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HERE
Copyright Choice City Health LLC 2010
Dana Griffin
EMAIL
PH) 970-407-9399
PH) 970-407-9399
Health Insurance
How long does it take to get approved for a health insurance plan?
This varies from company to company. For folks who are generally very healthy with little
medical history it can be as little as 2 to 5 days. However if the insurance company orders
medical records it can take longer - sometimes 3 to 4 weeks. Normally it is not necessary
for health insurance companies to order medical records with the application but they can
in certain situations.
Can I get "dropped" by an insurance company?
None of the companies we recommend or work with currently can single you out for
cancellation or drop you. As long as you keep paying your premiums you may keep the
plan as long as you want. You can also choose to terminate the plan on your terms if you
choose to.
Do I pay extra to use a broker?
No. The cost of a health plan is exactly the same to the penny whether you use a broker;
apply on line or go through the insurance company directly. The cost is the same each way.
Given that this is the case why wouldn't you use a broker? You get impartial advice from an
expert in the industry who can help guide you through the potential mine fields and pitfalls.
Will my rates go up in the future?
Unfortunately the answer is probably yes. They've been going up consistently over the last
30 years and it doesn't look like that will change any time soon.
Two major factors that cause rates to go up:
1) Each year we get older and the risk of claims is higher the more we age.
2) Medical costs are increasing on average about 12% a year annually and have done so
since 1970. As medical costs increase, so do claims and therefore premiums.
As independent brokers, if any of our clients' plans increase in cost out of line with other
options we can shop other carriers and other companies to help them stay with the best
deal and most competitive plans.
What is co-insurance?
Co-insurance is the percentage of coverage offered by the insurance company usually
after the deductible. The most common type traditional plan is 80% or known as an 80/20
plan. This means that once you reach the deductible the company pays 80% and the
insured pays 20%.
All good plans will have a cap or a limit on the co-insurance that you will pay.
Again depending on the company or plan this can range anywhere from $2,000 to $10,000.
What is a HSA plan? Is it normal health insurance?
Yes. The HSA stands for Health Savings Account. The insurance operates like regular
major medical health insurance. Typically it has a higher deductible and then usually pays
at a 100% after the deductible or in some cases at 80%.
The Health Savings Account is a feature through which you can write off most medical
expenses incurred on your tax return. In 2009 the maximum deduction is $3,000 for an
individual or $5,950 for a family. In 2010 it will be $3,050 for an individual and $6,150 for a
family.
If there is no co-pay on my plan, can I still go to the doctors?
Yes. For a plan without co-pays you can still go to the doctors as often as you wish. It
generally means you'll pay more for each visit so it's always good to weigh the extra cost
per visit versus the monthly savings on the health insurance premiums.
What is a PPO or Network?
This is the same thing. To help keep medical costs and health insurance premiums lower
most companies now offer a PPO network where if you choose to receive care within the
network you get better benefits as those providers have contracted with the insurance
company to provide the services at a lower cost. If you have a PPO plan or a network plan
you always want to make sure that (in order to get the best benefits) you stay in-network
wherever possible. It does also mean however that you can still be covered for doctors and
hospitals out-of-network.
What happens if I have a pre-existing condition?
Each health insurance company looks at each pre-existing condition differently. Therefore
some companies would be a better fit for someone with high blood pressure than others. It
may also be a different company that may be a better fit for someone suffering from
Asthma. For free advice you should speak with a broker as they can help you determine
which company would be the best fit for your particular situation.
I've already been declined coverage, what options do I have?
This really depends on when you were declined, the reason and which state you're in.
Again you should definitely contact a broker. We'll be glad to go through your specific
options. You may be able to get coverage with another company and most states also have
options for folks who have been declined from more than one company.
What is a deductible?
A deductible is the amount that you pay before the health insurance kicks in. Major medical
services kick in after the deductible however depending on the plan, preventative care,
doctor visits and prescription coverage, may kick in before the deductible.
What is the maximum out of pocket?
That is the most that you would be liable to pay e.g. the deductible plus your co-insurance.
If your plan is a 100% plan then it would be only the deductible. Some plans also have one
deductible per person; others have one for the entire family. You want to know the benefits
of the specific plan you are looking at.
I've heard about PPO discounts if I stay in-network, what is this?
Basically all medical providers have a full list price for any medical service. Insurance
companies with their buying power rarely pay the full price and negotiate lower costs for
their members from providers. This is how a PPO network works.
A PPO provider would provide services at a lower cost to someone with health insurance
because of the negotiated discounts. Depending on the services received this could be
anywhere from a 20 - 60 % discount. So it's always in your best interest to stay within the
PPO network wherever possible to receive these discounts.
What is short-term health insurance? Is this right for me?
Short Term Health Insurance is regular major medical coverage and is really designed for
people in transition. For example they have a waiting period before their group insurance
starts; they may only be a year away from Medicare and just need insurance for one year.
Short Term insurance lasts for up to 12 months and is much lower cost than permanent
traditional health insurance because at the end of 12 months the plan expires. You can
apply for multiple short term plans however the danger to be aware of is that short term
plans don't cover pre-existing conditions. If you have any pre-existing condition that you'd
like to be covered it may not be the best option for you. If you have any questions give us a
call and we'll be glad to guide you through your specifics.
Why do I have to pay now if I don't know if I'm going to be accepted?
All major health insurance companies require your payment information on the health
insurance application. Some companies take it out when you apply however it is more
common for the payment to be processed once you're approved and your policy is in force.
Each company differs a little in their processes.
Does applying mean I have to take the plan?
No. Submitting your application does not commit you to taking health insurance.
It enables your application to be processed by the underwriters and for the health
insurance company to come back with an offer - either the standard offer or a modified
offer depending on your specific situation. You always have a 10 day free look period by
law once you receive the documents on your health insurance to decide whether you want
to keep the plan or not. If you cancel within this free look period then youýll get a full refund
of any premiums you've already paid.
Can I cancel at any time?
Yes you can. Most companies pro-rate by the day so you're not locked in for any time
period. And if you did cancel during the middle of the month most companies will refund the
premium for the days you have not used. One or two companies will cancel the coverage at
the end of your current month.
.
This varies from company to company. For folks who are generally very healthy with little
medical history it can be as little as 2 to 5 days. However if the insurance company orders
medical records it can take longer - sometimes 3 to 4 weeks. Normally it is not necessary
for health insurance companies to order medical records with the application but they can
in certain situations.
Can I get "dropped" by an insurance company?
None of the companies we recommend or work with currently can single you out for
cancellation or drop you. As long as you keep paying your premiums you may keep the
plan as long as you want. You can also choose to terminate the plan on your terms if you
choose to.
Do I pay extra to use a broker?
No. The cost of a health plan is exactly the same to the penny whether you use a broker;
apply on line or go through the insurance company directly. The cost is the same each way.
Given that this is the case why wouldn't you use a broker? You get impartial advice from an
expert in the industry who can help guide you through the potential mine fields and pitfalls.
Will my rates go up in the future?
Unfortunately the answer is probably yes. They've been going up consistently over the last
30 years and it doesn't look like that will change any time soon.
Two major factors that cause rates to go up:
1) Each year we get older and the risk of claims is higher the more we age.
2) Medical costs are increasing on average about 12% a year annually and have done so
since 1970. As medical costs increase, so do claims and therefore premiums.
As independent brokers, if any of our clients' plans increase in cost out of line with other
options we can shop other carriers and other companies to help them stay with the best
deal and most competitive plans.
What is co-insurance?
Co-insurance is the percentage of coverage offered by the insurance company usually
after the deductible. The most common type traditional plan is 80% or known as an 80/20
plan. This means that once you reach the deductible the company pays 80% and the
insured pays 20%.
All good plans will have a cap or a limit on the co-insurance that you will pay.
Again depending on the company or plan this can range anywhere from $2,000 to $10,000.
What is a HSA plan? Is it normal health insurance?
Yes. The HSA stands for Health Savings Account. The insurance operates like regular
major medical health insurance. Typically it has a higher deductible and then usually pays
at a 100% after the deductible or in some cases at 80%.
The Health Savings Account is a feature through which you can write off most medical
expenses incurred on your tax return. In 2009 the maximum deduction is $3,000 for an
individual or $5,950 for a family. In 2010 it will be $3,050 for an individual and $6,150 for a
family.
If there is no co-pay on my plan, can I still go to the doctors?
Yes. For a plan without co-pays you can still go to the doctors as often as you wish. It
generally means you'll pay more for each visit so it's always good to weigh the extra cost
per visit versus the monthly savings on the health insurance premiums.
What is a PPO or Network?
This is the same thing. To help keep medical costs and health insurance premiums lower
most companies now offer a PPO network where if you choose to receive care within the
network you get better benefits as those providers have contracted with the insurance
company to provide the services at a lower cost. If you have a PPO plan or a network plan
you always want to make sure that (in order to get the best benefits) you stay in-network
wherever possible. It does also mean however that you can still be covered for doctors and
hospitals out-of-network.
What happens if I have a pre-existing condition?
Each health insurance company looks at each pre-existing condition differently. Therefore
some companies would be a better fit for someone with high blood pressure than others. It
may also be a different company that may be a better fit for someone suffering from
Asthma. For free advice you should speak with a broker as they can help you determine
which company would be the best fit for your particular situation.
I've already been declined coverage, what options do I have?
This really depends on when you were declined, the reason and which state you're in.
Again you should definitely contact a broker. We'll be glad to go through your specific
options. You may be able to get coverage with another company and most states also have
options for folks who have been declined from more than one company.
What is a deductible?
A deductible is the amount that you pay before the health insurance kicks in. Major medical
services kick in after the deductible however depending on the plan, preventative care,
doctor visits and prescription coverage, may kick in before the deductible.
What is the maximum out of pocket?
That is the most that you would be liable to pay e.g. the deductible plus your co-insurance.
If your plan is a 100% plan then it would be only the deductible. Some plans also have one
deductible per person; others have one for the entire family. You want to know the benefits
of the specific plan you are looking at.
I've heard about PPO discounts if I stay in-network, what is this?
Basically all medical providers have a full list price for any medical service. Insurance
companies with their buying power rarely pay the full price and negotiate lower costs for
their members from providers. This is how a PPO network works.
A PPO provider would provide services at a lower cost to someone with health insurance
because of the negotiated discounts. Depending on the services received this could be
anywhere from a 20 - 60 % discount. So it's always in your best interest to stay within the
PPO network wherever possible to receive these discounts.
What is short-term health insurance? Is this right for me?
Short Term Health Insurance is regular major medical coverage and is really designed for
people in transition. For example they have a waiting period before their group insurance
starts; they may only be a year away from Medicare and just need insurance for one year.
Short Term insurance lasts for up to 12 months and is much lower cost than permanent
traditional health insurance because at the end of 12 months the plan expires. You can
apply for multiple short term plans however the danger to be aware of is that short term
plans don't cover pre-existing conditions. If you have any pre-existing condition that you'd
like to be covered it may not be the best option for you. If you have any questions give us a
call and we'll be glad to guide you through your specifics.
Why do I have to pay now if I don't know if I'm going to be accepted?
All major health insurance companies require your payment information on the health
insurance application. Some companies take it out when you apply however it is more
common for the payment to be processed once you're approved and your policy is in force.
Each company differs a little in their processes.
Does applying mean I have to take the plan?
No. Submitting your application does not commit you to taking health insurance.
It enables your application to be processed by the underwriters and for the health
insurance company to come back with an offer - either the standard offer or a modified
offer depending on your specific situation. You always have a 10 day free look period by
law once you receive the documents on your health insurance to decide whether you want
to keep the plan or not. If you cancel within this free look period then youýll get a full refund
of any premiums you've already paid.
Can I cancel at any time?
Yes you can. Most companies pro-rate by the day so you're not locked in for any time
period. And if you did cancel during the middle of the month most companies will refund the
premium for the days you have not used. One or two companies will cancel the coverage at
the end of your current month.
.
