Choosing Health Care Insurance By Steve Meinhardt http://yumainsurancehealth.com Office: 928-217-3621 Mobile: 928-580-7102 Fax No: 928-344-3507 Email: steve@yumainsurancehealth.com Or - Fill out the contact form on my website and I ll get right back to you! http://yumainsurancehealth.com/contact/ Yuma Insurance located at: 2691 S 4 th Avenue, Yuma AZ 85364 Office Hours: Monday-Friday 8:30 to Noon/1:00 to 5:00
Limits of Liability / Disclaimer of Warranty: NOTICE: You Do NOT Have the Right to Reprint or Resell this Report! You MAY Give It Away The authors and publisher of this book and the accompanying materials have used their best efforts in preparing this report. The authors and publisher make no representation or warranties with respect to the accuracy, applicability, fitness, or completeness of the contents of this report. They disclaim any warranties (expressed or implied), merchantability, or fitness for any particular purpose. The authors and the publisher shall in no event be held liable for any loss or other damages, including but not limited to special, incidental, consequential, or other damages. As always, the advice of a competent legal, tax, accounting or other professional should be sought. The authors and publisher do not warrant the performance, effectiveness, or applicability of any sites or products listed in this book. All links are for information purposes only and are not warranted for content, accuracy or any other implied or explicit purpose. The material in this manual does not constitute legal advice, only the author s interpretation of the laws involved as he understands them. As always, legal advice should be obtained from a competent legal professional in any business venture. This manual contains material protected under International and Federal Copyright Laws and Treaties. Any unauthorized reprint or use of this material is prohibited. - 2 -
Introduction Choosing Health Care Insurance For more than a decade, health insurance and health insurance reform has been part of the national debate. From rising medical costs, increased premiums, changes in coverage, reduction in employer healthcare contributions and you and your family's ever changing health care needs, choosing which policy and coverage are best can be a very daunting task. There are so many variables to consider - deductibles, pre-existing conditions, maximum lifetime coverage and varying types insurance add-ons! It is no surprise that many individuals and families find themselves with the wrong type of coverage or not enough coverage and therefore are faced with tough decisions about their medical care. The purpose of this report is to help demystify the process of choosing Medicare supplements and health insurance for you and your family. When you understand the terminology, know the right questions to ask and are aware of your health insurance needs and budget you can confidently choose a plan that will best protect your family. Finding the Right Plan Before your even start your search for the right Medicare supplemental insurance plan for you and your family, there are three things you should consider and make notes about: 1) Your health care needs; 2) Your budget; and, 3) Your preferences. For instance, will you be joining an age bracket that requires increased annual screenings? What co-payment on prescription drugs can you afford each month? Do you prefer to be able to see a specialist directly without a referral from your family doctor first? These are questions to ask yourself and inventory to help you determine what your needs and preferences. - 3 -
Health Care Coverage Needs Choosing Health Care Insurance If you were seeking health insurance for a single person, a family with young children, or empty nesters, most likely you would be given three entirely different health plans. Health insurance can seem like trying to scale a mountain, but if you start with your individual needs, it will be more like a walk on the beach. Start by making a list of different types of health care you will need. For instance, an older couple might want to start with prescription medication coverage. Life, vision, and prescriptions would be a great starting point for older couples. Make a list of coverage options that are important to you and if you are not sure where to start, ask friends and co-workers for tips and ideas; chances are, they are in the same boat and can get you on the right track. Budget Considerations It would be terrific if costs and our budgets wasn't a concern but few of us are so lucky. Knowing how much you can afford in monthly premiums, co-pays and out-of-pocket expenses is also essential to choosing wisely. Premiums and deductibles, when dealing with health care, can get expensive. When deciding on a personal health insurance plan, your budget must be at the front of your mind. Higher deductibles usually mean lower premiums, but you must also be sure that paying a large chunk out-of-pocket still fits within your lifestyle. Deductibles are the payments which you will incur before your insurance company will cover any of your claims. A managed-care health insurance plan might be your best bet if you are thinking about keeping your premiums low. Managed-care health plans limit your choice of in-network providers, but allow you to keep the money under control. As with anything, the more choices you have, the more expensive the coverage becomes. Getting Proper Quotes The quoting procedure for personal health insurance is usually the most over-looked part of the process. Getting quotes can save a lot of time and energy in the long run because you will know exactly what is out there as far as different plans and pricing goes. - 4 -
There is a right way and a wrong way to get a quote. Many people don t think about the quoting process as being part of the actual health insurance procedure and will solely rely on verbal quotes over the phone and think nothing more before they pull out their charge card. Pre Quote Before you ever pick up the phone to talk to a personal health insurance representative, you should know what you are looking for. A good way to do this is to check out different insurance carriers and plans on the Internet to get an idea of what is offered and the prices of each type of plan. Discussing Quotes Once you have an idea of what you are looking for, then you can pick up the phone and start calling around. When you get an individual health representative on the phone, ask your questions to determine if the plan they are suggesting is the best for you. Ask about other plans, not shown on their website to see what other types of deals they may have and do not be afraid to tell them you will get back with them once you have looked over all of the information just because you are on the phone doesn t mean you have to purchase at that moment and usually, representatives will offer you other pricing and incentives if they know you are looking around. Remember it is the personal health representative s job to try and get you to make a purchase with their company. Obtaining Quotes Once you have discussed with the representative and have come up with a sample plan that fits all of your needs, ask them to send you a hard copy of the quote. If you decide that company is who you want to do business with it will be helpful to have it to refer back to. If one person offers you a great incentive, you want to be able to reference that quote if someone else picks up the phone next time. It is also imperative that you get a hard copy because with so many quotes, you will have a difficult time remembering which company promised what. This will help in comparing quotes at a later date, to have exactly what each company promised. Yes, this may take some time, but it will be well worth it in the long run when you come away with the best plan and pricing that fits your needs. In a recap of how to obtain proper personal health insurance quotes, remember to do your research ahead of time so you know what you are looking for. - 5 -
Ask questions about each plan and company including if there are any plans the representative thinks might fit your needs better. Finally, get a hard copy of the quote so that you can compare the different companies later and don t have to bother with remembering all of the details. Once you have done this, you can even help your friends and family with the correct way to get a proper health insurance quote. Medicare Supplement Plans The Basics Be sure to take care in selecting your Medicare Supplement Plans. It is always helpful to seek the advice of an insurance agent or broker who can thoroughly go over all of the plans with you before you decide. Let s start with the basics: What is health insurance? Health insurance is a plan that pays for the costs involved in your medical expenses. Sometimes this also includes coverage for disability or long-term nursing care, and can be provided through a government sponsored program or by any private insurance company. This kind of coverage can be bought by individuals or on a group basis. No matter which way you buy this kind of on health insurance, the coverage is paid for with monthly fees or premiums while the health insurance company provides protection for unexpected health care expenses. What is a Medicare Supplement Plan? This question may not be so easy. First, we need to briefly discuss what Medicare is. Medicare is a kind of health insurance plan, provided by private insurance companies. Medicare plans cover most health care expenses that a person might need, but they do not pay for all of the medical expenses that you could incur. This is where the need for Medicare Supplement Plans comes in. The Medicare Supplement plans are directly tied to the original Medicare plans and cover the cost of the gaps that are left by the original plans. Because the bridge these gaps that exist between the original policies and the costs that are charged by the hospitals and physicians, the Medicare Supplement plans are also known as Medigap plans. - 6 -
You can enroll in a Medicare Supplement Plan only if you have an Original Medicare plan part A and part B. The Medicare Supplement Plans (Medigap) can only be purchased in addition to the Original Medicare plans because they are not able to pay for the total cost of any medical expense. Medicare Supplement plans, however, are sold and administered by private insurance companies. There are 12 standard Medigap policies and they are labeled A through L. They are each different in scope and coverage, but no matter which insurance company sells them, they are required to provide the same policy coverage and benefits as described by the letter coverage that they are. Meaning, if you select Plan D it will offer the same coverage and benefits whether you purchase it from United Health Care or Humana. Note: it is recommended to sign up for a Medicare Supplement plan within thirty days of getting an Original Medicare plan in order to receive the maximum benefits and cost redemption. Seeking the advice and help of an insurance broker before selecting your plan will help you be aware of the coverage procedures of the respective insurance company and help you to choose the best fit for you and your family. In most cases, you will want to be aware of policies that may cost you a few dollars more per month, but can save you hundreds or even thousands of dollars per year in coinsurance and deductibles. Plans: vs. Medicare Advantage There are millions of American seniors that have purchased Medicare Supplement plans as well others who have purchased Medicare Advantage plans in an effort to reduce their health care related costs and to save on insurance premiums. There are also many that are confused about the different kinds of plans and what options are available. Medicare Advantage plans replace Original Medicare and work as substitutes. The plans vary according to each insurance company that is offering them, because they are not regulated by law to basically offer the same benefits like Medicare Supplement plans. There are many similarities among insurance carriers, but you may need to do a bit more digging to find one that will provide what you are looking for. - 7 -
In 2009, there were approximately 1400 Medicare Advantage plans that were eliminated by the Obama administration. This move has only helped the already popular Medicare Supplement plans but there may still be many who have heard about the Advantage plans and want to know what the differences are. That said, understand that with Medicare Supplement plans, you can visit any doctor or hospital that you desire. Also, those who select the Supplement plans often rarely have to pay directly for healthcare services, as there are plans that do not require a copayment or a deductable. The Medicare Advantage plans that were eliminated were plans that had the potential to charge policy holders more than the Original Medicare would have for home health care, dialysis, and other services. These plans also charged the beneficiaries the same exact amount whether or not there were any pre-existing conditions or any other issues. They also capped the annual out of pocket expenses for policy holders at $3400 per year. As you can see, there appear to be more advantages to selecting one of the Medicare Supplement plans compared to a Medicare Advantage plan but the best way to make a decision is to consult a professional and make sure that you understand all of the different options that each policy can contain. What To Look For In a Medicare Supplement Policy All Americans over 65 years old may enroll in the federal Medicare program. Medicare Part A covers hospital stays, and that is why most seniors are automatically entitled to this coverage. Medicare Part B has a small monthly premium and covers some of the costs related to doctor visits, laboratory tests, x-rays and additional outpatient services. This is perhaps the most popular additional coverage. - 8 -
Having both Medicare Part A and Part B will still not cover all medical expenses that you may incur. Medicare still has deductibles and coinsurance requirements, in addition to the need to purchase a separate policy for prescription drugs. This is, again, why people choose to purchase Medicare Supplement policies to fill in for these lapses and to better cover themselves for medical necessities. Because many, many insurance companies sell Medicare Supplement policies in each state, it is no wonder that many are confused and looking to purchase the one that is a good fit. The standard policies are designated by the letters A through L. Plan A is the most basic and all seniors are automatically enrolled at the age of 65. Plans B through J offer additional benefits. Law requires that the benefits remain the same, no matter which insurance company is selling it. You will want to find out as much detail as you can from your state s Department of Insurance or the federal Centers for Medicare and Medicaid Services (CMS) regarding the exact benefits covered by each Plan. Also know that not all of the insurance companies offer all 12 plans. When you are shopping for Medicare Supplement plans, you need to understand that the difference in competing insurance companies is related to the prices, customer service and the reputation of the insurance company. Here are some suggestions to keep in mind as you research the Supplement plan that is right for you: Take a look at your state insurance department, CMS, or speak with a local insurance broker that you trust in order to compare the different plans (A through J). A broker can help you to compare pricing but even if you do not consult with a broker, be sure to compare prices and shop around. Be sure that you understand how the pricing works regarding the premiums. While you may be looking for the least expensive, it may not end up the best choice overall. Understand what (if any) trade off there is. Take a look at the carrier s Select network. The Select Medicare Supplement offers lower monthly premium to those who agree to use hospitals and providers within that Select network. You will want to choose a company that has a large, statewide Select - 9 -
network that will save you money on premiums without restricting your provider choices too much. Know what the billing schedule is. There should be options for monthly, quarterly or once a year billing. Ask about any added value that the company is offering. Some insurance carrier s provide additional, varying value services like online health information centers or discounts on vision, hearing and wellness programs. As you may be dealing with this particular company for years to come, be sure that they offer the best in customer service standards. Ask about: Office locations and hours of availability. Automatic claims filing you don t want to have to do more paperwork than is necessary and the billing should be taken care of. Access to customer service via a toll-free phone number and via email correspondence. Online access to manage your account. You should be able to check claim status, change personal information (such as an address or phone number etc.) or look up a particular hospital or doctor. Perhaps the most important factor to consider is Reputation. Find a company that is known for their strength, financial stability and longevity in the insurance market itself. Please, take your time in selecting your Medicare Supplement plan, as this is a very important decision. It affects your health and financial security in the coming years. Don t be afraid to ask questions when you meet with an insurance agent or broker or to set up more than one meeting if it s too much information to take in in one sitting. Get all of your questions answered and feel good about your selection and plan. After all, this is the company that will be there when you need them, helping you for years to come. - 10 -
As a local insurance professional, your questions can be answered without any pressure and you can be sure that you are getting the best information possible Call or make an appointment today! Sincerely, Steve Meinhardt Office: 928-217-3621 Mobile: 928-580-7102 Fax No: 928-344-3507 Email: steve@yumainsurancehealth.com Or - Fill out the contact form on my website and I ll get right back to you! http://yumainsurancehealth.com/contact/ Yuma Insurance located at: 2691 S 4 th Avenue, Yuma AZ 85364 Office Hours: Monday-Friday 8:30 to Noon/1:00 to 5:00-11 -