Tips for Purchasing Health Family Insurance

Choosing the right health family insurance plan does not have to be difficult. When you shop around, you will be able to find a product that offers a cover that you need at competitive rates. To help you figure out how much you are expected to pay, ask about the out-of-pocket limit, premiums, deductibles, coinsurance and copayments. However, you need to be careful when choosing policies because bargain-priced premiums may end up being too limited. When you get the right policy, you will be able to save thousands if any member of your family gets sick. The tips for purchasing health insurance include:

· Identify your medical needs

Although you may not be in a position to foresee a sudden illness or injury, some medical needs should be anticipated. Therefore, if you are planning to have a family, maternity coverage is a must-have. If your family history shows heart disease, your choice of coverage should include the cost of cholesterol lowering drugs and cardiac screening tests.

· Buy enough coverage

It is important to buy a policy that covers your needs adequately. It does not make sense purchasing a policy that you cannot afford to handle. If you have a young healthy family, you may consider choosing a product that has a high deductible. A plan that offers a deductible of more than $1,000 can cost you less per month. In the long-term, you will be able to save a substantial amount of money.

· Consider the network

It is advisable to choose a specialist or physician who is members of a plan you are considering to buy. Many of the plans have directories of doctors in their network. Most of the policies cover a share of the costs of out-of-network care, while a few do not.

· Determine your share of costs

Plans need to disclose how much you are expected to pay, through coinsurance and copays. This is a type of cost sharing where you get to pay a part of the medical service. Therefore, when you fall sick, small copays will add up. An expensive procedure will expect you to pay several thousands in coinsurance. Furthermore, it is important to know whether your medication is covered. The plan’s list of covered drugs or formulary should include drugs you take regularly, particularly the expensive drugs.

· Factor-in your dependents

If you have kids below the age of 26 who do not have a health insurance cover through an employer, law permits them to be included on your insurance. Furthermore, many of the plans do not exclude children under the age of 19 because of pre-existing conditions.

Health Care Exchanges Are Coming!

Health care exchanges, also known as marketplaces are due to become operational in each state on Jan. 1st 2014. Open enrollment for the exchanges is set to begin Oct. 1st 2014. Anticipation has been building towards these events ever since the health care bill was originally signed into law. There has always been opposition to the law for various reasons. And there are still those who doubt the readiness or the ability of the exchanges to meet this timetable. They point to delays and changes in the law as evidence of this. However, the reality as we know it today is that these milestones will be met.

For now there are a number of things that everyone should know about the exchanges.

1. There are three different types of exchanges: state run, federally run and joint exchanges. The assumption is that to the buying public the structure of the exchange should be fairly transparent. In other words, it shouldn’t make any difference. They all are required to be run similarly.

2. Premium subsidies will be available for individuals who purchase coverage through the exchange. The subsidies will be base on income and will be applied to immediately offset the cost of coverage. All recipients of a subsidy will be required to reconcile when they file their tax return. So depending on what their actual income was for the year, they may receive additional subsidy or they may owe an amount if they actually earned more income than estimated.

3. The coverage plans available will be similar to plans you can purchase outside the exchange. All health insurance will be required to have certain mandated coverages after Jan. 1, 2014.

4. If you have health insurance now and like that coverage you will be able to keep what you have, if and only if, your current plan complies with all of the ACA coverage requirements. If it doesn’t you may be required to purchase a new plan with your insurance company that does meet all the new standards. Although the requirement for large employers to have coverage is delayed until 2015, the individual mandate to have coverage effective Jan 1st 2014 has not been delayed. The first year penalty for not doing so is 1% of AGI or $95.00 assessed at tax time. It increases after that.

5. Small employers will be able to purchase group health insurance in an exchange called Small Business Health Options Programs (SHOP).

6. Most underwriting will be eliminated and there will be no waiting periods for pre existing conditions; however, enrollment will only be able to take place during open enrollment and if certain life events cause changes in your status.

7. Brokers and agents will be able to sell insurance policies inside the exchange, but only those who have completed the training and certification to do so.

There are many other details that need to be considered when shopping for health insurance inside or outside the exchanges. It is a very important decision. You need to seek the advice and guidance of a qualified benefit consultant to guide you through the process. At least that much will not change.

This information has been provided by Mark E. VonMoss, Manager Financial Services Div. of The Insurancenter.

Healthcare Reform Questions?

Healthcare reform has caused a lot of questions to be asked over the last couple of years. One of the questions that we hear quite often is “When do I HAVE to buy health insurance?” Another way to frame that question for those who have had trouble getting coverage might be “When do I GET to buy health insurance?”

If you don’t have health insurance already through an employer or some other outlet, in the past, you could have purchased coverage any time you wanted to if you could qualify. That is all going to change.

Starting this year on Oct. 1st, the first annual open enrollment period began. The open enrollment period this year will be from Oct. 1 to March. 31st. In subsequent years open enrollment will mirror the Medicare open enrollment which is Oct. 15th to Dec. 7th. So as you can see, in subsequent years the window of opportunity will be much smaller than it is this year. That is significant for a number of reasons.

During open enrollment you do not have to answer health questions or satisfy any pre existing waiting periods. In fact, starting in 2014 you will not be able to purchase an individual health insurance policy any time, other than at open enrollment! The only exception to this rule is if you have what is being called a life event during the year. A life event is any significant change in your life such as birth or adoption of a child, marriage, divorce or any involuntary loss of coverage. These events will allow you to be able to buy coverage, but other than that you will not be able to, except during open enrollment. This is important because, barring any change from Washington; the individual mandate goes into effect Jan 1st of 2014. The mandate states that if you do not have coverage by Valentine’s Day then you will be subject to the penalty. The first year the penalty is $95.00 or 1% of your income, whichever is greater. The penalty increases substantially the second year and continues to increase every year thereafter.

Anther aspect of paying the penalty instead of buying insurance that is not being talked about is that if you get sick, you still don’t have insurance and will have to pay all your medical expenses out of pocket.

One advantage of shopping for individual health insurance through the public exchange is, if you qualify, you may receive a substantial subsidy that will decrease the amount you have to pay for coverage. This subsidy is based on income and can be quite generous. Other than that you will still have the private insurance market to shop for health coverage, but only during open enrollment.

As with any financial decision, you need a qualified professional to help you make the right decision for you.

Health and Medical Insurance – Information You Need To Know

Health and medical insurance are a must if you don’t want to compromise on the quality of health care and at the same time reduce the cost to yourself. Many people tend to ignore health insurance because they think that an unforeseen emergency will never happen to them. However, the situations today are such that there are umpteen health hazards at home and in the workplace. At the same time, the stress levels in life have increased a lot, which add to the health hazards. There are a lot of instances of very young people developing serious lifestyle diseases like hypertension, diabetes, etc. If a major illness strikes you or any of your family members then it is advisable to be protected by sufficient health and medical insurance.

There are different types of health covers like private, family, business and group health insurance policies. The one that you buy depends on your requirements and one good way of analysing these requirements is to consult the insurance brokers that operate throughout the country. Otherwise also buying health insurance can be somewhat confusing with the largest number of companies out there each trying to claim that it is the best. In this situation, a reliable insurance broker will be able to guide you as to which company and which policy will be the best suited for you. Another thing that you need to keep in mind while opting for an insurance policy is that it should be customized for you. This is possible when you consult an independent insurance broker as they are associated with a large number of insurance companies. They will definitely be able to find a tailor made policy that will suit your requirements perfectly.

Not only will you save a lot of time while dealing with the insurance brokers, but also a significant amount of money, as well. If you try to look for an insurance company by yourself, it means endless hours spent on the internet looking at various websites. This will be prevented if you consult insurance brokers. At the same time, these brokers will be able to get you the best policy at the most affordable rates. These brokers are adept at creating the best balance of coverage and costs while choosing an insurance policy for you. Most insurance brokers in the country have a strong internet presence in the form of their own user friendly websites. These websites provide all the information about their services, skills and expertise.

4 Major Qualifying Life Events That Allow Individuals to Enroll Outside of Open Enrollment

Over half of all enrollments occur outside of open enrollment, and the deadline for open enrollment is quickly approaching. The open enrollment deadline for plans effective in 2014 is March 31, 2014, but for individuals that want an effective date of April 1, 2014, the deadline is March 15, 2014.

However, consumers should be aware of major qualifying life events that allow for a “special enrollment period” to be able to purchase health plans on federal and state exchanges. The special enrollment period is from April 1, 2014 to November 14, 2014. Subsequently, open enrollment begins November 15, 2014 for plans effective 2015, and has been extended to February 15, 2015.

The four major qualifying life events for special enrollment are:

Moving to a new area. In order for this to be a qualifying event, a change of residency must incur a change in available health plan options. While most of the time, this requires someone to move states, in some cases this may happen with in-state moves. The new community based rating is relative to zip code, so you may want to look into this if you are moving.

Changes in your income. This applies to those who are already enrolled on a federal or state exchange, whereas the change in income must affect the eligibility to receive tax-credits or lower the ability to share costs.

Changes in your family size (e.g. if you marry, divorce, or have a baby). When the qualifying event that changes the number of dependents occurs, often the amount of coverage an individual seeks changes, as well.

Dropped coverage from existing health plan (e.g. coverage dropped because of job termination, marital separation, eligibility changes for Medicaid or CHIP, COBRA coverage expiring, or a health plan being decertified). However, voluntarily dropping your health plan or termination due to non-payment of premiums does not qualify individuals for special enrollment. Also, if you lose coverage from a health plan that does not offer the “minimum essential coverage” under the Affordable Care Act’s guidelines, you will not qualify for special enrollment.

REMEMBER: consumers should be aware of major qualifying life events that allow for a “special enrollment period” to be able to purchase health plans on federal and state exchanges. The special enrollment period is from April 1, 2014 to November 14, 2014. Subsequently, open enrollment begins November 15, 2014 for plans effective 2015, and has been extended to February 15, 2015.

Medically Underwritten Vs Non-Medical Plans: What’s the Difference?

If you have been wondering whether you can get insurance without the hassle of a medical exam, the answer is yes you can. Depending on your situation, a plan that does not need a medical examination for approval is a good idea.

Many of the insurance providers seek to determine whether an applicant has a medical history or pre-existing medical condition that is likely to alter the insurance rates or deny the applicant insurance.

However, there is a growing number of insurance carriers that do not require medical exams to base their insurance decisions. No medical exam life insurance plan are becoming common place, as more and more insurance shoppers opt for these types of plans. The difference between the traditional and non-medical plans includes:

· Coverage

The structures of the non-medical plans are different because a medical exam is not required. As a result, many of the insurance carriers offer less coverage, of up to $250,000.

Compared with the traditional plans that require a medical exam, the maximum face amount available may not be what you are hoping for. Nevertheless, shopping for the non-medical plan is advisable to get you a higher coverage.

· Benefits

Just like the traditional policies, the beneficiaries of the non-medical plan receive the benefits attributable once the policyholder dies, as long as the policy is still active.

Therefore, all premiums must be submitted as scheduled for the plan to remain active. Many of the providers offer a 30-day grace period, during which the premiums must be paid in. If you wait for too long, the policy can be cancelled and to get back on track, you will need to undergo a lengthy reinstatement process.

Most of the times, the insurance carriers release the funds without a problem, although the carrier has the right of conducting investigations if they suspect foul play.

· Price

The price is a major difference between the traditional plans and the non-medical plans. A medical exam allows the insurance provider to gather a lot of important information about you.

Therefore, the carrier is able to fully assess the risk you pose and your insurability. As a result, the premiums you can expect to pay will be based on facts and more likely to be lower.

On the other hand, non-medical plans cost higher because the carrier seeks to factor in the risk of not knowing the health status of the applicant. However, if you shop around you will discover insurance carriers who specialize in no medical exam life insurance, while offering their plans at competitive rates.

Furthermore, the growing number of insurance providers offering these types of plans has contributed significantly in bringing down the prices of non-medical plans.

How Much Medical Insurance Cover Do I Need?

Living life on prayer was considered to be okay in the medieval era when the population had no other option. To top it all, there was a lack of awareness and education forcing people to believe that illness was God’s curse and there was no way of escaping the wrath of the lord! However, the present times are a bit different. We have technology and a whole lot of medical services that re helping in improving the quality of life with every passing second. Given this situation, life insurance is mandatory. Don’t get us wrong, we are not asking you to divulge from your faith but investing in life insurance is always a wise decision.

Here are a few tips to help you decide the amount of life insurance cover that you should invest in:

Get a reality check on your existing physical condition

Getting your vital stats examined every once in a while is a good idea especially so if you are planning to invest in medical insurance. This will help you gauge the physical condition of your body and to a certain extent predict its ability to withstand the day to day wear tear. Use this understanding to decide the amount of insurance cover that you may need in an easy way.

Habits that die hard

If you are fond of smoking or drink on a regular basis, your immune system is already weakened and you are at a higher risk of contracting cardio vascular diseases as well as other health disorders. This is an indication that you may be better off with a higher medical insurance cover.

The premium that you can afford

Medical insurance amount is somewhere dependent on the premium that you can afford to pay. In your endeavour to gain maximum protection, don’t end up choosing a cover so big that you are unable to manage the premium.

The thumb rule

Health insurance is usually 50 percentage of your annual income. However, for those who have been diagnosed with certain healthy disorders or have incurred heavy expenses towards maintaining their health in the last three years, should seriously contemplate the ideal of increasing the cover.

Family history

This is important because a lot of diseases are hereditary and you are automatically at a higher risk if anyone in the family has the problem. Trace the family tree and highlight the serious health problems that you come across.

The Benefits of Using a Debt Management Program

It is vital to implement a policy and procedure management tool in your system if you are running a health care centre. By implementing a policy and procedure management tool in your health organization or individually managed health centre you would gain the following benefits that would help earn good reputation among patients and medical circles for your organization.

A policy and procedure management software would essentially preserve inputs from doctors and other medical staff and allow you to access when you need to take important decisions concerning patients. Correct information and quick access of medical data is important to make a proper diagnosis and treatment. The software tool which you use would ensure that it is done smoothly and without delay.

Risk management is an important cog in the wheel of medical care and without a comprehensive information management system it can meet with failure. Some of the important activities such as recording and tracking of incidents and corrections can be vital for health care professionals to make correct and timely decisions. The system allows them to take control of the stored information and arrive at a quality decision by apt data analysis. Making quality decisions means patient safety, which would also make you a safe health care establishment to approach.

A risk management system would effectively take care of incident reporting by providing a user friendly interface for physicians, nurses, para-medics and other health relevant employees to input their findings. The system would also allow reporting to be filed from any location of the medical facility. This saves a lot of time for the employees as well as the employers and make incident reporting an easy one. These are vital information for treating patients and the relevant results would hugely depend on the data that you would retrieve from the risk management software. The system would also allow you to report an incident comprehensively with related documents supported by notes and images with consummate ease.

A health care centre is a huge hub of activity and people hardly get spare time to ponder on things. Shortage of time, sometimes leads to incorrect decisions which in turn would affect the outcome of a patient’s treatment. The manual mode of tracking documents can consume time and delay reporting, analysis and diagnosis. The document management system saves the user from these perils and allows them to draw and analyze information to give out timely and effective results.

Stored information in a computer is always useful for future reference, but it has to be done with utmost safety to prevent tampering or leakage. A policy and procedure management system integrates ample safety measures to prevent such things from happening. Hierarchical information access is one way of controlling information flow and avoiding pilferage. The document management tools usually integrate these features in them so that the user information is aptly protected. If you are looking for software that can effectively control your document flow you can visit and know more about the tool and the segments it would essentially address in a health care environment.

Same Old Health Care Reform

As I write this article, it occurs to me that I have talked a lot about health care reform recently. Then I decided there is a good reason for that. That is what most people want to talk about right now, and mostly they have questions. Following is some of the more common questions that I get on a daily basis.

What is the health insurance marketplace, also known as the health insurance exchange? Simply stated they are mechanisms set up for consumers to shop for health insurance coverage. One of the main reasons for their creation was to have a place for consumers to determine if they are eligible for a subsidy to help pay for their insurance premium.

What is a subsidy? It is an amount of money based on the income of the applicant that they can used to help pay for their insurance premium. The only way to get a subsidy is to buy health insurance through an exchange and then only if you qualify due to your income level.

When can I sign up for health insurance? Before the creation of the government exchanges, you could buy health insurance anytime you desired. Now you will only be able to buy coverage during open enrollment or when a life event takes place. A life event is marriage or divorce, birth or adoption, or an involuntary loss of coverage. Open enrollment this year is from Oct 1, 2013 to March 31 2014. Next year and thereafter it will be from Oct. 15th to Dec 7th.

Do I have to buy health insurance? If you currently do not have coverage, you will be required to buy insurance or pay a penalty (being called a tax). The first year the penalty is 1% of your annual income or $95.00 for each person and $47.00 per child whichever is greater. The penalty increases substantially the second and third year and then will be indexed for inflation thereafter.

Can I only buy insurance through an exchange set up by the government? No, you can buy insurance through the private market or through the exchange. Either way, you can buy coverage with or without a broker.

Although with the additional complexities, buying without help is going to more difficult in the future. In fact, the rates for the same plan in or off the exchange have to, by law, be exactly the same. After Jan1, 2014, the rate is the rate.

The only reason to buy on the exchange is if you are eligible for a subsidy, which you can only receive inside the exchange. Otherwise the rate for a plan off the exchange will be the same.

Can I be declined coverage? No, after Jan 1, 2014 you cannot be turned down for health reasons. And they cannot impose any waiting periods for pre existing conditions. However, this is going to cause rates to increase unless enough healthy individuals who have not bought coverage in the past get in the system to help offset the claims of those who will be higher users of the insurance.

This information is being provided by Mark E. VonMoss, Mgr. Financial Div. of The Insurancenter.

The Health Insurance Process – When the Patient Gets Stuck

Studies show that ER costs make up the biggest portion of amounts owed from insured and uninsured patients struggling to pay medical bills!

In Network or Not?

Did you know that about 66% of emergency room doctors are independent contractors who may or may not be in your insurance plan? And in a practice called balance billing, any out-of-network provider or lab can bill you for whatever your insurance does not cover. You might receive bills from several entities, some of which you never even met!

What is an out-of-network provider mean? This is a healthcare professional that does not have a contract with an insurance plan. Therefore, the provider does not have to accept the insurance’s allowable amount as payment in full.

The Ambulance

Think about the ambulance too. If the ambulance company that takes you to the ER does not hold a contract with your insurance, you could be on the hook for more than $2,000.00 depending on where you live in relation to the ER and what level of care your receive prior to arriving at the hospital. Plus, if your insurance company concludes that an ER visit wasn’t warranted, you might owe even more money.

To avoid these nasty surprises, consider the following strategies:

Insurance Policy

It might sound rudimentary because it is. Ask your insurer what the plan does and does not cover in the event of emergency care. This includes the ER copay, coinsurance, and deductible – in and out-of-network. Many patients are surprised to learn there are different values for out-of-network care. Some plans even have a tiered payment system. Find out which area hospitals are in network with your insurance. Check with the hospital to see which ER doctors are in network in your insurance plan.

Find out how your plan defines a medically necessary ambulance ride and what is required to appeal a non-payment decision.

EMTs decide which hospital they will take you too but you can request a particular one. Request an in-network doctor when the admission forms are completed. Be aware, however, your insurance may deny the charge if you request a hospital further away and could have been treated at a location nearest you.

Out-of-Network Bills

If you get a bill for out-of-network charges that you could not prevent because of the emergency, then it’s time to get to work. Ask your insurer if they’ll cover the costs at the in-network rate. Contact the providers and ask what the insurance has already paid and ask them to settle for that or negotiate for a lower amount.

About a quarter of US states have consumer protection laws that restrict providers from balance billing in certain care situations like emergencies. Some laws apply only to certain health plans or certain providers. Contact your state’s insurance department for specifics.

If all this fails, contact your insurance to determine what must be submitted to file an appeal and time limits for filing. Generally, documentation from the provider(s) will be required. In the case of an out-of-network situation, ask the doctor to provide a letter attesting to a good faith effort was made to utilize a contracted provider and no equitable access to such provider existed.

It’s not easy blending thoughts of payment with a medical emergency but it is something you can prepare for.