As an insurance agent specializing in health insurance it amazes me when I see all these offers stating “Everyone’s Accepted”, “pre-existing conditions covered”, “This offer has been extended to this Friday only”. And the price, it’s high enough to look legitimate!
So what is covered? Not much. In fact, some of these companies want you to enroll before you can see their network of providers! Oh! And we are told, that the enrollment fee is not refundable?
We all know that health insurance costs are high because healthcare costs are high. Consumers are desperate for alternatives that are more affordable. With such high demand for alternatives comes an army of rogues ready to swindle the unknowing. For me it’s sort of like watching a horror movie where the monster is ready to pounce on the unsuspecting victim. It makes me want to yell so they will turn around in time and not be devoured.
It is really important to know what kind of policy you are buying. Maybe, you are considering a high deductible plan to keep costs low. Some plans offer high deductibles that are not annual deductibles but per occurrence! So if you had a big expense one month and then later that year had another event, then you are starting all over again. If you had a $5,000 deductible and three different events in a year then you would be out of pocket $15,000 and maybe the insurance company paid absolutely nothing! I have met with clients that had these plans but claimed they did not know.
Some plans are very basic and then you add riders to round out your coverage. It is a way to reduce costs, unless adding back everything that was stripped away makes the policy to expensive. Some plans cap the benefit on the really big expenses, so that they only pay a percentage of the total cost or even leave out some important coverage. The theory of insurance is that it will protect you and your family against the unplanned accident or illness. You especially need insurance for the really big expenses and unless you can predict the future you need the plan for any event or illness.
Seniors beware! Medicare only pays a portion of your healthcare needs so you supplement your coverage. It used to be simple. Pick plan A-J. Because law required the plans to meet minimum guidelines, you couldn’t get hurt. Now you have all these new Medicare Advantage plans that offer lower costs and on a fixed income that could really help. Did you know that the insurance company takes the place of Medicare? That means, your provider will have to accept payment from this insurance company. Have you ever heard of this company? If your provider is not willing to accept the terms of this company then you will need to find another provider.
Advantage plans can be less expensive but you need to know how they cost less. It’s sharing the risk with the insurance company. There are little charges like doctor office co-pays that you can live with. The bigger charges are your cost sharing for hospital stays, skilled nursing facility costs and durable medical equipment. If you had a bad year, these charges could be several thousand dollars.
We just wanted warn you about the monster in the room ready to pounce. You can protect yourself with just a little research. Just like shopping for a big-ticket item. Do your homework. Check your coverage now. Ignorance is not bliss. In fact, it can be quite costly.
This article was contributed by: All Insurance Matters, Inc., 5 Rockingham Road, Windham, NH 03087 (603) 890-0100 www.AllInsuranceMatters.com
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