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.
I was about to end this series about selling health care insurance across state lines but then a picture of my local bank popped into my head. The reason why this picture made me think is that the bank isn’t there anymore.
None of the local banks are around anymore! Why? They deregulated the nation’s banks about twenty years ago. (Banks were not allowed to cross state lines before then.) Do you remember small local banks? Are any of them still in your area?
The big banks gobbled up the small banks and the bigger banks gobbled up the big banks once they were allowed to open branches in other states.
My fear is that allowing our federal government to reduce regulation on the insurance companies will have the same impact on the industry as deregulation had on the banking business. Our coverage options will diminish, but eventually we will forget the smaller insurance companies just like we’ve all but forgotten the smaller banks that used to compete in our market.
It is entirely possible that this simplistic idea will result in less competition in the health insurance industry and not more. More competition resulted in less competition in the banking business.
Why won’t it do the same to the insurance industry? Will we wind up with fewer insurance companies to choose from when we need insurance coverage for health care?
If we allow the federal government to do this, who wins? The biggest insurance companies win. Who loses? You and I lose.
Allowing American health insurance companies to more freely sell across state lines could result in higher prices for those who need it most! I know that we have heard politicians on the news stating just the opposite time and time again, but I sincerely believe that they are wrong.
Although with proper regulation, additional competition can result in lower rates for all, unbridled competition could result in the destruction of our private health insurance system and real damage to those who have medical conditions. Deregulation won’t be good for business owners nor will it be good for consumers.
Why? A new company is likely to attract a disproportionate number of younger and healthier policyholders. This means that they will be able to charge less and they will be able to get more business.
Isn’t this a good thing? It could be, but it could also backfire in a big way.
The following is not based on my view as a Democrat or a Republican, but my view as an experience as an insurance agent who has been around the block a few times.
Health Care Reform Has Already Hurt Children!
It could backfire just like their mandate that was supposed to force the American health insurance companies to insure all children already has. You may want to watch my video about how health care reform is hurting children.
Have you had a chance to view this information on the news? Are the politicians working feverishly to correct their mistake, or is it being swept under the rug.
Once the older established companies enough of their healthier clients to the new company, their rates will go up very rapidly over a short period of time. The older and sicker policyholders may not have the option of switching to the new company and they get hurt by deregulation.
The new company can come into the state and offer a low price but not lower the average cost of insurance! Moving into the new state will be a good business decision for the new insurance company.
However it will not create a better situation for the average policy holders of that state. Although the healthier policyholders who are able to switch may benefit for a time, the sicker policyholders may get be forced to pay more and more and more. Their premiums may go up to the point where their coverage is completely unaffordable.
I’ll give you one big reason why allowing health insurance companies to sell across state lines won’t solve our problems: They are already selling across state lines!
Although Connecticut has only 1.5% of the nation’s population we have a significant amount of competition in our health insurance markets. We have 8 companies competing in the individual medical insurance market. We have 17 health insurance companies that compete in the group medical insurance market.
Almost all of the companies sell in multiple states. We have a Blue Cross Blue Shield franchisee. We have a United Health One subsidiary (formerly United Healthcare). Aetna and Cigna also sell in Connecticut.
The issue has been misrepresented by many people who are supposed to know what they are talking about. The issue isn’t whether or not insurance companies should be allowed to sell across state lines. The issue is about taking the states power away and making it easier for the insurance companies to sell across state lines.
Insurance companies want to get approval from one regulatory body and then be allowed to sell across the country. Allowing companies to do this will increase competition in theory, but in my opinion it will backfire in the long run.
This issue is smoke screen at best. And at worst it is part of a conspiracy to make the rich insurance companies richer and the rest of us poorer.
I never heard my Great Uncle Reverend McFadden accuse anyone of telling a lie. He would at times inform us that someone that we told a “falsehood.” If you say something that isn’t true it is only a lie or a sin if you know that what you said was not factual when you said it.
In honor of Reverend, I’m not going to call the politicians and others who have created and promulgated this myth liars. They could be stupid and/or uninformed. It actually does sound like a good idea until you think about it a little and do a little arithmetic.
Increasing the competition among private health insurance companies by allowing the companies to compete more easily across state lines could help a little. But it could also be the one of the worst things that you could do to those who need health insurance coverage the most.
There are several reasons why simply increasing the competition among medical insurance companies won’t have the positive impact on health insurance plans that many people think it will. We’ll just cover one in this post.
Let’s say that there are two kids in your neighborhood who are competing to be the kid who gets to buy your groceries for you. Little Bobby wants to charge you $5.00 and little Suzie wants to charge you only 60% of that or $3.00.
If you decide to use Suzie’s services, she will go to the store for you and buy your groceries. How much money will she ask you for? $103. Why? She will be buying $100 worth of groceries for you.
So she’s a little cheaper than Bobby, but not enough to make an impactful difference. If you give them both the same shopping list and they do their buying at the same store, they are both going to cost about the same.
No matter where I buy my health insurance coverage from, I’ll probably visit the same doctor, go to the same pharmacy and use one of the hospitals that is a short drive from my home. Do you get the idea?
The bulk of the costs that matter are going to be the same whether my insurance company is in the State of Connecticut, the State of Wyoming or in Paris, France.
Your share of the cost of your fellow policyholders’ doctors’ services, medicines, hospital stays and other health care costs make up 80 to 90 percent of your monthly health insurance premiums. Most of the rest of the costs are expenses that any business or government agency that provided the same service would also have to pay.
We have been told a falsehood by the individuals we’ve seen interviewed on the news. We have been told that the problem is that insurance companies’ profits are too high and that this is the main reason our policies cost so much.
The next time you hear someone on the news tell you how high an insurance company’s profits are, find out how many people they insure. Then divide the profit figure by that number. Then divide again by 12 to get a good idea as to how much impact their profits have on what you pay for your policy.
(By the way, insurance companies are already competing across state lines and have been for a long time. They just have to get their plans approved by each state insurance department separately. They are many medical insurance companies that sell policies in multiple states a few are in almost all of them.)
A little extra competition could help things a little bit, but not enough to fix our problems.
Unbridled competition would destroy the system. I will explain why in a soon-to-come blog post.
With a life insurance contract, the insurance company makes more money the longer you live. Since an annuity can pay you an income for the rest of your life, the reverse can be true.
An annuity plan has an accumulation phase and an annuitization phase. During the accumulation phase, you the policy owner, send funds to the insurance company much like you might invest in a mutual fund or add to a savings account.
Depositing money into an annuity can be a safer alternative to investing in stocks or bonds. One of the benefits of an annuity is that it can give you a lot of guarantees. (This is truer for fixed annuities than variable annuities.)
You won’t necessarily have to make regular payments. You can make one lump sum payment or make unscheduled payments over a period of time.
At some point, you may want some or all of your money and interest returned to you. (People typically do this after they have reached retirement age.) Your contract will probably give you several options when it is time to receive your funds. You can receive payments or you can get a lump sum. You can receive the payments over a specific period of time. You can receive a guaranteed amount of money each month for as long as you live. You can also receive interest only and leave your principal intact.
There may be tax advantages of waiting until you have reached retirement age, but you can receive your funds at any time.
If you decide to receive your money over a period of years, your policy will be in the annuitization phase.
What is a deferred annuity? A deferred annuity is an annuity that you put money into, but do not expect to receive any money back from the plan immediately.
This is contrasted with an immediate annuity where an individual deposits a lump sum of money and annuitizes it immediately. Often people will take funds that they have been investing in riskier vehicles and place those funds into an annuity when they are want to receive a steady income.
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.
Disability Insurance is one of the least thought about but most important types of insurance. Few types of insurance are as important.
Even when compared to life insurance, disability insurance may be more important. Why? If you die prematurely, your family will no longer have to feed you. They won’t have to clothe or house you.
If you become permanently disabled during your working years, not only will the burden of providing for the rest of your family be on someone else’s shoulders, but so will the cost of providing for you. A disability insurance policy can protect you financially.
Many of us get disability coverage from our employers. However, those who work for themselves have to depend on themselves to think about and pay for this coverage.
Only a small percentage of self employed men and women have this important protection. For this reason, disability insurance for self employed people is something that should be talked about a lot more than it is.
Not being able to get a job because of a permanent injury or sickness can hurt you more than not being able to get a job due to a poor economy. Poor economies often become a healthy ones, but our bodies my not rebound from every illness or injury.
Right now the best way for most people to lower Medicare Supplement premiums is not to have one. I’m not suggesting that you go without insurance. I’m suggesting that you take a good look at Medicare Part C.
Medicare Advantage policies are Medicare Part C plans. Medicare Advantage policies often provide better coverage than a combination of Original Medicare and a Medigap policy and do so at a lower cost to the consumer.
These policies often provide excellent coverage at a very competitive cost. When you have a Medicare Advantage policy, you get your benefits from a private insurance company instead of the federal government similar to the way that most people who are not on Medicare get their coverage.
Although these policies are great options for most Medicare beneficiaries, they are not for everyone. The only major drawback of these plans is that the benefits are network-based. You will need to get all of your non-emergency care from a provider in the network.
If you are in good health you will probably not need to get routine care while traveling. If you need emergency care it should be covered. However, if believe that you will need non-emergency care while away from home, Medicare and a Medicare Supplement policy will probably suit you better.
You are likely to see changes to your existing health insurance policy because of the health care reform bill. You are likely to see increased benefits as well as increased costs at least over the short term. Over the long run it is possible that some of the changes will have a positive impact on prices, but that remains to be seen.
In January of 2010 certain employers became eligible for tax credits for offering health insurance to their employees. This could have resulted in your employer offering health insurance to you when they would not have otherwise.
Effective in April of 2010, states are eligible for matching funds to help them insure more people through Medicaid. This might have meant that you were offered coverage when you would not have otherwise.
In June of 2010 many Medicare recipients who participate in Medicare Part D received money to offset their prescription costs. If you had high prescription bills, you may have received a $250.
If you have a Part D Prescription Drug Plan and reach the prescription “donut hole” in 2011 you will find that name brand drugs will cost you less. The manufacturers will be subsidizing the cost so that you will pay about half of what you would have paid before.
Effective in June of 2010 the Early Retiree Reinsurance Program started helping employers help their former employees who retired early. Employers who participate in the program will receive money from the federal government to help them continue to provide insurance for those who retired before they were eligible for Medicare. Dependents, spouses and surviving spouse may also get coverage through this program.
Effective in June of 2010 new options were made available for those who have pre-existing conditions. Your state has the option of offering a policy to you. If they don’t do so, the federal Health and Human Services will create a program for the state’s residents. In order to qualify, you must have been without coverage for that pre-existing condition for at least 6 months.