Top 10 Questions About Health Insurance Reform

Why do I need health insurance?
What is the cheapest health insurance?
What does health insurance cover?
Which health plan is best for me?
Should I switch from one carrier to another?
Do I have to enroll in my companies group plan?
Can I get coverage if I have a pre-existing condition?
What types of things are not covered?
What happens to my insurance if I lose my job?
How do I get a quote for health insurance?


Why do I need health insurance?

Three major reasons: 1. The financial risks of an uninsured medical expense can be a personal financial disaster for yourself and family. Who can afford thousands of dollars in medical bills?

2. You receive medical services at ‘discounted rates’ that Insurance providers have negotiated with doctors and hospitals, that saves you lots of money.

3. Your risk of death is 40% higher than those working age Americans that are privately insured. www.pnhp.org/new/2009/september/harvard_study_finds_.php


What is the cheapest health insurance?

When people ask this question they are usually referring to low monthly premiums. Low premiums are good but we encourage you to look at the total financial cost. Total financial cost is a combination of premiums, deductibles, co-insurance, and benefits provided. Many times a few more dollars monthly provides greater total benefits.


What does health insurance cover?

That depends on the plan you select. There are three major types of health plans.

Health Maintenance Organizations (HMOs), generally provide a wide range of services via the HMO network providers. They are usually best suited for those looking for lower premiums, preventative care, no deductibles. However co insurance cost may be greater and you must use the services of the HMO network.

Preferred Provider Organizations (PPOs) are popular because they allow the insured to select the doctor as long as the doctor is in the PPO network without a referral. PPO’s negotiated rates encourage you to stay in the network. That holds down your costs. Going outside of the PPO network usually requires you to pay higher copayments and deductibles.

Point-of-Service (POS) plans. POS plans are like HMO’s in that you select a doctor in the network as your “point of service’ that docter can then refer you out to a specialist, but the choices are generally broader than in an HMO. Like HMO’s and PPO’s going outside of the network can add considerable costs that the insured is responsible for.


Which health plan is best for me?

The best plan is one that meets you needs. Make a list of your wants and needs. How much can you afford monthly for premiums, do you want a deductible, how much are you able to spend on co-payments, do you have any special medical conditions that you need coverage for and what doctors will you use. Know what’s important will make selection of medical insurance coverage a lot easier.


Should I switch from one carrier to another?

Before you make a switch know your current plan and its costs and compare those with new plans. There should be a clear benefit to switching, cost is one but also be mindful of the differences in benefits. Insurance companies change rates and benefits all the time so shopping could save you money and your needs also change over time.


Do I have to enroll in my companies group plan?

Individual insurance is a good option if you work for a small company that does not offer health insurance or if you are self-employed. Buying individual insurance allows you to tailor a plan to fit your needs from the insurance company of your choice. It requires careful shopping, because coverage and costs vary from company to company. In evaluating policies, consider what medical services are covered, what benefits are paid, and how much you must pay in deductibles and coinsurance. You may keep premiums down by accepting a higher deductible.


Can I get coverage if I have a pre-existing condition?

Many people worry about coverage for preexisting conditions, especially when they change jobs. The Health Insurance Portability and Accountability Act (HIPAA) helps assure continued health insurance coverage for employees and their dependents. Starting July 1, 1997, insurers could impose only one 12-month waiting period for any preexisting condition treated or diagnosed in the previous six months. Your prior health insurance coverage will be credited toward the preexisting condition exclusion period as long as you have maintained continuous coverage without a break of more than 62 days. Pregnancy is not considered a preexisting condition, and newborns and adopted children who are covered within 30 days are not subject to the 12-monthwaiting period.


What types of things are not covered?

While HMO benefits are generally more comprehensive than those of traditional fee-for-service plans, no health plan will cover every medical expense.

Very few plans cover eyeglasses and hearing aids because these are considered budgetable expenses. Very few cover elective cosmetic surgery, except to correct damage caused by a covered accidental injury. Some fee-for-service plans do not cover checkups. Procedures that are considered experimental may not be covered either. And some plans cover complications arising from pregnancy, but do not cover normal pregnancy or childbirth.


What happens to my insurance if I lose my job?

If you have had health coverage as an employee benefit and you leave your job, voluntarily or otherwise, one of your first concerns will be maintaining protection against the costs of health care. You can do this in one of several ways:

* First, you should know that under a federal law (the Consolidated Omnibus Budget Reconciliation Act of 1985, commonly known as COBRA), group health plans sponsored by employers with 20 or more employees are required to offer continued coverage for you and your dependents for 18 months after you leave your job. (Under the same law, following an employee's death or divorce, the worker's family has the right to continue coverage for up to three years.) If you wish to continue your group coverage under this option, you must notify your employer within 60 days. You must also pay the entire premium, up to 102 percent of the cost of the coverage.
* If COBRA does not apply in your case - perhaps because you work for an employer with fewer than 20 employees - you may be able to convert your group policy to individual coverage. The advantage of that option is that you may not have to pass a medical exam, although an exclusion based on a preexisting condition may apply, depending on your medical history and your insurance history.
* If COBRA doesn't apply and converting your group coverage is not for you, then, if you are healthy, not yet eligible for Medicare, and expect to take another job, you might consider an interim or short-term policy. These policies provide medical insurance for people with a short-term need, such as those temporarily between jobs or those making the transition between college and a job. These policies, typically written for two to six months and renewable once, cover hospitalization, intensive care, and surgical and doctors' care provided in the hospital, as well as expenses for related services performed outside the hospital, such as X-rays or laboratory tests.
* Another possibility is obtaining coverage through an association. Many trade and professional associations offer their members health coverage - often HMOs - as well as basic hospital-surgical policies and disability and long-term care insurance. If you are self-employed, you may find association membership an attractive route.


How do I get a quote for health insurance?

Getting a quote for health insurance is easy. This website is setup to generate instant quotes with nothing more than you age and zip code. Simply visit the quote page to get your instant free quote.