You can have a claim denied due to pre-existing conditions
Better and less expensive options may be available to you
You can typically cancel the better, “long term” plans any given month
You Will Still Pay The Tax Penalty!
The Affordable Care Act (ACA) and therefore the IRS, treats short term insurance about the same way it treats a parakeet. You cannot avoid paying the tax penalty for not having health insurance by telling the government that you have a parakeet.
Why? The Affordable Care Act doesn’t consider a these plans to be health insurance.
Why? Neither short-term plans nor parakeets provide Minimum Essential Coverage (MEC). To be ACA complaint, an insurer cannot limit what they pay for hospital stays or doctors’ visits. You will find these limits in short term insurance. Health plans that are ACA complaint cannot deny claims based on preexisting conditions and must also meet other standards that short-term plans do not.
You Can Have A Claim Denied Due To A Pre-Existing Condition
In my opinion this is even worse than getting denied for a health insurance policy. When you apply for a short-term policy it is generally issued right away. Your insurer won’t take the time and expense of checking your medical records. So shortly thereafter you will get your policy and think everything is copacetic. If you file a substantial claim they can and probably will, dig through your medical records and try to deny your claim, shattering the false sense of security the policy gave you a just short while ago.
Better less expensive options are often available!
ACA-compliant health insurance is probably your best option if you are not eligible for Medicare, Medicaid or coverage from work.
If you qualify for a subsidy, and almost half of all Americans do, you may find that your premium for a much more robust policy that meets the minimum standards is lower then the cost for a short-term health insurance policy.
You can cancel most “long term” plans any given month
Most so called long term plans can be cancelled any given month. You can usually cancel a policy by faxing or mailing in a form. Some let you do it by phone. Ask your carrier for their rules and if they require that you cancel a certain number of days before your requested termination date.
Unfortunately you can only apply for a compliant plan during the open enrollment period unless you qualify for a Special Enrollment Period. If you cannot buy a compliant plan now, make sure that you consider doing so during the next open enrollment period.
When is the Open Enrollment?
The Open Enrollment period for 2016 started November 1, 2015 and will end January 31, 2016. The Open Enrollment Period for 2017 and future years is scheduled to be October 15th to December 7th.
Buying Outside the Open Enrollment
If you experience a life event that causes you to gain or lose eligibility for health insurance, you may qualify to enroll after the open enrollment period. Examples include: losing employer-sponsored coverage, losing Medicaid, turning 26 moving to another state, getting married or divorced.
As an insurance agent with over 30 years of experience I think it is unconscionable for an agent to offer a consumer a short-term plan when they qualify for an ACA compliant plan. An ACA complaint health insurance policy cannot deny you coverage due to a pre-existing condition, can help you avoid the tax penalty and has no upper limit on the major benefits.
Several companies cover insurance for those who travel overseas for business or pleasure. These international health insurance plans are inexpensive and provide coverage for trips to most areas of the world.
The cost of COBRA insurance is often much more than the low cost medical insurance through a non-group private health insurance policy. This is often true even when the coverage is offered by the same insurer.
If you have always received your insurance coverage through your employer and never purchase medical insurance on your own, you may believe that your group health insurance plan is your best option.
Many people want to know how to apply for COBRA insurance but never ask whether or not COBRA is their best option.
How does COBRA insurance work?
COBRA is a temporary extension of your group health insurance. Typically this extension lasts for 18 months, but in some circumstances this period can be longer. When you are on COBRA you will probably pay the full cost of your insurance. Your employer is unlikely to subsidize your costs.
Often people are lead to believe that group coverage is cheaper because they are unaware that their employer subsidizes their premiums. They are often unpleasantly surprised when they find out how much it really costs.
But often they pay it anyway. They don’t know that group health insurance is usually more expensive than non group or individual health insurance. Many people only shop insurance after COBRA ends.
When they wait until their 18 months is almost over to get the prices for other policies, they are often quite upset with themselves. Most of the insurance coverage that people get through their benefit packages at work is also available to them on a non group basis. You can purchase life insurance or dental insurance for the unemployed without going through an employer.
Be sure to get quotes for health insurance today. You may be surprised to find that your cost for COBRA insurance is higher than you would pay with another policy that provides the same coverage.
Those needing health insurance for individuals with pre existing conditions should be sure that they don’t take the first “no” as their final answer. They may pay more than they should if they take no for an answer or accept the first costly option. Not all insurance companies treat every condition and individual the same way.
An individual who believes that they have a pre existing health condition that will affect their ability to enroll in an insurance plan should first verify that their condition is a problem with all the plans available. Even if one or two medical insurance companies considers them a high risk or denies coverage, they should not assume that a second or third company will do the same.
Special Rules for Children with Pre Existing Conditions
Although there are certain conditions that adults will be denied for when they apply for any underwritten policy, this isn’t the case with children. The recent health care reform mandates changes this. As of September 23, 2010 (with few exceptions) a child who applies with a parent cannot be denied based on their medical history so long as one parent is approved for coverage. This is also the case when an individual applies through their place of business for a group health insurance policy with their child.
Adults with Pre Existing Medical Conditions
Health insurance companies do not all have the same underwriting guidelines. Each is a separate business and they will often assess the risk of insuring an individual differently. For this reason a person diagnosed by their provider with high blood pressure and high cholesterol, might be turned down based on their preexisting conditions when they apply for enrollment in a policy offered by one company. A second company may think that that person is a high risk, but approve their application but ask that they pay higher premium. A third company might not consider them a high risk at all and will approve that person for any of their plans with a standard premium.
Different companies will have different height and weight guidelines and therefore different opinions regarding whether an individual obese or whether they are just heavier than the average person and therefore will be willing to accept the risk of insuring that person. These differences apply to more serious preexisting conditions as well. Pre existing conditions like cancer, diabetes and heart conditions are treated differently by different insurance carriers.
You have to shop around not only for price and coverage, but also for the most favorable underwriting decision. Working with an agent who knows the health care insurance landscape in your area can go a long way towards making the experience of shopping around for health insurance less consuming and less of a hassle. An agent may be able to keep you from paying more than you should.
This is especially true when looking for private medical insurance for an individual with a pre existing conditions. Finding access to affordable health insurance means gaining affordable access to otherwise costly providers that can make a difference in the quality of your life.
There are ways to lower your monthly cost for health insurance. Three powerful ways include raising your deductible, shopping for a better price and becoming a better risk.
Your Deductible Matters
Raising your deductible even a small amount may result in a significantly lower premium. Although this strategy means that you will have less coverage, it may result in your having more coverage per dollar spent on medical premiums.
Compare Annual Premiums with Annual Deductibles
When making a decision about raising your deductible, be sure to consider how much you will save per year. Deductibles for health insurance are not monthly they are based on a 12 month period in most cases. To compare apples to apples, you should compare your savings over the same time period.
Shop Around for Medical Insurance
Comparison shopping is always a good idea. You may be able to dramatically reduce your monthly cost for health insurance by getting quotes on websites like this one. However, before making a final decision, be sure that the insurance company is approved by your state’s insurance department and that the policy covers what you need.
Healthier People Pay Less for Health Insurance
One little talked about way to lower your rates for health insurance is to become a better risk. This can mean that you have to do some research.
If, for example, you are in a higher rate category because of your weight it will pay to know what weight you need to be to get into the cheaper category. You may be paying 25% more because of five or ten pounds.
If you have are paying more because of a medical condition that is now resolved, you may be able to reapply and get a lower rate. If you don’t know why you are paying more, you will not know that you should shop around after you have been released by your doctor.
Taking on a little more risk by increasing your deductible can result in your paying much less for your insurance policy. You may also reduce your monthly costs for health insurance by doing some comparison shopping on websites like this one. Becoming healthier can also help you get a better rate. Combining these strategies can result in your monthly cost for medical insurance dropping substantially.
If your budget is tight, it may be time to start cutting the fat on your insurance policies. You may have unnecessary coverage on your car insurance policy and you may have deductibles that are too low on your other policies.
Buying too much insurance can be as devastating to our finances as buying too little. The difference is that having too much insurance is like wet rot destroying our financial homes little by little over time and having too little hits us like a grenade exploding in our living rooms.
You will get better coverage if you pay more for it. However, the question you should ask yourself is “will I get at least a dollars worth of additional value for each extra additional dollar I spend on insurance?”
Whether you have a Texas car insurance policy or a car insurance policy in Pennsylvania, you may not want physical damage coverage on an old car. If you do find out how much your insurance company is likely to pay you if that car is stolen or totaled. If you feel that amount is too low, you may want to drop that coverage and save some money. (Physical damage coverage is the part of your policy that pays you to replace your car. Dropping or reducing this coverage has no impact on what your carrier will pay a third party if you were to hit them.)
Insuring yourself against a $100,000 heart attack is probably a very good idea. Insuring yourself against a $200 doctor visit probably isn’t. Insurance works best when you let the insurance company cover you for the big stuff and you cover yourself for the smaller stuff.
As a general rule, as you spend more money on insurance, you will get better coverage. This is true for car insurance, medigap insurance, and all other types of insurance. However, the benefits do not increase at the same rate that the cost does. Insure yourself against the catastrophic events that you cannot cover yourself and think carefully about insuring yourself for the smaller things you can pay for yourself.
An insurance premium is the money that you the consumer pays to the insurance company. Insurance premiums are typically paid money monthly, quarterly, semiannually or annually.
How Do You Lower Your Insurance Premiums
Most suggestions for lowering your premiums fall into two categories. One category involves doing things that will make the insurance company see you as a lower risk. The other category involves ways to shop around for better coverage.
How to Lower Health Insurance Premiums
Your medical insurance premiums are based on several things. They include your geography, your health history, your current health status and the share of the risk you are willing to take.
Your premium is also partially based on other factors that are not within your control. These include your age, gender and the costs of health care.
Since you are more likely to go to doctors who are near to you, you will get a better rate if you live in an area where the doctors charge less.
Your medical history plays a big part in determining your premium. Being healthy and avoiding major health issues is the best way to keep your rates down. Those who do not smoke are usually charged less. Those who maintain a healthy body weight are also charged less.
You can take more risk and thereby lower your premium by taking a policy with a higher deductible. These policies are often better values than their more expensive sisters. The coverage afforded by a higher deductible policy is less, but the difference in premium usually more than compensates for the difference.
How to Lower Auto Insurance Premiums
Are you asking yourself How to Lower My Auto Insurance?Auto insurance rates are also partly based on geography. Your driving record and the cars you drive can be factors also.
Your age and gender can also impact your rate. However after the age of 30 or so the rates for men and women will be the same for most carriers assuming that the other rating factors are the same.
Where you live can impact your car insurance rate, but for different reasons than geography affects medical insurance rates. People tend to have more accidents areas that are more congested. This raises the premiums for those who live in cities over what they might pay in nearby towns. Also some areas have more thefts than others. This raises the rates for those who have “other than collision” insurance on their cars.
Your driving record is a very good predictor of whether you are going to get into an accident or not. Driving at safe speeds with an eye toward safety is always a good idea and it can keep your car insurance premiums down.
You can lower your costs by taking on more risk. Raising your deductible on your collision insurance and other than collision coverages can result in your getting a lower premium. You can eliminate these parts of your policy and reduce your coverage by more.
Collision insurance and other than collision insurance affects the money the insurance company might pay to you if your car is affected by a covered peril. It doesn’t affect how much it will pay to a third party or how much a driver who hit you might pay you.
Vision insurance coverage is a nice feature of many medical insurance policies. Maintaining your eye health is important and having an insurance company help you pay for your eye exam can help you to maintain good vision.
Some vision insurance plans will cover more than the exam. You may find that prescription eye glasses or contact lenses are partially covered as well.
Many people mistakenly believe that if they do not purchase a health insurance policy that includes vision insurance, they will not be covered if they injure an eye. You will find that a standard health insurance policy will cover injuries to the eye.
The same is true of eye diseases such as glaucoma. You can expect to have medical expenses associated with most diseases of the eye covered by your medical insurance policy.
There are several reasons why the presence or absence of a vision plan should not be a major factor in the selection or rejection of a health insurance policy.
Medical insurance – not vision insurance – will typically cover injuries to the eye
Medical insurance – not vision insurance – will typically cover diseases of the eye
You can find cheap discount eyeglasses online
Eye exams are relatively inexpensive
It is better to have a policy that includes vision insurance than to have one that doesn’t. Vision insurance can help you maintain eye health. However, overvaluing the coverage can be a mistake. Be sure that you don’t pay more for vision insurance than you would pay if you purchased your eye exam and prescription eyeglasses with your own money.
Vision insurance is a benefit that is nice to have, but one that people sometimes overpay for.
Before you can buy inexpensive medical insurance with confidence you will need to do a little research. There are some strategies you can use to avoid paying too much. There are three main steps. The first step is learning how health insurance policies work. The second involves shopping around. The third step is to compare the policies.
In order to compare health insurance policies, you should learn how they work. Knowing how health insurance deductibles, copays and coinsurance work is crucial.
Once you have a basic understanding of how insurance policies work, you should then start to shop around. Be sure that you limit your shopping to insurance companies that are approved to sell health insurance in your state. You can check with your department of insurance to see which companies have been approved for your area.
No insurance company offers the best bargain for every age, gender and situation. Each situation should be looked at separately. Some companies are better than others, but it is important to look at the policies as well. Not all of the policies offered by a good company will be good for you.
Finding insurance cover at a good price involves a little work, but learning a little more about health insurance can mean lowering your costs a lot.
The stop loss or out-of pocket maximum amount in a personal health insurance policy is as important to understand as is your deductible. Knowing how this provision of your policy limits your cost for health care makes it easier to select the right policy for yourself or your family.
Most health insurance policies will have a coinsurance provision that will require your paying 20% or more of your expenses after you have met your deductible. The stop loss provision limits your coinsurance to a few thousand dollars in most cases.
This way you will not be required to pay 20% of a catastrophic medical expense. You may required to pay 20% of the first $5,000 or $10,000 that is in excess of your deductible.
Regarding out of pocket maximum or medical stop loss. Insurance companies have 2 different ways of making their calculations. To make it even more confusing, the limits imposed by these provisions may not apply to all of your spending.
When comparing policies and determining which to buy, it is important that you understand which calculation method each company uses so that you can select the right policy. In some policies, your out-of-pocket maximum or stop-loss only limits the amount of coinsurance you are required to pay. In others, the limit also includes your deductible.
You may find two separate policies that work the same way, but have different stated limits for their out of pocket maximums. Both may require that you pay the first $1,000 of your medical bills each year (this is your deductible) and then 20% of the next $7,500 of your expenses each year (this is your coinsurance). The literature for one policy may express your out of pocket maximum as $1,500 because their calculation ignores the deductible. The other may express your out-of-pocket maximum as $2,500 because they include the deductible in their definition.
Not knowing how each policy defines these terms can cause you to under value or over value a policy and make the wrong choice. For this reason, it is important that you ask questions or read the literature carefully. You should be able to determine what your deductible and coinsurance limits are by reading each policy’s outline of coverage.
Regardless of which method a company uses to calculate their stop-loss or out of pocket maximum, the term applies to a 12 month period unless the policy’s term is less than 12 months. With some policies, the 12 months will start on the effective date or its anniversary. With others it may start on January first of each year.
The Term “Maximum Out Of Pocket” Can Be Misleading.
This is because the stop loss or maximum out of pocket provision will probably not include your copays. Copays are usually not limited. If you have to pay a copay each time you visit your doctor, you will pay that copay even after you have met your deductible and coinsurance limit.
Family deductibles, coinsurance and stop-loss provisions.
The stated limits for your cost shares, which include your deductible, coinsurance and stop loss, may be based on a per-family member basis. It could also be based on the medical expenses for the family as an aggregate. Stop loss insurance provisions as well as deductibles can work one of three ways:
You can have separate out of pocket limits for each family member
You can have one out of pocket limits limit for the family as a whole
Combined out-of-pocket limits
Separate limits for each family member
Which can be further limited by your family limit
The stop-loss or out of pocket maximum provision is an important part of a health insurance policy. Understanding how this provision limits your exposure should you have catastrophic medical expenses is important if you are going to buy the right health insurance policy.