverage, can be crippling to many people?s pocketbooks. When buying health insurance, it?s important to shop around. Your choice of what type of plan you purchase will be determined by what you can afford and what you need as far as insurance is concerned. There?s no right or wrong choice when it comes to health insurance but at the very least you should have catastrophic insurance.

There are basically three types of plans?Fee-For-Service, Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO). Fee-For-Service plans offer the most choice regarding doctors and hospitals but they often involve quite a bit of paperwork and are the most expensive. If you?re willing to give up some or a lot of choice, do less paperwork and save some money on premiums then either a HMO or a PPO is for you.

A HMO offers the least amount of choice, involves co-pays, has the least amount of paperwork and is the cheapest of the three types of insurance. A PPO combines some elements of Fee-For-Service and a HMO. You?ll have more choice than you would with a HMO but less than you would with a Fee-For-Service plan. It tends to be more expensive than a HMO but less expensive than Fee-For-Service. All three types of insurance have some aspect of Managed Care?which determines how much health care you can use?attached to them, with Fee-For-Service having the fewest restrictions and a HMO being restricted the most.

When shopping for health insurance ask the following questions?

* How much is the premium?
* What services are covered?
* What are the total deductible and out of pocket expenses per year?
* How much are the co-pays?
* What is the maximum lifetime benefit?
* How much freedom will you have when choosing doctors and hospitals?
* What are the pre-approval procedures for seeing specialists, undergoing a procedure or being given a test?
* What prescription drugs are covered and to what degree?
* Is mental health covered and to what degree?
* Is dental covered and to what degree?

As you begin to narrow down your choices, you can look more closely at specific plans that seem to fit your needs and determine which offer you the best value for your dollar?

America has one of the finest healthcare systems in the world and one of the most complex health insurance systems across the globe. Often, they seem to be at odds with one another, unable to communicate and work together. That can be one of the most frustrating parts of anyone?s foray into the world of healthcare professionals, hospitals and health insurance companies. For this reason alone, it?s important that you carefully and thoughtfully choose your healthcare benefits provider.

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Battling an Unfair Health Insurance Claim Can Really Pay Off

Are you having trouble getting your insurance company to pay your medical health costs? Join the club. When managed care entered the insurance scene a decade ago, its mandate was to contain rising medical costs. One way to do that is to deny claims, even when claims are legitimate. The consumer backlash led to many states establishing independent review panels and requiring insurance companies to develop in-house appeal procedures. Forty-two states now have independent review boards whose decisions can override those of insurance companies. Most consumers don’t even realize these review boards exist.

Another problem is that too many people just give up when their insurance claim is denied initially. The appeals process can be long and frustrating and many people don’t have the patience or time to pursue a claim no matter how legitimate. People must be persistent and they can win. Particularly if there’s substantial money involved, the time you dedicate to appealing insurance company decisions can pay off usually more quickly than you think. A Kaiser Family Foundation study recently found that 52%PRCTG% of patients won their first appeal for each claim made. The insurance companies aren’t getting with out paying anymore.

If your first appeal gets turned down, press on. The study found that those who appealed a second time won 44%PRCTG% of the time. Those who appealed a third time won in 45%PRCTG% of cases. Which means the odds are in your favor no matter how long it take. Remember that every time you appeal it costs the insurance company more money to fight you and they are not only going to lose money to you, but also in court costs. Medical health benefits are particularly tricky because insurance companies usually have a cap on the amount of money they’ll spend in a given year, or on the amount of visits they’ll pay for. But there’s often some flexibility when you can document that you or your child’s health warrants more care than your policy usually covers. Here’s how to get started:

Do Your Homework

Read your Policy: What are the benefits? Which kinds of services are included? Outpatient or inpatient care? Is it a serious or “non-serious” diagnosis?

Know the law: Contact your local Health Association to determine your states legal requirements regarding insurance payments for all illness. Does your state require full or partial parity? Are parity benefits available only to patients with “Serious Illness” or is a so-called non-serious illness also included?

Provide written documentation: Some insurance companies may not consider some diagnosis’s serious. In this case, you will need documentation to validate required services. Obtain a letter of medical necessity from your doctor and get test results showing the medical need for you or your child to receive certain services, based on the diagnosis.

Keep good records: Remember, you’ll be dealing with a bureaucracy. Keep the names and numbers of everyone with whom you speak, the dates on which you spoke, and what transpired in the conversation.

Start early: If you can, start the appeals process prior to initiating treatment. If the doctor says your child will need to be seen once a week for a year, begin immediately to appeal your insurance company’s policy of reimbursing only 20 visits a year.

Call and Ask the Insurance Company:

What are the prerequisites for receiving health benefits?

How many visits are allowed annually for you or your child’s diagnosis? Can multiple services be combined on one day and be counted as only one day or one visit?

Which services must be pre-certified–by whom?

Be positive, polite and patient with the customer service representative. Remember that he/she is only the messenger, not the decision-maker. They are the gatekeepers and can either provide you with access to a decision maker or make your life miserable, depending on how you interact with them.

Be persistent. There are no magic bullets. Be like a dog with a bone and don’t give up until you get the answer you want. If you get nowhere after several calls, ask for a supervisor or a nurse in the pre-certification department.

Remember that you do have the right to appeal if your claim is denied. Most consumers get discouraged and will not continue to pursue a claim that should or could be paid. Insurance companies count on that happening, so get out there and claim what’s justifiably belong to you.

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Family Health Insurance Plan – Saving Money Is Becoming Easier

Every once in awhile there will be front page news about the health care crisis. The escalating costs for hospital and physician services are making it more difficult for the insurance companies to stay competitive and at the same time take care of the needs of their policyholders. A family health insurance plan in today?s marketplace is evolving into something quite different from years past. The employer group health insurance insures the majority of Americans but there is a trend developing. There are more folks leaving their employer to start their own business. When you add that group of people to the folks that leave their employer because of lay-offs, illness, and terminations then you are creating a great demand for family health insurance.

Insurance companies are working hard to develop new solutions. The federal government has great interest in health care insurance. The hospitals and physicians are deeply affected by the insurance industry.
There has been a major shift in thinking about health insurance. It has become increasingly clear that higher deductible health insurance plans are much more cost efficient in the long run compared to the low deductible plans of years past. The higher deductibles reduce the cost of health insurance dramatically. The lower deductibles are no longer in vogue. The high premiums for the low deductible no longer justify the premiums.

Today?s Trends

1. High Deductible Major Med ? The insurance professionals are encouraging people to take the higher deductible major medical policies. You are well protected for a major illness or injury in exchange for self-insuring the smaller claims.

2. Health Savings Accounts ? This is the federal government?s contribution to the health insurance dilemma. These savings accounts are established by the individual for medical expenses only. They are tax deductible similar to an IRA and are great vehicles to use for the out of pocket expense from the higher deductible.

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Save money on your auto insurance: Money-saving car insurance tips

Are you paying too much for your auto insurance? If you believe you are paying too much for your current auto insurance coverage then the following suggestions may help you save money:

1. Shop around
Sure, you?ve read this tip everywhere but it?s true. Only by shopping around for auto insurance coverage and getting quotes on premiums from several insurance companies will you be able to know for certain you are getting your car insurance coverage at the best available rate.

When shopping for your auto insurance policy, remember to compare more than insurance rates. Ask about how insurance claims are approved and processed, and how quickly they?re paid. Look into each insurers? financial stability (there are independent rating services that can help you with this.) Remember, during times of stress like after an accident you will be dealing with the insurance company and you?ll want to make sure you?ll be helped when you need it most.

2. Select a higher insurance deductible
When you file a claim, a deductible is the amount you pay first before your insurer pays the remaining balance. Often people select lower deductibles, so when they have to submit a claim, their out-of-pocket expenses are minimal. But the truth is, the higher your collision and comprehensive deductibles the lower your auto insurance premium. The savings by increasing your deductible to say %1,000 from %250 are significant?you can save hundreds of dollars off your insurance premium.

Of course, the flipside is that if you should have to submit an insurance claim you are responsible for paying the deductible. So select the maximum deductible you can afford to pay?the higher the better because the difference in your car insurance premiums will mean more cash in your pocket.

3. Remove or reduce coverage on older vehicles
If your car is getting up there in age, you may want to think about dropping the collision or comprehensive coverage (or both) on your policy. You need to think about this one though – it’s not always a clear-cut decision. You need to weigh the cost of the two coverages with the value of your car and your chosen deductibles. For example, if you had a 10-year-old car that?s worth about %1000, and your deductible was %1000, the coverage is not actually going to help you.

4. Ask about discounts
Most insurance companies offer discounts. While the availability of discounts will vary depending on your insurer, where you live and whether you meet eligibility, make sure to ask if there are any discounts you can take advantage of. The following is a list of a few of the more common discounts (if available in your state, each insurer will have different eligibility requirements):

? Multi-vehicle discount – available if you insure multiple vehicles with the same insurer
? Multi-line discount – available if you insure your home and auto with the same insurer
? Good driver discount – if you have not had an accident or ticket in a long time
? Good student discount – if you?re a student with good grades, usually about a B average
? Safe driver discount – if you?ve taken and passed an accredited driver safety course
? Anti-theft discount – if your vehicle has certain anti-theft devices installed
? Safe vehicle discount – if your vehicle has certain extra safety features
? Retiree discount – if you?ve reached a certain age, usually 50 or 55
? Low mileage discount – if your vehicle is not driven often
? Occupational discount – if you work in a certain field or hold a certain degree
? Auto club discount – if you are a member of an auto club, like AAA
? Association discount – if you belong to certain associations, like your alma mater
? Away-at-school discount ? if your child is attending school out of town

5. Choose a car that costs less to insure
If you?re purchasing a new car and have narrowed it down to two or three options, compare the auto insurance rates of each to see if there is a notable difference in the cost to insure. Remember, insurance rates are more for vehicles with high theft rates and repair costs. If there is a significant difference in cost to insure your first choice car, you may have to reconsider.

6. Drive safely
OK, this one is obvious but true. Driver?s with no accidents, tickets or insurance claims almost always pay less for their auto insurance coverage. Your driving record is an influential factor in determining your insurance rate. Tickets and at-fault accidents affect your insurance rates for years. With a less than perfect driving record, you can find yourself paying a lot of extra insurance premium over the years.

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How Does My Driving Record Affect My Car Insurance Premiums?

In order to legally drive a vehicle on the roads of the United States of America, the vehicle being operated needs to have the appropriate auto insurance applied to it. Drivers are required to insure their vehicles in order to comply with the rules and regulations established by the federal government. Persons who have auto insurance will be required to pay car insurance premiums.

This is the amount necessitated by the insurance company which needs to be paid by insurance policy holders in order to cover the cost of the individual’s coverage. Different policy holders will often pay different amounts, or premiums, either monthly, semi-annually or annually. Since there can be such a difference between one person’s premiums and the next, many people are interested in learning why there are such variations in price. Primarily, what insurance companies look for in determining a person’s car insurance premium is their driving record.

A person’s insurance premium is a direct reflection of the information that is found within the person’s driving record. Insurance companies look at the last three to five years of a person’s driving record in order to determine how much of a liability the driver would represent to the insurance company. The reason that insurance companies look at these driving records is because individuals who have had tickets or accidents are more likely to have tickets or accidents in the future, as compared to drivers that have not been in any accidents or acquired any citations from law enforcement officials. Insurance companies order your driving record from the Department of Motor Vehicles from your state of residency, in addition to any other states in which you have been licensed to drive. The specific number of accidents and citations found in your file will affect the price of your car insurance premium.

Most states issue points for individuals who are in violation of the various driving rules that are put in place and sometimes for those who have gotten into auto accidents. Insurance companies often use the point system and the number of points in a driver’s record in order to determine their auto insurance premium(s). In order to compete with other insurance companies, many insurance providers will try to offer the lowest insurance premium while still protecting their own company from any liability the driver may cause the insurance company.

Premiums can be established initially when the driver adopts a specific company’s policy, but they can be changed over time if the driver gets into an accident or if they receive a ticket. Specific changes to a driver’s premium as a result of accidents or citations will vary from company to company. If you have a question about how your specific policy will change, it will probably be easiest and most convenient for you to get individualized answers regarding your policy, and a potential premium change, by getting in contact with your insurance company. If you have your account number, you will be able to contact an insurance agent who can give you the information that you are looking for when it comes to your auto insurance account.

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