Getting the Most Benefit From Your Policy

The key to getting the most benefit from your health insurance policy is knowing your policy coverage. Many people donít actually read the policy for the policy plan book; they may not be aware that the policy may pay 100% of certain procedures, like annual physicals, mammograms, flu shots or certain labs tests.

The policy plan book will outline for you what procedures are not subject to the deductible or co-pay

(your out-of-pocket expense). Some insurance companies have shifted their emphasis from health insurance to health improvement and maintenance and will pay for the cost of gym membership, nutritional counseling or plans to stop smoking.

If you were trying to lose weight and knew that you could get these services at no cost, wouldnít you take advantage of them?

If you wanted to quit smoking, wouldnít it be beneficial to know that you could get the patch for

free? It is very wise to know what services are available to you through your insurance company, and you will only know if you take the time to read through your policy.

Health insurance is an expensive item; take advantage of every aspect of it that you can, not only for yourself but for the members of your family. By taking full advantage of the free benefits of your health insurance policy, you will be healthier and possibly require fewer visits to your doctor.

Health Insurance for Every Need: Understanding the Kinds Available

In the United States, there are about five different types of health insurance available: traditional health insurance; preferred provider organizations or PPOs; point-of-service plans or POS; health management organizations or HMOs; and most recently, health savings accounts or HSAs. With so many types of health insurance, it may be confusing trying to figure out which one best fits your needs, so thoroughly research each and speak with a professional if you need clarification. 

Traditional health insurance is the one that most people think of when they think of health insurance. You pay the insurance company a premium every month, and if you have an accident or need for health coverage, you have a deductible amount you must pay and then the insurance company picks up the rest of the bill. You often have an inexpensive office and/or prescription co-pay with traditional health insurance.

With people living longer, health insurance companies began to look for more ways to reduce their costs, developing different health plans such as PPOs. PPOs are plans which will cover nearly all of your medical expenses as long as you stay within a preferred network of physicians or hospitals. This network creates a "preferred provider" list that you can choose from. Treatment outside this network of providers is covered but only at a reduced rate, meaning you end up paying more to see a physician outside the network. By limiting the physicians and hospitals covered in their network, the insurance company can control, to an extent, their costs and lower your premiums. POS plans work like PPOs, but require you to have a primary care physician through whom you can receive referrals for specialists. If you need to see a neurologist or a dermatologist, you must first visit your primary care physician for an initial diagnosis in order to receive a referral to a specialist for a more thorough diagnosis. POS plans also have a preferred provider network, and if you choose to visit a specialist or physician outside that network, your coverage will be limited.

HMOs combine a stricter version of PPOs and POS plans. HMOs have a defined list of physicians, often much smaller than PPO networks, which you may see. You will not be covered at all if you see a physician outside your HMO network. Furthermore, you must also get a referral from your primary care HMO physician to see any specialist. However, these restrictions mean that you pay an extra low or no monthly premium.

HSAs were recently signed into law by President Bush. You can deposit money into a special non-taxed, interest-gaining savings account that must be used for medical expenses. The ideal situation for an HSA is to combine the account with a low-cost, high-deductible insurance plan. The savings account is designed to allow you to cover the high deductible if you find the need to cover expensive medical costs while the insurance company will pick up the rest of the bill. 

Again, it is important to carefully consider each option before choosing a single health insurance plan. Your health is important-make sure it is protected in the best way possible.

Health Insurance When Living Abroad

You may not know this already, but when planning on traveling abroad you cannot take your local insurance with you. You will need to purchase an international insurance plan offered by a multinational insurance company. While they may be hard to track down, it is the best way to assure that in the event of an accident or illness you will be able to acquire medical attention if needed.

Many of these plans will cover you up to six months in another country. When you speak with the insurance company, be prepared to give an extensive list of information to them. This will range from health problems you've had in the past ten years, your hereditary conditions to substance abuse, and almost everything else-if it has anything to do with your health be prepared to disclose the information. If you are planning on traveling with more than one family member, then be prepared to give information for each family member as well.

Many times your basic coverage will include emergency treatment regardless of which facility it is administered. This is not the case with minor medical treatment. It is important to know whether you are buying an insurance plan that is an HMO or PPO. If you are under an HMO or health maintenance organization, then you will be limited to receiving care from only the providers who are in their network. You can retrieve a list of all the companies within your insurer's network upon request. If you are under a PPO, or preferred provider organization, you will have the opportunity to pick the best facility you see fit, but your insurer will only cover a portion of the incurred cost.

If you plan on staying abroad for more than six months then you will need to look into what is called expatriate health insurance. Only larger companies supply this type of insurance, as it is much more extensive with the type of options that can be applied to each policy. The type of treatment options that are covered with expatriate health insurance are those that are labeled as specialty treatments, like chiropractic therapy and acupuncture. There are many options that can be applied to expatriate health insurance depending on your family's needs and how long you plan on spending abroad.

There are many options for health insurance when you are traveling abroad. While many individuals never consider purchasing insurance when traveling to another country, this should be at the top of your list when planning for a trip. Health insurance should not be taken lightly. Be sure you understand every aspect of your policy before deciding with any one particular company.

Health Savings Accounts

If you are considering changing your health insurance

policy, you should be aware of the alternative of a

Health Savings Account (HCA).

Health Savings Accounts started to become available

(and legal) in 2004, allowing people with

high-deductible insurance policies to set aside

tax-free money to fund medical expenses up to the

maximum deductible amount.

If you donít have to use the funds, it rolls over

every year. Once you reach age 65, you no longer are

required to use it for medical expenses, although you

certainly can; you can withdraw funds under the same

conditions as a regular IRA.

Although you will be penalized if you use the funds

for non-medical expenses prior to age 65, you can use

the money for vision care, alternative medicine or

treatment and dental care.

For 2008, an individual may fund up to $2,900 tax

free. The maximum deductible would be $1100 and the

maximum out-of-pocket cost would be $5,600.

For a family, the maximum tax-free contribution is

$5,800 with the maximum deductible of $2,200 and the

maximum out-of-pocket cost would be $11,200.

Health Savings Accounts are certainly a viable way to

shelter income while providing catastrophic insurance

coverage in light of the high cost of low-deductible

health insurance plans.

For healthy people, it deserves some research. Consult

with your insurance agent for all of the details

involving this approach to managing your insurance

needs.

Healthcare for Long-term Patients: Is this Insurance Right for You?

Long-term care insurance is not right for everyone. For a small percentage of the population this coverage is an affordable and worthwhile type of insurance. Determining whether or not long-term care insurance is right for you won't be the only task at hand; looking for scams will also be a concern.

As you get older, the need for assistance in your everyday life increases. Whether it is in-home care or residing in a nursing home for a few months you will most likely need some way to pay for these types of services. In order to maintain long-term care insurance you must pay for them each and every year until death. Many policies are canceled by policyholders that are on fixed incomes and are simply unable to pay for the increasing premiums as they get older. If the only funds you are receiving were those from Social Security or SSI, then it would be wise to not purchase a policy. Also, if you find that every day purchases and paying for utilities makes you stretch your budget to the limit, you probably should stay clear of this policy. This type of policy is only right for someone who has significant assets they want to preserve for their family, remain independent, or just to spare their family the expense of a nursing home bill.

Comparing policies can prove to be difficult because every company is selling a different combination of benefits and coverage. Many companies offer to pay a fixed amount for each day you receive care, while others will cover a percentage of the overall cost of care or supply a specified amount. Beware of these types of policies unless they offer inflation protection. You see, if they do not account for the increasing cost of nursing home costs, then you are stuck with a policy that really does you no good.

Just like a standard healthcare plan, you will have to receive services at designated locations. If you go outside of this network they will simply refuse to pay for any care that you receive. If you have any type of mental disease or nervous disorder then don't expect many carriers to accept you (the one exception is Alzheimer's). There are more restrictions in this type of insurance than any other health insurance.

If this type of policy is right for you, please make sure that the company is reputable. There are many individuals who thrive on the fact that not many people will make an informed decision when it comes to purchasing long-term health insurance. Be sure to read the fine print and find out everything you can about the policy before committing to a company and a long-term health insurance plan.

How to Choose the Best Health Insurance for You

With so many different types of health insurance plans and restrictions out there, it can be difficult finding the best health insurance for you. However, this process is not impossible to do well with a little research. There are a few items to look for when deciding on health insurance plans, and by considering them all you can make a good decision for yourself and your family about health insurance. 

The most important thing to look for is coverage. More often than not, insurance will cover physician visits and fees. Your health insurance should also cover hospital expenses such as room and board in case you are kept overnight or longer for observation or treatment. Good health insurance should also cover surgeries and any expenses associated with surgical treatment. Beyond these typical items of coverage, health insurance plans can diverge greatly. To really understand what coverage you would utilize and which plan would save you the most money, you will need to make a list of items that you want covered in an insurance plan. For instance, do you have glasses or contacts? Then you may be more interested in a plan that covers vision - either paying for your eye exam and/or partially paying for your glasses or contacts. Though many people think that health insurance covers prescriptions, prescription coverage is actually an optional benefit. If you know that you often have prescription drugs to fill, finding insurance that offers prescription coverage may be a must. If you are a woman and plan on having or want to have children, maternity care or family planning services are also optional benefits that you may want to consider. Once you make this must-have list of optional coverage, you can begin looking for health insurance plans that give you the opportunity to add these optional benefits. 

Another item you should definitely consider is if your current physicians or specialists are included in the health insurance company's preferred provider network or if you have the opportunity to choose any physician (often the case only with indemnity or traditional health insurance plans). If you would like the freedom to choose your own doctor, traditional health insurance plans or preferred provider organizations may offer more attractive plans - though these also cost a little more. 

Lastly, consider price. After researching different coverage plans and physician requirements, compare deductibles and monthly premiums to find the best deal. Often, you can get group rates through your employer, or you may find that artist organizations (for freelance artists) offer health care plans. By researching price, as well as other health insurance options, you can make the best choices for your family.

Medicare

Medicare is a governmental program which provides

medical insurance coverage for retired persons over

age 65 or for others who meet certain medical

conditions, such as having a disability.

Medicare was signed into legislation in 1965 as an

amendment to the Social Security program and is

administered by the Center for Medicare and Medicaid

Services (CMS) under the Department of Human Services.

Medicare provides medical insurance coverage for over

43 million Americans, many of whom would have no

medical insurance. While not perfect, the Medicare

program offers these millions of people relatively low

cost basic insurance, but not much in the way of

preventative care. For instance, Medicare does not pay

for an annual physical, vision care or dental care.

Medicare is paid for through payroll tax deductions

(FICA) equal to 2.9% of wages; the employee pays half

and the employer pays half.

There are four "parts" to Medicare: Part A is hospital

coverage, Part B is medical insurance, Part C is

supplemental coverage and Part D is prescription

insurance. Parts C and D are at an added cost and are

not required. Neither Part A nor B pays 100% of

medical costs; there is usually a premium, co-pay and

a deductible. Some low-income people quality for

Medicaid, which assists in paying part of or all of

the out-of-pocket costs.

Because more people are retiring and become eligible

for Medicare at a faster rate than people are paying

into the system, it has been predicted that the system

will run out of money by 2018. Health care costs have

risen dramatically, which adds to the financial woes

of Medicare and the system has bee plagued by fraud

over the years.

No one seems to have a viable solution to save this

system that saves many people throughout the country.

Prescription Insurance Policies

Some health insurance policies do not provide for

prescription coverage and a separate policy must be

purchased for prescription medications.

This is an area where it pays to do some homework and

research and find the best policy for you.

Prescription coverage insurance is not a necessity;

like health insurance coverage, it is a calculated

risk, although the risk is not as high.

Usually you can buy prescription insurance at any

time, so if the doctor determines that you need an

expensive maintenance drug, you may opt in at that

time.

It is important to know that if you presently have

prescription insurance you can usually only change it

at a specific time of the year, although you can add

new prescriptions, you canít change plans.

The person who seldom takes prescription medications

probably does not need prescription insurance;

however, a person who takes maintenance drugs for high

blood pressure, diabetes, depression, heart disease or

immune disorders most likely needs insurance against

the high costs of drugs.

Prescription insurance policies usually have "tiers",

which usually means that a generic drug is at a low or

no co-pay, a tier 2 level may be the brand name

genuine, and a tier 3 may be a brand new expensive

drug that the co-pay could be a set high-percentage of

the cost.

In choosing prescription insurance, you should first

list the prescriptions that you take and the retail

amount of them. If you chose not to purchase

insurance, this would be your monthly cost.

Find out from the provider what the monthly premium

for you would be, then what the prescription co-pay

amount would be and add these two figures together.

Which is the less expensive alternative?

Protection during the Golden Years: Health Insurance and Retirement

Health insurance for retirees or senior citizens can be confusing, especially with so many options and requirements. However, health insurance is crucial for retirees. As you grow older, your health obviously becomes more of an issue; you may visit the doctor more, need to fill more prescriptions, or even receive in-home care. Before you retire, prepare for health insurance to ensure that you receive the best benefits.

The first step in planning your health insurance coverage in your retirement is to see if your employer offers insurance coverage after you retire. If the company does, you should certainly consider it. Look at the plan, the deductible, and the coverage. Many near-retirees believe that Medicare will cover their medical payments, but this is not always the case. With this sort of coverage, you will most likely receive better health care but at a more expensive cost. As a retiree, you will certainly have a health insurance budget to maintain, and you will have to decide if the cost of your employer's insurance is too expensive.

If your employer does not offer coverage, Medicare will be an important and integral part of your health insurance if you are 65 years of age or older. Medicare works like traditional health insurance plans in that you have been contributing a small portion of every paycheck you earn into this plan. Once Medicare begins, you will make co-payments for office visits or treatment. Medicare will also cover the expense of certain medical equipment or needs. 

However, Medicare did not cover a number of items that are typical of health insurance. The government recently updated Medicare and divided it into three parts: Part A, B, and C. Part A covers hospital care, such as home health care, hospital stays, and hospice care. This part does not require a premium. Part B covers the more routine medical expenses, such as office visits and laboratory tests, while Part C enrolls you into a fee-for-service or managed care plan that reduces your out-of-pocket costs. Despite these different options, Medicare restricts your coverage by not covering certain kinds of care or illnesses and diseases. Thus, there is also Medigap coverage, which helps fill in the gaps in health insurance that Medicare leaves. Medigap coverage differs from state to state and has different payments.

Beyond Medicare and Medigap, there are also long-term care insurance plans that you can buy. You often see these plans advertised on the television at very low prices. These plans can help cover the costs of a nursing home or home health care. With so many different options and limitations, if you are retiring soon, you should take a look at your budget and what you can afford as well as what sort of coverage you feel you will need.

Say Cheese: Dental Benefits

Dental insurance is often an afterthought when obtaining health insurance for a number of reasons. Some people may simply dislike the dentist and use the lack of dental insurance as a reason to not visit the dentist; others may feel that dental insurance is not worth the added cost to their monthly health insurance premium. Still others may simply feel that their teeth are in good shape and there is little need to spend the extra money to cover a part of their body that does not currently have any problems. Nevertheless, dental insurance is important because of several benefits.

When people think of the cost of dental work or procedures, they often think of costly bills. Even simple procedures like getting your wisdom teeth removed can average in the hundreds of dollars per tooth! However, one obvious benefit to dental insurance is the coverage of simple but costly dental procedures such as getting a tooth removed. In the end, the slight increase in a monthly premium may be worth it to avoid a high dental bill. Moreover, dental insurance also helps financially if a dental emergency develops. Perhaps you are in need of a root canal or dental implants - both extremely costly procedures that you often do not anticipate. Dental insurance will most likely cover a portion, if not all of these expensive procedures.

Also, while many feel that brushing and flossing daily is all the dental care they need this is simply not true - even for young, healthy adults. Dental disease is common and can affect your body in a number of ways. For instance, some dental diseases left untreated can lead to more serious medical issues such as kidney infections or even diabetes. Most people do now know of the connection between dental diseases and other illnesses. Thus, having dental insurance that covers routine visits to the dentist, which can help uncover dental diseases early, is extremely important. Dental insurance is designed to encourage preventative care, because spotting dental diseases or dental problems early reduces the overall cost of treatment. 

Dental insurance may seem like just another gimmick to get a few more dollars out of you, but it is essential for your health. Your regular health insurance plan, whether it is through your employer as a group plan or an individual plan, should offer you the option of buying dental insurance coverage, and you should consider this piece of the plan thoroughly when purchasing health insurance.

Shop 'Till you Drop: Shopping for Health Insurance

Shopping for health insurance can be a frustrating hassle. There are so many companies with so many rates to compare. However, it is important to take your time and find the best company for your money. Although it may be frustrating, health insurance is a necessity. In any area, there are usually quite a few health care providers that can supply you with a quote over the phone. You could also use the Internet as a resource. By using these tools, you can make the shopping process go more smoothly.

The first step is going to be deciding which type of insurance you should be shopping for. If you have a family, it would be in your best interest to find a company that will give you one decided premium and co-payment plan no matter how many children you add to the plan at any time. Without a family, you would be shopping for individual health insurance but will need to decide if you are in need of short-term insurance or insurance for an extended period. Short-term insurance is for people who are in-between jobs and expect to enroll in whichever health insurance plan their future employer sponsors.

Once you have established what type of insurance you need, it is time to make some calls. Go through your local phone book and start calling down the line. After answering a few simple questions, you can get a quote and move on to the next company. Cost is one of the most important factors. If you find two or more of them with very similar premiums and a low co-payment amount, you should compare the benefits. Can you add immediate family at no charge? Will this health insurance include dental, emergencies, prescriptions, or doctor visits? This may help you find one that appeals more to your needs and is within your budget. Using the services of the Internet to find a company will be a very similar process. Some reputable web sites out there will ask you to fill in a few blanks and then give unbiased quotes from many different health insurance companies.

Whether you are going to be doing your shopping over the phone or on the Internet, you should use your best judgment of the information that you get on each company to decide on one that makes you comfortable. The Better Business Bureau can also help you be sure that you are not being scammed. Health insurance is a cost that is necessary to save you money in the long run on prescriptions, doctor visits, and unforeseen emergencies. Don't get left with bills that you have no way of paying because you didn't have insurance.

Something Old, Sometime New: Insurance When You are Getting Married

Health insurance providers are not created equal. Before a couple is married, the option of sharing coverage is extremely unusual unless one of your insurers offers domestic partner insurance. As you become engaged, if you both have separate insurance it is important to talk about the both of you switching to the better plan once you are married. There are a few factors consider, which include deductibles, co-payments, and the benefits of each separate plan. Marriage is a big step, and it can be done with ease if the two of you settle important decisions such as your health insurance plan before you take the big leap.

Your deductible is the amount you must pay each year to start your policy. Once this payment is made you will be responsible for whatever amount of co-payment your insurance company requires for you to pay for the health expenses that are covered in your particular policy. The amount of co-payments that you will be responsible for is established at the time you agree to your health insurance policy. It is going to be a certain percentage of health expenses; for instance, you pay 10% while your insurer will be paying the other 90%. You and your fiancÈ should compare both of your plans and figure out which deductible and co-payment plan seems most appropriate for the two of you. 

Married couples are usually eligible for certain benefits that unmarried couples are not. Being insured separately by the health care provider sponsored by your employers may no longer be the most beneficial option for you. If you or your fiancÈ has insurance, and the other does not, once the two of you are married they can be added to the other partner's plan. Cost of adding an additional person is definitely something that should be examined. You should not be required to pay more for adding a spouse or even a child in the future because most plans are offered to immediate family at no extra cost. The best way to compare policies is to estimate a yearly amount of normal health expenses, emergencies, co-payments, and deductibles. Whichever plan has the lowest cost to you will almost always be the best choice.

In addition to sharing health insurance with your new spouse, you may also want to consider switching the rest of your insurance plans, such as the policies you have for your separate automobiles. This is because most companies will give you a discount on having more than one vehicle insured. You may also be interested in finding a company that can insure you home, automobile, and health in one place. If you carry more than one policy with a company, they will also usually give you some sort of discount on them. It is important to sit down and discuss insurance with your fiancÈ because the two of you could be saving money and stress by figuring out what decision is best before the time comes.

Stay Legal! Avoiding Insurance Fraud

Everyone knows that the health insurance industry is continually raising monthly premiums, and many feel this is unjust to you as the consumer. However, the health insurance industry has had to fight increasing health insurance fraud. The amount of money spent on investigating and prosecuting fraud is then passed on to policyholders. Many people do not understand what health insurance fraud entails, though. With reports estimating health insurance fraud is a $30 billion to over $100 billion industry per year, the topic should not be taken lightly. Every health insurance policyholder should understand what health insurance fraud is and its consequences. By doing so, you are more able to recognize and fight fraud. 

Health insurance fraud is typically defined as intentionally deceiving, misrepresenting, or concealing information to receive benefits from the insurance company. Essentially this means that you assert that you paid for certain medical procedures or expenses out-of-pocket which you have not actually received, and you are submitting claims to the insurance company to receive reimbursement. Another example of member fraud is to conceal pre-existing conditions or to alter medical documents so that non-policyholders or ineligible members receive medical benefits under your policy. Perhaps your sister does not have insurance and needs medical attention. Having her use your name and policy to cover the expenses is health insurance fraud. While you may think that this is a small issue in comparison to your sister receiving treatment, it is actually very serious to your health insurance company and industry, and will result in fines and possible imprisonment if your are caught.

Not only policyholders commit fraud, but providers (physicians, hospitals, etc.) do as well. Since physicians and hospitals bill the insurance company for services they provide for you, they are also receiving reimbursement from the insurance company. When providers commit fraud, they may be billing the insurance company at higher rates for services rendered or they may bill for services you never received. In these cases, you will probably be asked to cooperate in the insurance company's investigation. 

Another type of health insurance fraud that has developed recently targets the policyholder more than the insurance company. Schemes have developed where fake insurance companies or agents sign unsuspecting customers for coverage at surprisingly low premium rates. They often act much like a regular insurance company for the first few months, paying for smaller medical claims like physicians visits. But once you have a more serious medical condition that needs treatment, the insurance company will disappear - along with the money you have been paying in premiums.

The rule with health insurance fraud is much like that of any other scam: if a deal seems too good to be true, just remember - it probably is. Remember to be honest in your dealings with health insurance companies and expect the same in the return from these companies, as well as your health care providers. Stay legal to avoid fines and prison and to continue receiving health insurance coverage.