Insurance
What You Don’t Know Can Kill You
Health Insurance Limitations
Health insurance often requires a mountain of paperwork that has a lot of fine print. Unfortunately, this means that few people read their plans thoroughly nor do they fully understand what their plan covers or does not cover. Here are some common limitations in health insurance coverage that you should know.
Some of the most shocking health insurance limitations are found in the the fine print holes in the insurance policy. For instance, many people have found that their health insurance did not cover a routine or necessary medical procedure because they did not receive an authorization code prior to the procedure or the hospital did not correctly fill out the paperwork. Your medical claim can be denied simply because the hospital used odd codes for your treatment. While any claims denied by the insurance company can be disputed, this process is not only tedious, but time-consuming and draining, especially for someone who is already ill. There is also little success in winning disputed claims, which makes this option rather limiting.
Another surprising health insurance limitation happens more often than people realize. Imagine this situation: you are diagnosed with a medical condition and need an operation. You research surgeons and hospitals within your plan. You understand your plan’s coverage of hospital care. You have your operation and then you find a massive medical bill in the mail. Apparently your health insurance did not cover the anesthesiologist or other specialists that may have consulted in your operation. Thus, you have to pay these specialists for their services, even though you were under the impression that your plan would cover these costs associated with the surgery. Such a bill can be in the thousands of dollars, and there is little you can do to dispute the charges. The only way to avoid these charges is to make sure that you ask before the operation who will be involved and ensure that they are covered in your health insurance plans.
Other limitations are put on a number of treatments. For instance, you may need physical therapy or visits to a psychiatrist. Many health insurance plans will put a limit on the number of covered visits for such medical treatment. Without realizing it, you may surpass the maximum visits allowed by your health insurance and end up racking up huge bills.
Many people think that buying health insurance will cover them medically, but this is only correct to a point. When securing insurance, you should read through your health insurance package carefully, and when you are about to undergo any expensive medical procedure, be sure to consult your health insurance plan first.
Ways of Paying for Health Insurance
When it comes to health insurance, many people don’t exactly know everything that there is to know about the subject. That only stands to reason, it is not something that is easily understood because of its complexity. For instance, when you visit the doctor you may be asked to pay something that is called the “co-pay”, and other times you may not have to do anything at all depending on your plan. Let’s look at some of the ways that health insurance is paid for.
Often times, your employer will sponsor your insurance and you only have to pay what is known as a “co-pay” or co payment. The co-pay is a set amount that is determined by your insurance company when you receive covered services. This is a significantly smaller fee than you would be paying without the co-pay. Many companies offer this type of payment option because it is easier on the employee to pay this way.
You may consider opening what is known as a Healthcare Savings Account (HSA). This will assure that you always have a location in which to retrieve payments for various medical expenses. The HSA is a pre-tax savings account where a portion of your pre-tax income, determined by you, is deposited into an account automatically. Since this account comes from your paycheck pre-tax, that means it will lower your overall taxable income. This means you are saving money in terms of taxes and saving lots of money towards your overall health care costs.
For certain disabled individuals and those above the age of 65, Medicare is also another way to pay for health insurance. While they will not pay all of your healthcare expenses, they will pay for most of them. Medicare, however, doesn’t cover prescription drugs and nursing homes. It is important that you check the different types of restrictions that may apply. There are low-cost prescription discount cards that have been proven to save people who require costly medications on a regular basis over 50% of what they would have been paying without any health care.
Paying for health insurance doesn’t have to be complicated as long as you understand just what is going on in terms of where you stand with your plan. Discuss any questions you may have about the plan before committing to one. While one plan may be right for many people, it does not always mean that it will fit your specific needs.
Healthcare for Long-term Patients
Is this Insurance Right for You?
Long-term care insurance is not right for everyone. For a small percentage of the population this coverage is an affordable and worthwhile type of insurance. Determining whether or not long-term care insurance is right for you won’t be the only task at hand; looking for scams will also be a concern.
As you get older, the need for assistance in your everyday life increases. Whether it is in-home care or residing in a nursing home for a few months you will most likely need some way to pay for these types of services. In order to maintain long-term care insurance you must pay for them each and every year until death. Many policies are canceled by policyholders that are on fixed incomes and are simply unable to pay for the increasing premiums as they get older. If the only funds you are receiving were those from Social Security or SSI, then it would be wise to not purchase a policy. Also, if you find that every day purchases and paying for utilities makes you stretch your budget to the limit, you probably should stay clear of this policy. This type of policy is only right for someone who has significant assets they want to preserve for their family, remain independent, or just to spare their family the expense of a nursing home bill.
Comparing policies can prove to be difficult because every company is selling a different combination of benefits and coverage. Many companies offer to pay a fixed amount for each day you receive care, while others will cover a percentage of the overall cost of care or supply a specified amount. Beware of these types of policies unless they offer inflation protection. You see, if they do not account for the increasing cost of nursing home costs, then you are stuck with a policy that really does you no good.
Just like a standard healthcare plan, you will have to receive services at designated locations. If you go outside of this network they will simply refuse to pay for any care that you receive. If you have any type of mental disease or nervous disorder then don’t expect many carriers to accept you (the one exception is Alzheimer’s). There are more restrictions in this type of insurance than any other health insurance.
If this type of policy is right for you, please make sure that the company is reputable. There are many individuals who thrive on the fact that not many people will make an informed decision when it comes to purchasing long-term health insurance. Be sure to read the fine print and find out everything you can about the policy before committing to a company and a long-term health insurance plan.
Easy as 1-2-3: Obtaining Health Insurance
Many people are often concerned about obtaining health insurance. They are confused about their options or about how to obtain the best health insurance for them or their family. There are several ways to obtain health insurance, though, and some of them are not always obvious, but can be quite easy in the end.
Health insurance is commonly obtained through an employer. Nearly all employers these days offer some sort of “group” health insurance plan for employees. The term “group” simply denotes that there is a large group of people on the plan, which decreases the cost of the monthly premium for all members. These plans can cover yourself, your spouse, and your family, depending on the specific policy. Covering more than just yourself obviously increases your monthly premium, but the ability to cover your family inexpensively is a huge benefit. To obtain group health insurance through your employer, you should contact your human resources department or whoever is in charge of benefits in your company. You should be able to buy into the group health insurance plan at any time during your employment.
If you leave an employer who offers group health insurance without first finding other coverage, you can also use the COBRA law with your previous employer’s health insurance coverage. COBRA is a government act that allows you to continue coverage under your previous employer, though at a more expensive rate. If you had coverage for your entire family, COBRA will allow you to continue this full coverage for a certain period of time.
There are several million people in the United States who are unable to participate in any group health insurance plans, however. Health insurance companies do offer individual plans for those who do not have coverage through their employer, are self-employed, or are ineligible for government health insurance assistance, such as Medicare or Medicaid. Individual health insurance plans are more often than not very expensive in relation to group health insurance plans. These plans can also cover family members and spouses for additional costs. Finding individual health plans is not difficult. Almost all health insurance companies offer individual plans; you can now search online for individual health insurance plans. Some Web sites even allow you to compare pricing and details of plans offered in your area – much like shopping for car insurance.
There is also federal health assistance available depending on certain criteria. If you are over the age of 65 or if you have a disability or specific condition (detailed by the government), you are eligible for Medicare. Medicaid is another government health insurance program that is based on income. Overall, it is simply important to be covered, no matter how you go about doing it. Research your options of coverage and speak with a professional to find out more about the health insurance options available to you.
Advantages to Managed Care Plans
There are many different types of Health insurance plans out there. Picking the right one for yourself can be troublesome in the beginning, especially if you don’t know what you are looking for. You might have trouble deciding which one would be better for you.
Health insurance is divided into two large categories—indemnity and managed care plans. Indemnity plans, also commonly called reimbursement plans, will reimburse your medical expenses up to a certain limit. Under the Reimbursement plan, the insurer pays a percentage of the total charges, regardless of how much the charges are. With the indemnity plan, the insurer will pay a specified amount every day for a specified number of days. The amount reimbursed does not rely on the cost of medical care, but what you are reimbursed will never exceed your expenses.
The other popular type of health insurance plans is managed care plans. The three types of policies categorized as managed care plans are HMOs, POSs, and PPOs. This type of insurance is more popular than the indemnity plan, as they offer more flexibility. With these types of options you either pay a monthly fee no matter how many times you see a doctor, or pay a co-payment but no monthly fee. With managed care plans, you are given options of care. The plan you choose and the amount of money you wish to pay determines how big of a network of doctors and specialists you can see and still be covered under the plan. Some managed car plans (most often PPOs) offer sponsorship programs from a network of hospitals and medical services. You can often get this kind of plan through your employer.
Managed healthcare plans are better for the average person due to the fact that they are more cost effective. While indemnity plans may give you a lot more freedom in cost, you will have to use the healthcare provider that the insurer chooses. If you have a specific disability, this can present itself as a problem. In the long run, a managed care plan will save you money, especially if emergencies arise when you are out of town. These types of plans also are more flexible in policy. Before you purchase any kind of health insurance, be sure to research the many options available for you and your family to ensure you receive the best coverage possible for the lowest monthly premium or deductible.
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