Still Doubtful About Buying Health Insurance?

Health procurement has been a major cause of concern and area of research for every civilization of the past and of the modern world. The evolution of medicines and courses of treatment is very diverse and dramatic. So much money and effort is being spent on research to find cure of diseases every year. So many medical schools are dedicatedly working to bring out quality medical professionals to solve health issues. With continued efforts and resources we have sufficient know how and infrastructure to cure or control many diseases and thus saving many lives or improving life quality in the process.

But can the common man avail this treatment? Availing medical treatment can be a big financial pain. Many in a country like India die or worsen their health condition because they don’t take the required treatment or delay the treatment because of affordability issues. That is why health insurance is very important. Health insurance saves you in your most critical times. It acts as an alternative source of financing your hospital bills (including medicine bills of one month prior to hospitalization and three months post hospitalization).

Even though medical emergencies do not happen frequently to most people one cannot afford to not have health insurance. With rising medical costs one would be exposing oneself to high amount of risk if not well equipped with insurance. Generally the attitude of young people towards health insurance is very lax. Most people ignore when they are told the importance of having health insurance. Some still treat it as an avoidable expense or a luxury. They realize its value when they see some of their relative or friend in that situation where they need health insurance the most.

Health emergencies come uninvited; they can come in the form of a sudden road accident or heart attack. Immediately, a good amount of money has to be arranged to get the patient required treatment. Sometimes, the bill reaches in lacs. That kind of money is not available so readily for most of us. It is high time we understand the value of having health insurance cover for our family. With affordable premiums if we can get protection then why shouldn’t we go for it?

Health insurance policies have many tax benefits also, under section 80D of the Income Tax Act, 1961, the premium paid is deductible from the total taxable income upto Rs.15000 for self, spouse and minor child. If individual or spouse is more than 60 years old the deduction available is Rs 20,000. An additional deduction for insurance of parents (father or mother or both) is available to the extent of Rs. 15,000/- if less than 60 years old and Rs 20,000 if parents are more than 60 years old.

When buying health insurance one needs to carefully study the policy. There are some clauses that need special attention, for example, whether the insurer is providing reimbursement of the full room rent of the hospital or upto some limit. Some insurers have a clause like the room rent is paid upto 15% of the total sum insured, over and above it is paid by the policyholder. These technicalities can be discussed with a professional. Also if one compares the insurance plans online on the sites of insurance comparison portals, these points are highlighted in the best interest of the customer. Thus, plan and stay happy. Insurance not only gives us financial aid when needed it also gives us peace.

The Features Of A Good Health Insurance Plan

The skyrocketing medical expenses, make health insurance plans very essential. When you have an insurance plan, you feel more secure because you are covered even in emergency medical situations. You do not have to start looking for money to get medical attention and you do not have to use the money you have to cater to the medical needs when you have a health insurance plan. There are so many health insurance providers today offering all sorts of plan and you therefore must know what features to look out for to get a plan that is most valuable for your medical needs.

1. Good room rent limits. This is an important feature when hospitalization is inevitable. A good health insurance plan should not have a maximum limit on the room rent so that you know this expense is well covered no matter how long you or a member of your family gets admitted in hospital. Such plans are however hard to find because most come with small percentages on maximum limits, they will pay for room rent. At least choose a reasonable percent to get better value from your plan.

2. Preexisting disease cover. A good plan should cover even pre-existing diseases you have before you buy your insurance plan. This is the best kind of policy because then you get the important medical care you need with the diseases compared to plans that do not include preexisting diseases in their plans. Choose a plan that covers the preexisting conditions and one that has a lower waiting period for claims on the same.

3. Impressive hospital network. When getting a health insurance plan, a good one is the one that makes it possible for you to get medical help from a number of hospitals. Such an impressive hospital network ensures that you get help as soon as you need it and from a hospital nearest to you. Choose a plan that directly ties you up with the good hospitals within your locality to enjoy better delivery of services. Cashless facilities are best because you won’t have to go through the process of filing for reimbursements.

4. High no claim bonuses. The truth is that you will not always make claims on your health insurance. For this reason, a good plan should offer you no claim bonuses when no claims are made. It affects the sum assured by the next renewal, but you definitely want to choose a policy that offers you high no claim bonus, so you get better value for your money even when you do not end up laying claim.

5. Least exclusions. A good health insurance plan should cover most of your health needs. There is always an exclusive section of the policies and unfortunately most people forget to go through it before taking up the policies. Ensure you check the section out and select a plan that has the least number of exclusions to help you relax knowing that it has you covered for most health issues.

5 Keys to Choosing the Right Individual Health Insurance Plan

The internet has made it easier to compare different health insurance policies and shortlist health insurance plans.

With the right health insurance policy, one can make substantial savings if a family member gets sick.

Although there is no golden rule to choose the right individual plan, yet, some common tips help in the decision making process. Five keys to choosing the right individual insurance plan have been listed below:

• Determine your need and your affordability: Even before you start your online search for insurance plans, one needs to be sure about the details of the plan. You need to make sure that the benefits offered by the plan covers what you need for yourself and your family. However, the perfect plan will also come at a considerable cost. As an informed customer, you need to do a proper cost benefit analysis to make sure your trade-off between price and benefit is in the appropriate proportion. If we take into account, frequent trips to the doctors, medications and dental coverage – such scenarios eliminate unsuitable plans and makes the comparison process much easier.

• Don’t overbuy: The scenario is similar to buying a luxury car where the monthly EMI equals your home loan payment. There is no point in purchasing a health insurance policy with benefits which are unlikely to be used at a high and unviable cost. For relatively young and healthy individuals, a policy with a high deductible is more suitable. Deductibles are the amount paid by insurers before certain benefits kick in. A plan with a decent deductible will cost considerably less per month and could save money in the long run.

• Walk through several plans: It is always advisable to go through several plans. In the process, benefits associated with different health insurance plans can be reviewed and analyzed for better decision making. At first glance, some plans may look appealing. Later, the same plan turns out to be a costly affair due to cost sharing arrangement. The burden of medical cost in the future will be a big headache. Hence, going through and analyzing several plans is the best way forward.

• Co-insurance and co-payments: Several health insurance plans require the holder to contribute to the coverage payments. The contribution is called co-insurance and is the portion the customer has to pay after deductible. A co-pay is a flat fee one has to pay while paying a visit to a doctor or specialist. While choosing a personal health insurance policy, consumers should look into co-insurance and co-payments factors.

• Reputation matters: After identifying the price and need of the plan, reputation of the company should also be in the reckoning. Ideally, a company with a long haul in the market should be trusted and relied upon. There are many ways to assess the standing of insurance companies and their health insurance policies.

Guide to Individual Health Insurance

The new Covered California health insurance marketplace offers a wide range of affordable health plans for you to choose from. Whether you are self-employed, or looking for coverage over and above what your employer currently offers, there is a plan that will likely meet your needs. Federal regulations require that health plans operating under the Affordable Care Act (ACA) meet certain access requirements. In California, those requirements include timely access to healthcare providers, as well as geographic access standards.

Here is a general guide to individual health insurance that you can refer to when choosing a plan. And do not forget these important dates regarding open enrollment for 2016.

Provider Networks

When selecting a health insurance plan, it is important to verify the plan’s provider network of doctors, hospitals, nurse practitioners, therapists, and other health care providers. It is equally important to understand what is not covered as well. Understanding your plan’s provider network helps you save money, receive better care, avoid unexpected fees and costs, and be happier with the care you receive.

Out-of-Network Care

You are not restricted to health care providers in your network, but should you decide to use one outside of your network, health insurance will cover less resulting in a higher out-of-pocket cost for you, except in the case of emergencies.

Provider No Longer in Network

If your health care provider leaves your network, you will generally need to find a new doctor inside the network, and most plans will assist you in doing so. As a rule, a health plan’s continuity of care policy allows a patient to continue care with a doctor no longer in the network for a certain period of time at the lower cost-sharing rate.

Cost-Sharing Requirements

Each plan has different cost-sharing requirements. Typically, your overall share of costs is a combination of the premiums you pay plus any other co-payments, co-insurance or deductibles for which you are financially responsible.

How to Find a Doctor

In most cases, the plan you choose will have a list of doctors who accept your insurance. The Medical Board of California offers some great tips on choosing a doctor:

  • Ask friends, family or co-workers about physicians they like.
  • Ask your county medical society or association for names of physicians in your area.
  • Once you have some names, call and ask if the doctor is accepting new patients and whether they accept your insurance plan.
  • Check with the Medical Board to verify the physician has a current California license.
  • Meet with the physician and consider having a physical done to determine if this is the doctor for you and your family.

Selecting a Hospital

When you undergo treatment in a hospital or other facility, ask to have any services performed by in-network providers. Your physician may decide which hospital is appropriate for your care, but you can still check the hospital’s California HealthCare Foundation rating by visiting www.calqualitycare.org.

This guide to individual health insurance is far from complete. For more information and a more comprehensive glossary of insurance terms and other marketplace information, visit www.healthcare.gov.

Learn More

From preventative services to out-of-pocket maximums, understanding your individual health insurance plan options can be a confusing – and frustrating – endeavor. A health insurance agent is one of your best resources for information on coverage that meets your unique needs.

Buying Health Insurance Through a Broker

In its most simple definition, a health insurance broker (also commonly known as an agent) is someone who is licensed to sell health insurance. However, there are many other services they provide you that fall under the umbrella of selling health insurance. Here are some of the most important:

  • Perhaps the most important fact to know about working with an agent is that it’s free. Insurance agents are paid by insurance carriers, not by consumers. So don’t worry about having to pay some service fee for signing up for a plan with an agent, because it will cost you nothing more than if you were to do it yourself
  • Health insurance is confusing, and an agent will explain it to you until it makes sense. Ask all the questions you want, that’s what they’re there for. Want to know what your coinsurance will be on a certain plan? Want to know what coinsurance even means? Ask away!
  • An agent can help you compare plans that you’re interested in. When you let an agent know what it is you’re looking for, they will narrow down your possibilities and explain the benefits of each. They can check to see if your doctors and preferred medical facilities are in-network, and they can just to see if any prescriptions you take are covered (and how much).
  • Your agent is your agent as long as you have your policy. This means that you have someone you can contact when you have questions or even when you want to shop around for a new plan. You’ve got someone in your corner, as opposed to just winging it and picking out a plan on your own.

Because I’m sure you don’t want to be here reading all day, those are only a few of the biggest benefits of using a licensed agent to buy health insurance. That’s not even including how much time and frustration an agent can save you (we’ll save that for another article!).

To make it even more convenient for you, many brokers have the ability to access plans that are both on and off-exchange (government-run Marketplaces for health insurance). This provides you with even more options. Additionally, for agents who can access on-exchange plans, they can also determine your subsidy eligibility that can lower your premium and out-of-pocket expenses. Again, saving you yet another headache.

The next time you need to enroll in or change a health plan, keep a licensed agent in mind- it won’t cost you anything, but it will certainly save you a lot.

Angela is the Media Content Writer for Health Choice One, a health insurance brokerage that charges nothing to help individuals and families get health coverage. Health Choice One works with major medical plans like those discussed in this article. Additionally, agents can help you enroll in short-term and supplemental plans if you’re not currently eligible to enroll in a major medical plan.