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How Health Insurance Works


When I consider purchasing an individual health insurance plan for myself or my family, do I have any financial obligations beyond the monthly premium and annual deductible?

Answers: It depends on the plan, but some plans have the following cost-sharing elements that you should be aware of.

Co-Payments: Some plans include a co-payment, which is typically a specific flat fee you pay for each medical service, such as for an office visit. After the co-payment is made, the insurance company typically pays the remainder of the covered medical charges.

Deductibles: Some plans include a deductible, which typically refers to the amount of money you must pay each year before your health insurance plan starts to pay for covered medical expenses.

Coinsurance: Some plans include coinsurance. Coinsurance is a cost sharing requirement that makes you responsible for paying a certain percentage of any costs. The insurance company pays the remaining percentage of the covered medical expenses after your insurance deductible is met.

Out-of-pocket limit: Some plans include an out-of-pocket limit. Typically, the out-of-pocket limit is the maximum amount you will pay out of your own pocket for covered medical expenses in a given year. The out-of-pocket limit typically includes deductibles and coinsurance. But, out-of-pocket limits don’t typically apply to co-payments.

Lifetime maximum: Most plans include a lifetime maximum. Typically the lifetime maximum is the amount your insurance plan will pay for covered medical expenses in the course of your lifetime.

Exclusions & Limitations: Most health insurance carriers disclose exclusions & limitations of their plans. It is always a good idea to know what benefits are limited and which services are excluded on your plan. You will be obligated to pay for 100% of services that are excluded on your policy.

Beginning September 23, 2010, the Patient Protection and Affordable Care Act (health care reform) begins to phase out annual dollar limits. Starting on September 23, 2012, annual limits on health insurance plans must be at least million. By 2014 no new health insurance plan will be permitted to have an annual dollar limit on most covered benefits.

Some health insurance plans purchased before March 23, 2010 have what is called “grandfathered status.” Health Insurance Plans with Grandfathered status are exempt from several changes required by health care reform including this phase out of annual limits on health coverage.

If you purchased your health insurance policy after March 23, 2010 and you’re due for a routine preventive care screening like a mammogram or colonoscopy, you may be able to receive that preventive care screening without making a co-payment. You can talk to your insurer or your licensed eHealthInsurance agent if you need help determining whether or not you qualify for a screening without a co-payment.

There are five important changes that occurred with individual and family health insurance policies on September 23, 2010.

Those changes are:
1. Added protection from rate increases: Insurance companies will need to publically disclose any rate increases and provide justification before raising your monthly premiums.
2. Added protection from having insurance canceled: An insurance company cannot cancel your policy except in cases of intentional misrepresentations or fraud.
3. Coverage for preventive care: Certain recommended preventive services, immunizations, and screenings will be covered with no cost sharing requirement.
4. No lifetime maximums on health coverage: No lifetime limits on the dollar value of those health benefits deemed to be essential by the Department of Health and Human Services.
5. No pre-existing condition exclusions for children: If you have children under the age of 19 with pre-existing medical conditions, their application for health insurance cannot be declined due to a pre-existing medical condition. In some states a child may need to wait for the state’s open-enrollment period before their application will be approved.

How To Get On Track Financially


images (10)Many people go through life feeling as though the world is against them.  This is usually because their financial situation is a mess.  People in this situation can avoid feeling like a victim by taking control of their finances.  This means becoming financially literate, saving money and eliminating debt.

Anybody who has a loan, credit card or overdraft should make getting out of debt their number one priority.  Unfortunately, debt is not something that magically goes away.  Borrowers will have to be pro-active if they wish to become debt free.

The simplest way to do this is make payments in FULL and on time.  Anything less than this could affect the borrower’s credit rating.  Those who can afford to do so may wish to pay more than their required minimum repayment amount.  If borrowers do this, they should ensure that the lender does not charge an early repayment fee.

A borrower’s worst enemy when it comes to debt is late fees and interest rates.  If borrowers only make minimum repayments, they will pay very little of the principal amount off.  This will only extend the lifespan of their debt.

The key to paying off debt is prioritizing the debt with the highest interest rates.  If a borrower is having a hard time paying off their loan, they should speak to the lender about a payment plan or debt consolidation loan.  Payday loans should be avoided unless the borrower is in a dire situation.

Financial freedom is not a difficult goal to achieve.  Once debtors have paid off their loan, they can start saving for the future.  These savings can be invested, passed down as an inheritance or used to purchase something.  When all debt is paid off, borrowers should focus on limiting their spending and living within their means.


How To Find Life Insurance If You Are A High Risk Client

A lot of people who have not been able to find an affordable life insurance policy end up feeling that there are no affordable policies for them. If you are considered as a high risk client by insurance providers, you should know that there are affordable options for you. You should take the time to compare the different policies available to you and select one that corresponds to your budget.

It is possible that insurance providers have refused to insure you if you have chronic health issues and are over the age of 50. If you have been offered coverage, it is likely that the premiums were a lot more than what you could afford. However, subscribing to life insurance is very important, especially if you fit in the high risk category.

High Risk Life Insurance Companies

There are insurance providers who offer policies to individuals who find themselves in the high risk categories. The goal of these companies is to offer affordable high risk life insurance coverage to everyone. These insurance providers have a good understanding of several types of risks and can usually work with you to put together a life insurance policy that corresponds to the amount of coverage you need and to your budget.

You will have to provide your insurance with as much information as possible about your medical problems and your lifestyle. These details will be used to assess your risks and to create a policy that will correspond to your needs. You will not get the lowest premiums available but you will be able to subscribe to an affordable policy and get a fair amount of coverage.

You can find affordable life insurance by selecting the right insurance provider. The risk category you find yourself in should not keep you from purchasing a life insurance policy.