MA’s problem.
Posted by editor on Feb 29, 2008
by: Christine Zafra
There is an Act in Massachusetts that requires everyone aged 18 and up to have a health insurance plan. This would be very beneficial for the college students and 18 year olds alike.
But, is it really? Not everyone in MA can afford health insurance. The government’s end goal might be good but they haven’t really checked on the status quo. Many residents of MA cannot afford it and they might just end up paying for something they did not use or worse, they might find themselves buried in debt because of this Act. Legislators should have known what’s going to beneficial for all.
Some Health Insurance Terms
Posted by Administrator on Feb 22, 2008
Coinsurance
The share of your covered expenses, usually a percentage, that you must pay after the deductible is reached. For example, a policy may require you to pay twenty percent of the cost up to a certain dollar amount.
Conversion of Privileges
Allows the participant or beneficiaries to convert coverage to a different plan of insurance without providing evidence of insurability. The privilege granted by a group policy is to convert to an individual policy upon termination of group coverage.
Coordination of Benefits
Provisions in group policies that limit the total benefits payable under two or more group policies so that benefits do not exceed the actual amount of covered expenses incurred. COB is particularly important when a husband and wife each have obtained family coverage under separate group policies. Some policies may reduce the amount of benefits payable if benefits are payable under other insurance coverage.
Co-Payment
A specified dollar amount a subscriber to a managed care plan must pay for covered health care services. It is paid to the provider at the time the service is rendered.
Deductible
The initial amount of covered expenses a policyholder will have to pay before benefits are paid under the policy. Generally, higher deductible means lower premium. Remember, the deductible should not be so high that you could not afford to pay it should you become ill. Ask your agent or company representative if the deductible is a flat annual amount or if you must pay a deductible for each treatment, or for each family member. Some major medical policies have what is known as a “variable deductible” which means that the deductible will be the greater of a fixed dollar amount or the dollar amount or the total expense coverage.
(Please check http://www.ins.state.pa.us/ins/lib/ins/consumer/brochures/2003_health.pdf for further reading.)
Questions on Getting Health Insurance (Final Part)
Posted by Administrator on Feb 15, 2008
I’ve had a serious health condition that appears to be stabilized. Can I buy individual health coverage?
Depending on what your condition is and when it was diagnosed and treated, you can probably buy health coverage. However, the insurer may do one of three things:
- provide full protection but with a higher premium, as might be the case with a chronic disease, such as diabetes;
- modify the benefits to increase the deductible;
- exclude the specific medical problem from coverage, if it is a clearly defined condition, as long as the insurer abides by state and federal laws on exclusions.
One of my medical bills was turned down by the insurance company (or health plan). Is there anything I can do?
Ask the insurance company why the claim was rejected. If the answer is that the service isn’t covered under your policy, and you’re sure that it is covered, check to see that the provider entered the correct diagnosis or procedure code on the insurance claim form. Also check that your deductible was correctly calculated.
Taken from http://childrenshealthinsuranceinfo.com/
Your 5-minute guide to health insurance
Posted by Administrator on Feb 14, 2008
These 29 tips can help guide you through a sometimes bewildering array of options.
Access to health insurance is protected by federal law if your employer offers group coverage. But if you need to buy insurance on your own and you have a history of medical problems, finding affordable insurance can be a challenge.
Either way, you can take steps to control your health-care costs.
Get the most from your employer plan.
Questions on Getting Health Insurance (Part 2)
Posted by Administrator on Feb 11, 2008
I’m planning to keep working after age 65. Will I be covered by Medicare or by my company’s health insurance?
If you work for a company with 20 or more employees, your employer must offer you (through age 69) the same health insurance coverage offered to younger employees. After you reach age 65, you may choose between Medicare and your company’s plan as your primary insurer. If you elect to remain in the company plan, it will pay first for all benefits covered under the plan before Medicare is billed. In most instances, it is to your advantage to accept continued employer coverage.
But be sure to enroll in Medicare Part A, which covers hospitalization and can supplement your group coverage at no additional cost to you. You can save on Medicare premiums by not enrolling in Medicare Part B until you finally retire. Bear in mind, though, that delayed enrollment is more expensive and entails a waiting period for coverage.
Taken from http://childrenshealthinsuranceinfo.com/
To be continued…
Questions on Getting Health Insurance (Part 1)
Posted by Administrator on Feb 8, 2008
What is the first thing to know about buying health coverage?
Your aim is to assure yourself as well as your family against the most serious and financially disastrous deficiencies that can result from an illness or accident. If you are offered health benefits at work, carefully review the plans’ literature to make sure the one you select fits your needs. If you purchase individual coverage, buy a policy that will cover major expenses and pay them to the highest maximum level. Save money on premiums, if necessary, by taking large deductibles and paying smaller costs out-of-pocket.
Is it possible to buy a single health insurance policy that will most likely provide all the benefits I might need?
No. Although you can select a plan or buy a policy that should cover most medical, hospital, surgical, and pharmaceutical bills, no single policy covers everything. Moreover, you may want to consider additional single-purpose policies like long-term care or disability income insurance. If you are over 65, you may want a Medicare supplement policy to fill in the gaps in Medicare coverage.
Taken from http://childrenshealthinsuranceinfo.com/
To be continued…