March 14, 2009

5 Things To Think About When Buying Health Insurance Policies In A Poor Economy

If you are buying Health Insurance in today's bad economic climate then here are 5 five things to watch out for.

1. Does your health plan give you cover both at work and away from your job?

A lot of health insurance policies have specific exclusion clauses which wipe out your benefits for anything that could have been covered under Workers Compensation or a similar law. Now stop and read that last sentence once more and pay close attention to the words 'could have been covered'. That is correct, the majority of self employed people and even a few small business owners do not carry Workers Comp on themselves.

There are specific insurance plans that will cover you on and off the job, as long as you are not required by law to have Workers Compensation coverage.

2. Are you writing it off?

Home based business owners, independent contractors (1099's), professionals and a lot of self employed people do not take advantage of the present tax laws.

A lot of individuals who are paying 100% of their own costs are eligible to deduct their monthly insurance premiums. Just that alone can reduce your out-of-pocket costs by up to 40%. Ask your accountant if you are eligible or check out the IRS website for more information.

3. Look carefully at any plan's internal limits

All insurance policies use some form of internal controls to determine how much the company is going to pay out for a specific service or procedure. Here there are two basic methods which are used:

A. Scheduled Benefits

Many plans, some of which are specifically marketed to self employed and independent individuals, have a detailed schedule of what the insurance company will pay per doctor office visit, hospital stay or even what limits are placed on payments for testing in any 24 hour period. This structure is frequently associated with 'Indemnity policies'. If you are presented with one of these plans make sure that you see the schedule of benefits in writing. It is vital that you understand any limits up front because once you reach them the insurer will not pay anything above the stated amount.

B. Usual and Customary Expenses

'Usual and Customary' refers to the rate of pay out for a visit to the doctor's office, procedure or hospital stay that is based on what most doctors and facilities charge for a particular service in that geographical or comparable area. 'Usual and Customary' charges represent the highest level of coverage on almost all major medical plans.


4. Do not forget that you are able to shop around

Because you are reading this you are probably shopping for a health plan.

Every day people shop for everything from food to a new home and while shopping price, value, personal needs and general market conditions are evaluated by the buyer. Bearing this in mind, it seem very strange that most people never ask how much a procedure, test or even doctor visit is going to cost. In today's ever changing insurance market it is going to become more and more important for these questions to be asked. Inquiring about price will help you to get the most from your plan and reduce your out-of-pocket expenses.

5. Be aware of networks and discounts

Nearly all insurance companies work with medical networks in order to access discounted rates. In broad terms, networks consist of medical professionals and facilities who contract to charge discounted rates for services provided. In the majority of cases the network forms one of the defining properties of your program. Discounts will normally vary from 10% to 60% or even more.

Medical network discounts vary but to ensure that you pay the lowest out-of-pocket expenses, it is imperative that you preview the network's list of doctors and facilities before committing yourself to a policy. This is not only to make sure that your local hospital and doctors are in the network, but also to see what your options would be if you need referral to a specialist.

Follow these tips and you will get cheap health insurance that provides you with the level of cover you require.

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