Health Insurance Blog

August 5, 2011

How to Find Cheap Health Insurance?

The idea of buying something at low cost is appealing, especially when we are struggling through the economy but  health insurance is one thing that shouldn’t be compromised only for its cost.

The cost of health insurance has gone up dramatically over the years which has forced, though unfortunately, many to go without health coverage. However, it is not a wise decision since health bills can pile up fast and burn a hole in your pocket.

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The choice of health insurance shouldn’t entirely depend upon its price but still there are ways to lower the price of the health policy without compromising with the coverage level.

  • Shopping around: Shopping around would let you compare the cost of the policy with its price. You can check with different insurers before deciding on one.
  • Insurance broker: Unlike a captive agent,  an insurance broker can access multiple insurers and hence is capable of shopping around for you.  Insurance broker can also help in finding health insurance policies for clients with health conditions such as -cancer and HIV.
  • Employer policies: Many employers offer health policy. You can opt for that. Often group health policy is a cheaper option than individual health plan since in group health plan the premium is divided between the group members.
  • High deductible: You can increase the deductible rate to lower the initial premium level. However, you may also keep in mind that it is the amount that you are agreeing to pay first if a cause arises before your health coverage kicks in.

You must avoid discount plans

Often you may have heard commercials for health policies at ridiculously low rates, these plans however aren’t health insurance rather discount plans. Discount plans aren’t health policies and therefore don’t offer coverage for all the conditions covered under a standard health plan. Moreover, most of the physicians wouldn’t accept discount plans and you may end up paying out of pocket for the hospital and doctor bills. What the discount plans do is just offer you some discount on the prescription drugs when bought over the counter.

Hope you will find the tips useful. Continue enjoying a healthy life.
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August 2, 2011

Types Of Health Insurance

If you are out shopping for health insurance you may find it a difficult task choosing the right kind policy from the many variations available. In this write up I have tried simplifying it for the general health insurance shoppers. Following are the major categorization of health insurance.

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All the health insurance plans can be classified under the categories of fee-for-service and managed care. Any other policy can be comfortably placed in between.

Fee-for-services: Under the fee-for-service plans, also called indemnity plan, you would have the autonomy to choose your doctor. The insurance company wouldn’t have any control over your choice of doctor or specialist. Fee-for-services policies are therefore more expensive and demand more out of pocket expense.

Patients, however, don’t enjoy full control over their fee-for-service plans. All these policies are managed to some extent by the insurer, for example – you may need a prior permission from the insurer to avail the services of emergency room.

Managed care: Managed care plan on the other hand puts more control in the hands of the insurer. It is designed to limit unnecessary expenses on health policies. The policy holder would require to receive permission from the insurer or its listed primary health care provider to visit a specialist. Also managed care plans would restrict your choices on the doctors you can access. With managed care you have to limit your choices only to the specialists listed with the insurance provider.

Managed care however is cheaper than fee-for-service plans. If you have decided to buy a managed care plan, you may ask the insurer if your current physician is listed with them.

Medicare: Medicare if a Federal Government funded health program that is available to Americans at the age of 65.  Medicare may also extends services to people below 65 years of age with certain disabilities or with terminal renal diseases. You may check with your employer about signing up with the Medicare program.

January 4, 2011

The Most Common Types Of Health Insurance Frauds

One of the reasons for high cost of health insurance is the pilferage due to health insurance frauds and abuses. Health insurance frauds are so prevalent that it is estimated that  every year the USA economy loses over $100 billion in such fraudulent activities.

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Health insurance frauds can take many shapes but one of the most common practices is to inflate the bills and charges for the services that are not rendered. Following are the types of health insurance frauds that take place almost everyday.

  • Fake procedure: Often the insurers are charged with bills of tests that were not performed. Often falsified tests are mingled with the legitimate tests performed. Unfortunately this is often done in collaboration with the patient.
  • Inflated bills: Charging more than actual cost is one of the most common form of health insurance frauds. The health bills are exaggerated to receive more money from the insurer. Doctors are found to charge the patients more who are insured and describing it as the right amount. This is an illegal practice.
  • Copay exemption: Copay is the part of the claim that the patient has agreed to pay on the total bill amount. The patients are exempted of their copays and it gets attached to the bills claimed against the policy.
  • Unbundling: Separate bills are sent for services that otherwise would have come under a bundle. Insurance providers often pay lower cost of the commonly offered services, known as bundle and hence separate bills are sent to receive more compensation from the insurer.
  • Double billing: Duplicate claims are submitted in order to gain from the health insurance claim. Often the offices of the insurer is inundated with claims and immoral physicians take this advantage of submitting multiple claims for the same services offered.
  • Upcoding & Miscoding: Putting wrong codes for the services offered or charging for more complex procedures than the one performed are known as miscoding and upcoding respectively. These methods are commonly used to get more money on claims.

It is important to identify and prevent the fraudulent activities to keep check on the rising health insurance costs.

January 3, 2011

Individual vs Group Health Policy: Which Is Your Option?

If you are planning to shop for health insurance you may already be aware of the ordeals of choosing the best plan. Often one has to make a crucial choice between the group health plan vs individual plans. Group health plans are often offered at the workplaces and majority of Americans are covered under their group health plans. However, private health plans too have certain advantages and are often purchased to cover the gaps left by the group plan.

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This blog would discuss about the benefits offered by group plan and private health plans to help you decide better.

Group health plans

  • Offered at the workplace and is the major source of health coverage for Americans.
  • Group plans are cheaper than private  health policies.
  • Insurers can’t discriminate against the members of the group.
  • Guaranteed renew.
  • One can’t be denied coverage based on preexisting condition.
  • Often you can add your spouse and children in the policy.
  • Under the COBRA benefits you can stay covered under your group health plan for as long as 18 months till you enroll for another group plan. Hence, there is no discontinuation of coverage.

Individual health insurance plans

  • Unlike group plans, wider choices are available with individual health plans.
  • Greater flexibility both in terms of coverage as well as cost.
  • You can customize the plan to suit your needs.
  • You’re not required to pay higher price as the healthy member of the group.
  • Flexibility to shop around. You can change your insurer at your own accord.

Individual health plans however have stricter qualifying criteria and the insurer can deny you coverage based on pre-existing conditions, which is not the case with group health plans. But in group health plans you may end up paying higher premium if the group consists of members with pre-existing  conditions and old. You may therefore compare long term benefits against expenses and decide accordingly.

December 29, 2010

Medicare Basics For Elderly Americans

Medicare is the Federal Government funded health program that is designed to offer necessary health coverage to elderly Americans. We all know that with age the requirement for medical assistance grow. The private insurers are particularly reluctant to cover elderly patients as they are into greater health risk. Also, you lose the health coverage offered by your employer as you retire. The Government therefore has come forth to cover individual over 65 years of age through Medicare. This write up has discussed the basics of Medicare to help you make better decision.

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Qualifying criteria for Medicare

Medicare is an entitlement program and any American meeting the qualifying criteria would qualify for Medicare. The qualifying criteria for Medicare is constant through out America. You can enroll for the Medicare part-A 3 months before your 65th birthday to 3 months after. One may qualify for Medicare if:

  • One is over 65 years old.
  • With certain disabilities.
  • Suffering from terminal renal disease.

Types of Medicare coverage

The entire Medicare coverage is divided into parts. There are part-A to part-N, of which the first four parts, namely part- A, B, C and D are the most discussed.

  • Medicare Part-A: The Medicare Part-A would cover inpatient care in hospitals, home health care and skilled nursing care if you meet certain criteria.
  • Madicare Part-B: The Medicare part-B would cover doctor services and part of preventive care services which would help you in staying healthy.
  • Medicare Part-C: The Medicare Part-C is also known as Medicare+ or Medicare Advantage. It may require you to bear some expenses of the coverage. However, its most comprehensive in nature of all the Medicare plans and covers hospital stay, skilled nursing care as well as partial prescription drug coverage.
  • Medicare Part-D: The Medicare Part-D mainly covers the prescription drugs. It is provided in collaboration with the private health insurance providers and hence individual plans are likely to vary between policies.
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