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5 Basic Facts About Purchasing Health Insurance Policies In A Bad Economy
Posted by | Posted in Personal Health | Posted on 09-07-2009
If you are buying health insurance in today’s poor economic climate then here are 5 five things that you need to look out for.
1. Does your plan give you cover both at work and away from your job?
Many health insurance policies have specific exclusion clauses which wipe out your benefits for anything that could have been covered by Workers Compensation or a similar law. Now stop and read that last sentence again and pay special attention to the words ‘could have been covered’. That’s correct, most self employed people and even some small business owners don’t carry Workers Compensation on themselves.
There are insurance plans which will cover you on and off the job 24 hours a day, as long as you are not required by law to have Workers Compensation coverage.
2. Are you writing off your insurance premiums?
Independent contractors (1099′s), home based business owners, professionals and many self employed individuals do not take advantage of the current tax laws.
Many people who are paying 100% of their own costs are permitted to deduct their monthly insurance premiums. Just that alone can lower your out-of-pocket costs by as much as 40%. Ask your accountant if you are eligible or check out the IRS website for more information.
3. Look closely at any policy’s internal limits
All health insurance plans have some form of internal controls which are used to determine how much they will pay out for a specific service or procedure. There are two basic methods which are used:
A. Scheduled Benefits
Many plans, some of which are specifically marketed to indpendent and self employed people, have a clear schedule of how much the insurance company will pay per visit to the doctor, hospital stay or even what limits are placed on payments for testing within a 24 hour period. This sort of structure is generally associated with ‘Indemnity policies’. If you are offered one of these plans be sure to see the schedule of benefits in writing. It is important that you understand these type of limits up front because once they have been reached the insurer will not pay anything above the stated amount.
B. Usual and Customary Expenses
‘Usual and Customary’ refers to the payment for a doctor office visit, procedure or hospital stay that is based upon what most doctors and facilities charge for a particular service in that geographical or comparable area. ‘Usual and Customary’ charges also represnt the highest coverage on almost all major medical plans.
4. Do not forget that you can shop around
If you are reading this there is a fair chance that you are shopping for a health plan.
Each day people shop for everything from food to a new house and while shopping value, price, personal needs and general market conditions are evaluated by the buyer. Bearing this in mind, it is very disconcerting that most people never ask how much a procedure, test or even doctor visit cost. In today’s ever changing health insurance market it will become more and more important for for people to ask these questions. Asking about price will help you get the most out of your plan and reduce your out-of-pocket expenses.
5. Be aware of networks and discounts
Nearly all insurance firms work closely with medical networks in order to access discounted rates. In broad terms, networks are made up of of medical professionals and facilities who agree to charge discounted rates for services provided. In most cases the network forms one of the defining properties of your program. Discounts will generally vary from 10% to 60% or more.
Medical network discounts do vary but to make sure that you minimize your out-of-pocket expenses, it is vital that you preview the network’s list of physicians and facilities before committing yourself to a policy. This is not only to make sure that your local hospital and doctors are in the network, but also to see what your choices would be if you were to need referral to a specialist.
Watch the video related to personal health insurance
www.purgasonforsenate.com – Chuck Purgason believes in affordable, workable market based health care coverage available to all who choose to have insurance. Senator Purgason worked hard in the State Senate to get the Health Care Freedom Act (HCFA-Prop C) on the August 3rd Missouri Primary ballot. He is educating folks about HCFA and campaigning for its approval by Missouri citizens to guarantee their right to refuse a Federally mandated program. When elected to the US Senate, Chuck will make the repeal of Obamacare a top priority. Personal health care choice is a right not to be removed by Congress. Chuck believes that the Constitution should prevail in this matter. Reform is long over-due. Chuck believes that giving the ability to purchase coverage across state lines is one step. A pool for citizens with pre-existing conditions similar to those now available for drivers with poor driving records could be instituted as well freeing up the current non-market based system. Senator Purgason recognizes that the United States leads the world in medical research and cutting edge medicine. Chuck wants to insure that this achievement is not compromised for future generations by a big government system that will bankrupt and mortgage our children and grandchildren’s legacy.
Help answer the question about personal health insurance
Personal family health insurance with deductible $5000 or less?Trying to find a Health Insurance plan with a deductible of $5000 or less. Found a Blue Cross one for about $7500 but that's to much since I only make $15000 a year.
You can easily check your minimal health care rates in internet, for example here – health-quotes.talk4fun.net
Way to go Dave! Thanks for standing up for us!
They try to do it in thirty days, however, it can take longer due to obtaining the necessary doctors reports. I have seen it done in fifteen days and as long as five months. It also depends if you are going on a group plan or as and individual…Good Luck….
You need a trusted adviser to help you through the process of purchasing health insurance so that you understand what you are purchasing. Some may suggest going on line to get a quote but you probably already know that there is much more to health insurance than price. Some might even suggest a discount plan which is not insurance at all.
Ultimately, you are the one who determines the affordability of your health insurance plan by deciding how much you will participate in sharing the cost of your health care with your insurance company.
If you choose a plan that covers everything i.e. doctors office visits, prescription drugs, preventative health benefits, maternity coverage as well as low deductibles and low copays your monthly premiums will be significant.
On the other hand if you are reasonably healthy and use the health care system infrequently you could consider a plan that covers only the major health catastrophe which will result in a relatively low monthly premium. You then can use the monthly premium savings to pay for the occasional doctor visit and still come out ahead.
You might also consider a temporary health insurance policy if you anticipate getting another job with benefits.
Check with the agent that writes your home or auto insurance he/she can provide you a health insurance proposal that takes into account your budget and health situation. They can answer questions as to what is and is not covered by the policy, explain deductibles and copays and show you the hospitals and doctors that participate in the network.
Use the Internet to educate yourself but use an agent to purchase the coverage.
My husband is a retired Marine, so we use Tricare for our insurance. We pay only $115 every quarter, so we are very fortunate to have insurance for such a low cost. This price includes all family members, including kids until they're 21, or 23 if they're a student full time. The only problem I've had and many people have gone through the same thing is that they've switched formularies several times on some medication I take, forcing me to switch to another brand or I would have had to pay a much higher co-pay. And one time I had to have a procedure done and they made me go to a military base to have it done instead of going to a regular doctor out in town. If you're within so many miles of a base and need something done, they will probably make you go to the base. We lived farther away than the maximum miles, but I still had to go to the base.. It wasn't no big deal, but I would have liked to have stayed with a local doctor. We previously used Aetna with my husband's former employer because my employer didn't take Tricare (a doctor's office) and our co-pays were written off since we were employees. I never had any problems with Aetna.
YOU need to obtain it from your prior insurer.
As long as you keep asking these vague questions, you'll never get intelligent responses.
Is this an S-corp or a C-corp?
If it's an S-corp, the premiums are included in the wages on the W-2, but then excluded as an adjustment on the front of the 1040. It wouldn't make a difference on collecting EIC.
Edit, as 100% owner of the S-corp, he *can't* deduct it any other way. The IRS will figure this out on an audit and then BOTH of you will owe the excess refund back.
See page 15, column 1 and column 2 of the 1120s instructions. Specifically the part about insurance being included in box 1 of W-2 and deducted on line 29 of the 1040.
http://www.irs.gov/pub/irs-pdf/i1120s.pdf
And no, it doesn't come out the same for EIC.
Claiming $30K in wages vs claiming $33K in wages and subtracting $3000 in premiums is a difference of $2447 in EIC vs. $1816. The excess $631 is illegal.
Since you've already identified the issue–that the bogus calculation makes you eligible for EIC when it shouldn't, don't sign.
Unfortunately, affordable for someone 54 isn't likely. Well, I guess affordable is a relative term.
It depends on your geographic location. I assume that you're in CA. If so, your best bet is to apply for coverage through a group (in CA a group is 2 or more people). If you don't have a group, create one with a friend or colleague. If I'm not mistaken, groups cannot be denied coverage. The insurance companies don't have to make the coverage cheap but they have to provide it. Best of luck!