Health insurance plans fall into four main categories:
Health Maintenance Organizations
Preferred Provider Plans
Major Medical Plans
High Deductible Health Plans
About 10 years ago, these different types of plans were very distinct and could easily be identified.
Today, the lines have blurred, making it hard to distinguish one from the other in many cases.
In a traditional sense, a Health Maintenance Organization is a health plan where your care is managed by your primary care physician along with the Health Maintenance Organization itself. These plans typically have low co-payments for services at a doctor’s office and even for hospitalizations and surgeries. A big drawback to these plans is that when you get sick, you end up being limited to which doctors you can see and you will need referrals from your primary care physician and approval from the managed care organization for anything from diagnostic tests to surgeries and hospitalization.
Preferred Provider Plans were originally a spin-off of HMO’s. Insurance companies saw they had good discounts with in-network providers and consumers were upset with the oversight from the managed care companies. So, they created plans that had the features people liked – low copayments and little insurance company oversight. Also, there are benefits when you go out of network, but they are reduced by 20% – 30%.
The health plan that has been around the longest is the Major Medical Insurance plan option. Originally these plans had a deductible, coinsurance, a maximum out of pocket amount and some had separate benefits for hospitalization and surgery – often provided by Blue Cross with the major medical being offered by a traditional insurance carrier. Today, you don’t see people carrying one plan for hospitalization and another for other services and plans that are sold as major medical usually incorporate a network and enhanced benefits for seeing a network provider. So, they look more like a PPO plan without copayments.
Finally, we have the High Deductible Health Plans typically associated with Health Savings Accounts. These plans are just Major Medical Plans with deductibles, coinsurance and out of pocket limits that conform with the limits set forth by the Federal Government (Here is a nice HSA overview the US Office of Personnel Management Prepared for government workers).
To learn more about Health insurance quotes, affordable health insurance, affordable health insurance quotes, health insurance plans, visit Benepath.com.
Health insurance issues are always a significant concern for both employers and individuals. Headlines frequently describe the ever increasing cost of healthcare and insurance, and constantly changing rules can make obtaining proper coverage a complicated matter. Many insurance shoppers are turning to the internet for information that they can use to make informed decisions and compare plans, packages and rates. To this end, Benepath has designed a website that offers users a comprehensive resource such as insurance news, informative articles and a powerful interface that allows users to compare quotes within seconds.
“One of the most common complaints about insurance shopping that we’ve heard is that it can be confusing to compare one plan to another,” explains Clelland Green, Benepath’s President. “We have made it our mission to give insurance shoppers the power and knowledge they need to make the best healthcare decisions for their families.” Benepath accomplishes this with a user-friendly website, an easy-to-use health insurance quote system, and a wealth of information that every insurance buyer should know.
The site benefits both the insured and the uninsured. Those who are interested in saving money on their existing plans can quickly compare offers from leading insurers, while new insurance buyers can find the exact package that suits their needs and their situation. Employers who want to offer their employees the security of a comprehensive benefit plan can also request quotes that best suit their business and their budget.
About Benepath: Benepath was founded by Clelland Green in 2004 as a consulting firm to provide insurers and managed care organizations with advice regarding the development of consumer directed health plans (CDHs) such as HSAs, HRAs, and high deductible health plans. When it became clear that insurance brokers did not have a firm grasp of the CDH market, Benepath was founded with a unique business model to ensure that businesses and individuals learned about the importance of these products and how they could be a better fit than traditional health insurance plans including HMOs and PPOs.
Posted on Saturday, May 15th, 2010. Filed under Health Insurance.
The easy answer for most people is yes. But just like everything else, you get what you pay for and their are no “deals” to be had.
The biggest thing to watch out for are insurance policies that offer copays for doctors office visits and prescriptions that have a low price.
Why?
Office visits are cheap (relatively speaking) usually costing somewhere between $50 and $80 a visit – a practice in Southern California even made their medical costs easily available.
A broken leg can cost you $10,000 – $20,000 including the hospital visit, ER physician costs, follow-up visits, X-ray/MRI’s etc.
So an inexpensive plan with copays usually has very high cost sharing for hospitalizations, surgeries, etc. Some even have limits on the total amount they will cover for every time you visit the hospital or have a medical event.
Do you really want a health plan that gives you a $35 copay for an office visit but ends up costing you $10,000 when you have a real medical emergency?
This is all another good reason to use an agent.
Agents do not cost you a penny. That’s right – the premium you get from an agent will be the same as if you went to the health insurance company directly.
They represent lots of carriers.
And a good experienced agent knows the pitfalls of the plans and can help you make an informed decision on which medical insurance quote to buy.
I hope so, because you can avoid a lot of mistakes if you did.
But how do you find and pick a good one?
Well, a good place to start is by getting a quote at Benepath ;-), or you can check out the National Association of Health Underwriters or the Independent Health Insurance Association. But seriously, there are a few important things to consider when selecting an agent:
How much experience does the agent have? Personally, I would not work with anyone who has not been doing this for less than one year or at least who works directly with more experienced agents. There are two reasons for this. First, most people (over 80%) who start in the insurance business don’t make it past the first year. So, anyone who makes it past the first year is more likely to be around when you need them. The second reason is someone with a year’s experience has been able to see enough of the good and the bad of carriers in your area to have good judgment about the options for you.
How knowledgeable is the agent? – Just because someone has been in the business 10 years does not mean they are a professional. You want to ask questions that give the agent an opportunity to demonstrate to you that they know their trade. Ask them to tell you the pluses and minuses of the different carriers in your area. Look for details and not just generalizations.
Does the agent represent all the major carriers in your area? You want to make sure the agent represents the major carriers in your area and you know who they are. If you don’t, just read the billboards as you drive down your local freeway… Stay away from agents who only represent one carrier. These are captive agents and their job is to represent the company they work for and to sell you their policies. Maybe their program is the best for you, but in most cases and independent agent can represent that carrier as well. You want an agent who can provide you with multiple health insurance quotes and give you side by side comparisons of the benefits and price of each plan.
Ask them about their process for helping you pick the right plan. There are literally over 1,000 possible plans to choose from when you add up all the various options, copays, deductibles, etc. They should have a good answer for this question; one that lays out a serious path for matching you up with that right health plan.
Now pick up the phone and start asking some good questions.
Happy Hunting!
Posted on Thursday, May 13th, 2010. Filed under Health Insurance.
Before you buy a policy, you have to pick the health insurance plan to buy…
Too many people are trying to do this by themselves, thinking they can pick a health plan as easily as choosing a brand of peanut butter. More often than not, they end up very dissapointed with the results.Makes sense, but it just isn’t that easy.
My advice is to carefully choose an insurance agent and work with them to find the right coverage for you at the best possible price. Doing this is free and you directly benefit from the agent’s experience and expertise. Remember these men and women are doing this as a job and most insurance agents who sell individual health insurance focus on that market, meaning they are not really doing many other things than working with people like yourself to find health insurance.
So, they know which carriers pay their claims timely, they know which carriers have quality policies without lots of loopholes, they know which carriers have the best provider networks and so on. They also know the experience of their customers as they always get the call if things go wrong.
In future blogs I’ll give you some pointers on picking a good agent and on buying a policy yourself if you really don’t want an agent.
Happy Hunting!
Posted on Wednesday, May 12th, 2010. Filed under Health Insurance.
Finding quality health insurance is never easy, unless you have no health problems, aren’t overweight, and don’t smoke. Basically its easy to find health insurance if you don’t need health insurance.
So, if like most Americans, you or someone in your family has some minor health condition (ADD for kids, high blood pressure, overweight, etc) you will go through a process of getting health insurance quotes with the best rates, then going through underwriting and finding out that either:
You are going to pay more than you originally thought for the same coverage, or
You will get a policy at about the same price, but it will have riders that exclude or limit coverage for your health condition
What are you going to do about it?
You essentially have three choices.
Accept the increased premium or policy riders – This is usually the best course of action because now that you have gone through underwriting, you will have to disclose this to other carriers you try to get a better deal with. Ultimately, you will most likely end up with the same result.
Look for another carrier – If you were offered a policy with riders, you may be able to find another carrier who does not rider policies and only increase premiums. Then you can decide if you want to pay the higher premium or accept the limits on your coverage. If your condition is severe, many states have programs that offer guaranteed issue coverage – but it can be very expensive.
Reject the offer and continue to go without health insurance – This is a very poor option as even though you may not have been provided with the coverage you want, you do have coverage and a broken leg can cost up to $20,000. So, it may not be perfect, but it certainly will protect you and your family from financial difficulties due to unforeseen medical expenses.
Of course this is all a short term problem until the guaranteed issue provisions of health care reform go into effect in 2014, but until then you will need to manage with what is available.
Happy Hunting!
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Posted on Tuesday, May 11th, 2010. Filed under Health Insurance.
New viruses take their toll physically and financially. Be prepared to deal with new medical problems by having affordable health insurance.
Lately it seems like every time you turn around there is a new bug making its way around the world. Some of them may be treated with existing medicines; some of them may not. Either way, if you wind up getting sick and need a lot of doctoring, and if you don’t have affordable health insurance that covers your needs, you may have a problem on your hands.
Let’s face it, if you come down with something new and difficult to treat, you will likely be paying out more money than you have budgeted. That’s due to the nature of our expensive health care system. Even if you do have a high deductible, you’re going to be in a pinch financially. What are your options? The main option is to find affordable health insurance that offers the kind of coverage you need. Start by working out your budget first and then working out what you need. With list in hand, hit the Internet and start searching for health insurance quotes.
Once you’ve found a few sites that you like and that are professional and up-to-date in their information, ask for quotes and then compare them with others you have. Go for about three or four quotes to get an idea of what is out there. Pare down your list to show you the affordable health insurance quotes.
Next, you comb through what each of those affordable plans offers. For this you may need to speak directly to a health insurance agent. Write out a complete list of things you want answered and go to town asking them all. It’s important that you know that what you may get is what you need. Once you have found a cost match, your benefits are very important. Be careful here because some of the quotes may look enticing financially, but don’t offer the cover you need. So, read the fine print.
Weed out what is not suited for you and keep going until you have a quote that offers good benefits and it works with your budget; something you can manage financially. While this might seem like a daunting process, it does pay off in the long run with the thing you needed the most – affordable health insurance.
Clelland Green is with Benepath.com, a leader in providing health insurance quotes. Benepath provides individuals, families, and businesses with affordable health insurance quotes in just a few mouse clicks. To learn more, visit https://www.benepath.com.
While a policy may be inexpensive, it may not be what you need. Check that out first and ask questions when you don’t understand why a policy is less expensive, but won’t suit your needs. An experienced health insurance broker will have the answer for you. For instance, the policy might onlyhaveminimal drug coverage and no cover for hospital stays, and you are asthmatic and need drugs fairly often and have the occasional hospital visits for attacks. That kind of policy would not work for you.
Ask for up to six quotes and then spend some time with them and figure out why the premiums are different. In some instances it may depend on your age, your health or whether or not you have pre-existing conditions. Typically, when you ask for quotes online, use the same information withevery company when you fill out the online forms. If you don’t, it gets even more confusing.
To learn more about Health insurance quotes, affordable health insurance, affordable health insurance quotes, health insurance plans, visit Benepath.com.
While you might be understandably angry with the health insurance company that denied you health insurance coverage, it isn’t the insurance company making up the rules about who gets accepted and who gets denied. That is done by the state department of insurance, and every state has one. They are the people who set the rates for insurance companies to do business in the state and don’t allow insurance companies to take too many high risk policyholders.
This entire time people have been thinking it’s the insurance companies themselves denying coverage, when really, insurance companies are bound by the rules laid down by the state department of insurance. What does this mean? It means that in order for insurance companies to stay in business, the rules need to state that they don’t take high risk policyholders or they won’t be in business for very long.
To learn more about Health insurance quotes, affordable health insurance, affordable health insurance quotes, health insurance plans, visit Benepath.com.
Posted on Sunday, April 25th, 2010. Filed under Health Insurance.
Organization itself. These plans typically have low co-payments for services at a doctor’s office and even for hospitalizations and surgeries. A big drawback to these plans is that when you get sick, you end up being limited to which doctors you can see and you will need referrals from your primary care physician and approval from the managed care organization for anything from diagnostic tests to surgeries and hospitalization.
Hmmmm…
Finding quality health insurance is never easy, unless you have no health problems, aren’t overweight, and don’t smoke. Basically its easy to find health insurance if you don’t need health insurance.