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HEALTH INSURANCE - Page 3

Types Of Healthcare Plans (continued)

 

e.  Long-term healthcare plans cover costs when care is required in an extended care facility, such a a nursing home.  These plans may also cover long-term rehabilitation needs.

 

f.   Catastrophic healthcare plans are designed to cover very large medical costs, due to severe disease or accident.  These plans have very high coverage limits, and do not cover the normal medical expenses provided by general healthcare plans.

 

 

Factors To Consider When Buying Health Insurance

 

In addition to the types of healthcare plans available, several other factors should be considered when purchasing or enrolling in healthcare coverage.  These factors impact both the amount and type of coverage you can get, as well as the cost of the coverage.

 

1.     Your age, and particularly your health history, are very important in determining the type of coverage available and its cost.  If your health is very poor, and/or you have serious pre-existing conditions, health insurance may not be available at any reasonable cost.  Otherwise, coverage may be available, but vary considerably in price, dependent on your health history.  Consider the following:

 

a.  Smoking, being overweight and high blood pressure and cholesterol is frowned upon by health insurers, and will cause your rates to be much higher.  Losing that weight, quitting smoking and getting blood pressure and cholesterol under control before you apply for health insurance (if possible) will help to lower your cost considerably, as will adopting other aspects of a healthy lifestyle.

 

b.  Unfortunately, the health history of your parents, and perhaps siblings, will also influence your rates.  There really is nothing you can do about this.  But, do not be tempted to give inaccurate answers to any health questions asked by the insurer in order to try to get a lower premium.  They will check your medical history with your physicians for pre-existing conditions and other issues.  And, If the insurance is issued and a significant claim is made, the insurer will research your application to see if it is accurate.  If misleading or inaccurate answers are discovered, your claim may be rejected for cause.

 

2.     As noted, the amount of flexibility to choose both doctors and hospitals varies significantly among plans.  If you have preferences as to who provides your healthcare, make sure the healthcare coverage you are considering takes this into account.

 

3.     Deductibles and co-pays are an important consideration of any healthcare policy. Generally, the higher the deductibles and co-pays, the less expensive the insurance. Determine how annual premiums change depending on deductible and co-pay levels, before you decide what is right for you.  Remember, insurance generally should be used to cover the risk of large financial loss.  Consider getting a plan with high deductibles and co-pays to save on premium payments, especially if your are generally healthy .  Make sure to keep track of deductibles during the year to prevent mistakes.  And consider participating in your employer’s Flexible Savings Account Program (if available), or setting up a Health Savings Account or Health Reimbursement Account so you can pay for medical expenses not covered by your insurance plan with pre-tax dollars.

 

4.     Most healthcare policies have a cap on the amount of benefits that can be received for any specific illness and/or injury during the lifetime of the insurance policy, for both individuals and the family in total.  In other words, if the lifetime cap is $500,000, that is all the policy will pay in total.  After that amount, you are on your own.  And in today’s world, medical expenses can mount very quickly.  Since insurance is supposed to cover against large financial loss, consider getting a policy with a high per occurrence and lifetime limit (ideally no less than $2 million), even if you have to accept high deductibles and co-pays to make it affordable.

 

5.     Determine if the policy includes coverage for long-term healthcare needs, such as ongoing rehabilitation needs or extended stays at nursing home facilities.  Most healthcare policies will cover these needs for a maximum amount that can run out fairly quickly.  Consider if you need to get additional coverage for potential long-term needs. Remember, insurance is intended to cover large expenses, and extended care costs are generally extensive.

 

6.     Make sure you understand what medical costs are excluded in each coverage alternative you are considering.  Major differences can exist which may turn out to be extremely important.  If you need maternity coverage, make sure it is included.  If you do not need maternity coverage, exclude it and save money.  No ones knows the future, so the more comprehensive the coverage is, the better.  Do not make the assumption that certain required medical procedures or treatments will never apply to you.

 

7.     If possible, make sure any serious pre-existing conditions are covered under the policy at some point in time after initiation of the policy.  Usually no more than six months to a year needs to elapse before pre-existing conditions will be covered.  However, some pre-existing conditions will never be covered because of cost to the insurer.

 

8.     Make sure the policy is renewable at your option and is not a temporary policy.  Many people, when they are between jobs, buy temporary policies that expire after a set period of time.  If you do not get hurt or sick you probably will be able to renew.  But, if you do get hurt or sick, and you have not yet secured a job that provides coverage, you will probably not be able to renew and you will become uninsured.  

 

9.     Check to see if any higher risk lifestyle choices like motorcycle riding, scuba diving, taking non-prescription, illegal drugs, etc. will impact either your ability to get health insurance or its cost.  If so, you might consider abandoning those activities to improve your chances of obtaining reasonably priced health insurance.

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