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Health Insurance 101 for Individuals and Families

The changing healthcare and health surprised down the road if a claim is
insurance landscape in the United States denied. This is important whether you
has resulted in more individuals and are purchasing a standard medical,
families purchasing health insurance temporary, or student health insurance
coverage on their own. Rather than touch policy.
on the number of reasons why this is the 6. Does the insurance company you are
case, I would like to provide individuals considering have a substantial network of
and families finding themselves in this preferred doctors and hospitals in your
position with ten basic ideas to assist area? In addition to family doctors,
them with getting the best health what type of access will you have to
insurance policy for their specific specialists and the best hospitals in the
situation. Below is a combination of ten event you or a family member is diagnosed
questions and suggestions that will with an illness that requires specialized
provide the tools necessary to get a care? Also, what are your options for
medical insurance policy that will best preferred health care providers when
work for you and your family. traveling?
1. What are your typical health and 7. If you need to go "out of network",
medical care expenses in a calendar year? will you still have coverage? Most
Most people are surprised when they go insurance policies will have coverage in
through this exercise to learn that they the event you need to go outside of their
would be financially better off in most network for care. However, review how
years to purchase a high deductible these out of network claims will be paid.
health insurance plan and use the premium Will there be an additional deductible?
savings to directly offset heath care How are reimbursement levels determined
expenses throughout the year. for out of network claims? What is your
2. How long do you anticipate needing the maximum out of pocket for out of network
health insurance coverage? For example, claims?
many companies sell temporary policies 8. Are you looking for an opportunity to
that can be put in force for 1-6 months reduce your taxable income? If so, make
and they are relatively inexpensive. If sure your plan qualifies as a high
you are in between jobs or in a waiting deductible health plan and look into all
period for employer coverage, this may be of the aspects of a Health Savings
your best option. Account. In the right situation, HSAs
3. What is your budget? If your budget can be an excellent way to pay for
is tight, having a $1000, $2500 or even eligible health care expenses, reduce
$5000 deductible is better than having no your taxable income and save for
coverage at all. The ability of doctors retirement.
and hospitals to save and prolong life in 9. What are the financial ratings of the
the United States is in many cases insurance company you are considering?
extraordinary. However, their treatment A.M. Best, Standard & Poor's, and Moody's
is not free and going without health are organizations that rate the financial
insurance coverage can in some cases stability of insurance companies.
result in you and/or your family losing 10. What type of customer service will
an entire life's worth of savings and you get from your insurance agent? Do
assets. they specialize in health insurance? Do
4. Be careful to choose a plan that they have a staff that is willing and
covers the "big stuff". It is nice to able to assist you in the event you have
have a policy that covers items such as: a claim, billing, or other customer
physician office visits, routine service problem?
physicals, outpatient testing, and blood If you do not have the time or patience
work. However, it is essential to have to look into all of the items mentioned
coverage for major services such as above, develop a relationship with an
cancer treatment, transplants, critical independent insurance agent that
illness, traumatic accidents, and specializes in evaluating and servicing
infectious diseases. Find out the health insurance policies. A good
lifetime maximum amount as well as if the independent insurance agent will be able
policy contains "internal" dollar limits. to save you time, money, and be an
5. Always carefully read and understand excellent resource for evaluating all of
the pre-existing condition clause and the items mentioned above.
policy exclusions so that you will not be




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