Information for Buying Health Insurance

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Buying health insurance today? A person always wants to buy the plan that would be best for them including the best coverage for the most stable, lowest premium. So, what type of plan should that person look for? Should he or she look at a low deductible? High deductible? Doctor co-pay or no co-pay? Prescription drug card? Other value added services? There are a number of questions and different people have different needs and desires. The question becomes, where should a person start?

First, list the doctors and hospitals you use or would use if needed. Next gather information from companies that have your providers in their provider network. Make a fair assessment of your health, your past and current medical conditions and medications you take and have taken. At some point, you will need to disclose this medical information. It may be better disclosed sooner than later. If you have a medical condition that could cause a company not to issue a plan, it is best to make an informal inquiry to an underwriter asking how the company may handle a your situation, before you submit an application.

Now you are ready to gather insurance plan information. Know that health insurance plans vary company to company and most insurance companies have several plan options. One option this writer would encourage you to consider is an HSA qualified high deductible plan (QHDP). These plans currently have deductibles for a single person beginning at $1,200 per year up to $10,000. The high deductible plans can be attractive because the premiums can be much lower than other plans. Note: Family deductibles work differently than the deductible you may be used to. If you are insuring more than one person, be sure that you understand how the deductible works.

Most importantly, wellness and preventative expenses may be covered up front without the deductible. This means that a person could have an annual physical and have if covered by the insurance company (they may have a small co-pay – e.g. $20). Preventative testing is provided without out of pocket cost. For example, depending on your age, you may have free access to preventive services such as:

  • Blood pressure, diabetes, and cholesterol tests
  • Many cancer screenings, including mammograms and colonoscopies
  • Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression and reducing alcohol use
  • Routine vaccinations against diseases such as measles, polio or meningitis
  • Flu and pneumonia shots
  • Counseling, screening, and vaccines to ensure healthy pregnancies
  • Regular well-baby and well-child visits, from birth to age 21.

Note: Testing for which a medical condition is present is not considered preventative testing and wellness and preventative benefits may not apply to “grandfathered plans” (plans issued prior to 3/23/2010).

If you buy a HSA Plan, you should gather information on setting up an HSA side fund to pay qualified out of pocket medical expenses tax free. Further information and quotes on health insurance plans may be obtained on www.MRMS-.INC.com . Most every situation is different and you should seek professional assistance when considering any insurance products.

Written by

Steven A. Buttice is the president of Medical Reimbursement & Management Services, Inc., a firm specializing in issues affecting seniors, including seminars and consultation on Medicare Plans, Long Term Care and other types of insurance, claims issues, and sales/service of insurance products since 1984.

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