Title:

5 Basic Facts About Health Insurance Policies In A Bad Economy

Word Count:
617
Summary:
Many health insurance plans have specific exclusions that eliminate your benefit
s for anything that could have been covered under Workers Compensation or simila
r laws. Now read that last sentence again.

Keywords:
Health Insurance Policies

Article Body:
1. DOES YOUR PLAN COVER YOU ON AND OFF THE JOB?
Many health insurance plans have specific exclusions that eliminate your benefit
s for anything that could have been covered under Workers Compensation or simila
r laws. Now read that last sentence again.
COULD HAVE BEEN COVERED!?
That is correct. Most self employed people and even some small business owners d
o not carry Workers Comp on themselves.
There are designed insurance plans that will cover you on and off the job 24-hou
rs a day, if you are not required by law to have Workers Compensation coverage.
2. ARE YOU WRITING IT OFF?
Independent contractors (1099's), home based business owners, professionals and
other self employed people generally are not taking advantages of the tax laws a
vailable to them.
Many people who are paying 100% of their own costs are eligible to deduct their
monthly insurance payments. Just that alone can reduce your net out-of-pocket co
sts of a proper plan by as much as 40%. Ask your accounting professional if you
are eligible and/or check out the IRS website for more information.
3. INTERNAL LIMITS
All true insurance plans use some form of internal controls to determine how muc
h they will pay out for a particular procedure or service. There are two basic m
ethods.
-Scheduled Benefits
Many plans, some of which are specifically marketed to self employed and indepen
dent people, have a clear schedule of what they will pay per doctor office visit
, hospital stay, or even limits on what they will pay for testing per 24-hr. per
iod. This structure is usually associated with "Indemnity Plans". If you are pre
sented with one of these plans, be sure to see the schedule of benefits, in writ
ing. It is important that you understand these type of limits up front because o
nce you reach them the company will not pay anything over that amount.
-Usual and Customary
"Usual and Customary" refers to the rate of pay out for a doctor office visit, p
rocedure or hospital stay that is based on what the majority of physicians and f
acilities charge for that particular service in that particular geographical or
comparable area. "Usual and Customary" charges represent the highest level of co
verage on most major medical plans.

4.YOU HAVE THE ABILITY TO SHOP!

If you are reading this you, are probably shopping for a health plan. Every day
people shop, for everything from groceries to a new home. During the shopping pr
ocess, generally, the value, price, personal needs and general marketplace gets
evaluated by the buyer. With this in mind, it is very disconcerting that most pe
ople never ask what a test, procedure or even doctor visit will cost. In this ev
er-changing health insurance market, it will become increasingly important for t
hese questions to be asked of our medical professionals. Asking price will help
you get the most out of your plan and reduce your out-of-pocket expenses.
5. NETWORKS AND DISCOUNTS
Almost all insurance plans and benefit programs work with medical networks to ac
cess discounted rates. In broad strokes, networks consist of medical professiona
ls and facilities who agree, by contract, to charge discounted rates for service
s rendered. In many cases the network is one of the defining attributes of your
program. Discounts can vary from 10% to 60% or more. Medical network discounts v
ary, but to ensure you minimize your out-of-pocket expenses, it is imperative th
at you preview the network's list of physicians and facilities before committing
. This is not only to ensure that your local doctors and hospitals are in the ne
twork, but also to see what your options would be if you were to need a speciali
st.
Ask your agent what network you are in, ask if it is local or national and then
determine if it meets your own individual needs.