If you are looking to buy health insurance in today's poor economic climate then here are 5 five things that you must watch out for.
1. Will your health plan cover you both at work and away from your job?
Many health insurance policies carry specific exclusions which eliminate your benefits for anything that could have been covered by Workers Compensation or similar laws. Now take a minute to read that last sentence once again and pay particular attention to the words 'could have been covered'. That is right, most self employed people and even some small business owners do not carry Workers Compensation on themselves.
There are specific insurance policies which will cover you on and off the job, if the law doesn not require you to have Workers Compensation coverage.
2. Are you writing off your health insurance premiums?
Home based business owners, independent contractors (1099's), professionals and a lot of self employed people do not take advantage of the current tax laws.
A lot of people who are paying all of their own costs are entitled to deduct their monthly insurance payments. This by itself can lower your net out-of-pocket costs by as much as 40%. Ask your accountant whether you are eligible or check out the IRS website to get more information.
3. Look closely at any policy's internal limits
All health insurance plans use some sort of internal controls which determine how much the company is prepared to pay out for a specific procedure or service. Here there are two basic methods:
A. Scheduled Benefits
Many plans, some of which are specifically marketed to self employed and independent individuals, have a detailed schedule of how much they will pay per visit to the doctor, stay in hospital or even what payment limits are imposed for testing within a 24 hour period. This sort of structure is generally associated with 'Indemnity plans'. If you are presented with one of these policies make sure that you see the schedule of benefits in writing. It is important that you understand these type of limits up front because once you reach them the company will not pay any expenses above the stated amount.
B. Usual and Customary Expenses
'Usual and Customary' refers to the rate of pay out for a doctor office visit, procedure or hospital stay that is based upon what most physicians and facilities charge for a particular service in that geographical or comparable area. 'Usual and Customary' charges represent the maximum level of coverage on most major medical plans.
4. Remember that you can shop around
If you are reading this you are probably shopping for a health policy.
Every day people shop for everything from food to a new home and while shopping value, price, personal needs and general market conditions get evaluated by the buyer. Bearing this in mind, it is very disconcerting that the majority of people never ask what a test, procedure or even doctor visit cost. In today's ever changing health insurance market it is going to become increasingly important for for people to ask these questions. Asking about price will help you to get the most from your policy and reduce your out-of-pocket expenses.
5. Pay attention to networks and discounts
Almost all insurers work with medical networks in order to access discounted rates. In broad strokes, networks are composed of of medical professionals and facilities who agree to charge discounted rates for services provided. In most cases the network itself is one of the defining attributes of your program. Discounts will generally vary from 10% to 60% or more.
Medical network discounts vary but in order to make sure that you pay the lowest out-of-pocket expenses, it is vital that you check out the network's list of physicians and facilities before committing yourself to a plan. This is not only so that you can ensure that your local doctors and hospitals are part of the network, but also so that you can see what your options would be if you need referral to a specialist.
1. Will your health plan cover you both at work and away from your job?
Many health insurance policies carry specific exclusions which eliminate your benefits for anything that could have been covered by Workers Compensation or similar laws. Now take a minute to read that last sentence once again and pay particular attention to the words 'could have been covered'. That is right, most self employed people and even some small business owners do not carry Workers Compensation on themselves.
There are specific insurance policies which will cover you on and off the job, if the law doesn not require you to have Workers Compensation coverage.
2. Are you writing off your health insurance premiums?
Home based business owners, independent contractors (1099's), professionals and a lot of self employed people do not take advantage of the current tax laws.
A lot of people who are paying all of their own costs are entitled to deduct their monthly insurance payments. This by itself can lower your net out-of-pocket costs by as much as 40%. Ask your accountant whether you are eligible or check out the IRS website to get more information.
3. Look closely at any policy's internal limits
All health insurance plans use some sort of internal controls which determine how much the company is prepared to pay out for a specific procedure or service. Here there are two basic methods:
A. Scheduled Benefits
Many plans, some of which are specifically marketed to self employed and independent individuals, have a detailed schedule of how much they will pay per visit to the doctor, stay in hospital or even what payment limits are imposed for testing within a 24 hour period. This sort of structure is generally associated with 'Indemnity plans'. If you are presented with one of these policies make sure that you see the schedule of benefits in writing. It is important that you understand these type of limits up front because once you reach them the company will not pay any expenses above the stated amount.
B. Usual and Customary Expenses
'Usual and Customary' refers to the rate of pay out for a doctor office visit, procedure or hospital stay that is based upon what most physicians and facilities charge for a particular service in that geographical or comparable area. 'Usual and Customary' charges represent the maximum level of coverage on most major medical plans.
4. Remember that you can shop around
If you are reading this you are probably shopping for a health policy.
Every day people shop for everything from food to a new home and while shopping value, price, personal needs and general market conditions get evaluated by the buyer. Bearing this in mind, it is very disconcerting that the majority of people never ask what a test, procedure or even doctor visit cost. In today's ever changing health insurance market it is going to become increasingly important for for people to ask these questions. Asking about price will help you to get the most from your policy and reduce your out-of-pocket expenses.
5. Pay attention to networks and discounts
Almost all insurers work with medical networks in order to access discounted rates. In broad strokes, networks are composed of of medical professionals and facilities who agree to charge discounted rates for services provided. In most cases the network itself is one of the defining attributes of your program. Discounts will generally vary from 10% to 60% or more.
Medical network discounts vary but in order to make sure that you pay the lowest out-of-pocket expenses, it is vital that you check out the network's list of physicians and facilities before committing yourself to a plan. This is not only so that you can ensure that your local doctors and hospitals are part of the network, but also so that you can see what your options would be if you need referral to a specialist.
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