Monthly Archives: July 2017

Cheap Health Insurance

Cheap health insurance is still available, it has not gone the way of the nickel soda or the 10 cent candy bar. As the cost of medical treatment continues to rise, finding cheap health insurance is becoming increasingly difficult. Cheap health insurance is an option for not having any health insurance at all. Choosing cheap health insurance is not something bad, but people have to understand they must go about it the right way.

Cost

Health insurance costs are rising all the time. The costs vary, so do plenty of research before choosing one or another. Many agents will work very hard to get you an affordable health insurance plan for your family at a cost you can live with. The rising cost of health care has made it so that even those with very limited budgets simply have to get some form of health insurance or they run the risk of encountering a large medical bill that can put their financial future in jeopardy. One good tactic to lower your monthly cost is to simply choose a plan with a higher deductible. A good scenario might cost you a couple hundred dollars but a bad scenario could ruin you financially and devastate your family. Check what they cover, deductibles, whether there are maximum payouts under any one category, whether they are for a family or individual health insurance, and of course the cost of the benefits which can vary a great deal. The cost of health insurance can vary greatly depending on the amount of coverage you need, if you were take all the options available in private health insurance then the premium would be astronomical and something which very few people can afford to do. Always check the policy because it might include things which you don’t need, for instance if you are a single man and a policy includes costs for pregnancy then this obviously won’t be needed. If you are considering the lowest cost health insurance then look into purchasing a policy that only covers major illnesses.

Part of the problem is the rising cost of medical care due to uninsured patients. Because of that, hospitals charge inflated rates to cover their own costs. Most low cost health insurance schemes provide for all basic medical and health related expenses, the difference lies in the type and extent of coverage that each of them provides. Low cost health insurance is for people whose annual income falls below a certain range. Health insurance costs depend on the health insurance rate and the range of coverage. Check the monthly cost and amount of deductibles charged and the extent of cost that they cover. There are several ways you can obtain affordable, low cost health insurance.

Search

The costs vary, so do plenty of research before choosing one or another. The best place to start your search for cheap health insurance providers is undoubtedly the internet. However, don’t be tempted to simply perform a search for ‘cheap health insurance’ as there is a high probability that almost all health insurance providers have this statement somewhere in their site’s text. See how cheap term life insurance really be by researching and comparing quote on-line from these top life insurance providers. Generally, health care can be exclusive, therefore if you are searching for a health insurance plan for your family unit, you have to look for plans that are both reasonably priced, and that would offer health coverage you require. Instead, take your time and do your research. With any Commendable Cheap-Health-Insurance plan, you need to read the Cheap-Health-Insurance terms of service of the Cheap-Health-Insurance account and search for any extra Cheap-Health-Insurance fees. As when looking at any health insurance policy, you ought to search for coverage that has a maximum payout of at least $1 million.

Conclusion

As the cost of medical treatment continues to rise, finding cheap health insurance is becoming increasingly difficult. The key to finding cheap Health insurance is knowing every option that is available, a process that can take a long time for an individual to complete. The key with health insurance and especially cheap health insurance is you need to know where health insurance is.

How To Get Low Cost Health

For those who don’t know, health insurance is simply the coverage of medical claims of an individual, against the medical costs. Like many others you may not be able to afford an expensive insurance policy – but you can eliminate all the frills you don’t need and get the low cost health insurance you want and still be adequately covered. Health insurance, as with any kind of insurance today, whether individual, personal, business or family health insurance, is always a gamble. You’re gambling that you’ll take out more than you are paying in and your health insurance company is gambling they will pay out less.

You want to know what to look for in any type of good insurance. If you have always had a health insurance benefit where you’ve worked and especially if you were a state or federal employee and now find you have to buy your own, you may not be able to afford the level of coverage you used to have. Finding good low cost health insurance today is easier than most people think.

To start, shopping for free health insurance quotes online is the easiest and best way to find low cost health insurance coverage. If you have any permanent health problems, such as diabetes, or have had cancer at any time in your family history, your monthly cost could easily be more than your house and car payment combined, but there are many different good insurance plans available today in the US.

The cold hard facts are the older you get the more important your health insurance policy becomes; this isn’t to say that you should not be concerned about your insurance when you’re younger. In case your doctor decides that something is an absolute medical necessity and it’s not covered under your current policy, the insurance company may exercise its discretion in paying for it, but don’t hold your breath. Many report they were eventually covered yet many more people get turned down.

One of the best ways to find low cost insurance is to get free health insurance quotes online. You can generally get very fast quotes and you want to compare several companies, as they will all have different criteria. This will be the fastest way to find low cost insurance.

Most importantly, you want a health insurance provider or company that has a good track record for paying without fighting you on every little detail. Your local agents may only be able to offer what they have currently available and not be able to offer you what’s best for both your pocketbook and your health.

The death rate in any given year for someone without insurance is twenty-five per cent higher than for someone with insurance so you want to make sure you get the best coverage you can get at the lowest cost as soon as possible. Heart-attack victims who don’t have insurance are less likely to be able to get angioplasty, which is often the treatment of choice. People who have pneumonia who don’t have insurance are less likely to receive initial or follow-up x-rays or necessary consultations.

In general because people who are uninsured are sicker than the rest of us because they can’t afford proper medical care, they can’t get better jobs, and because they can’t get better jobs they can’t afford insurance, and because they can’t afford insurance they get even sicker.

Although it does increase your risk, one way to lower your insurance costs is to set a higher deductible; if you’re in good health you’ll like come out ahead, barring an unforeseen event such as an accident, etc. Keeping yourself in better health will help you with less health insurance claims. All the insurance companies have to be very competitive because it’s so quick and easy to compare them with the other competing companies online.

Children without any insurance are less likely to receive proper medical attention for serious injuries, for recurrent ear infections, or for asthma for example and you want to avoid having to face a $100,000 open heart surgery without having any insurance.

So taking out insurance with higher deductibles and spending a little time online comparing at least five or more companies will make it more likely that you’ll find the best low cost insurance. There are many different health plans so make sure you get an understanding of all the low cost health insurance policies that are available from each company. Cheap or low cost insurance does mean a lower price and in some cases lower quality, but the price may be more important to some than the quality of the health plan. You don’t want to pay for more than you need but you want to consider any possible future health events you might encounter too.

Finding good, hopefully cheap, low cost insurance without giving up quality does not simply mean looking for the lowest premium but it means fully understanding all of the costs that will be involved in your policy. And finding the best health insurance is easy to do online, whether you’re shopping for long-term or short term health insurance from California, Texas or Florida.

With the rise of medical insurance costs today, most people look for low cost health insurance premiums that will ensure quality medical attention at the time of need, but at a price they can simply afford. Make sure to keep in mind that with low cost insurance options, you’ll need to compromise somewhat on the variety of services covered. Proceed surely but carefully.

Health Insurance and Health Care

The health care and health insurance dilemma in the United States penetrates and corrodes the very core of the quality of the American life. Our politicians and legislators are falling all over each other to produce both State and Federally mandated solutions for one of the most expensive problem facing our nation today. Documentaries such as “Sicko” with Michael Moore, and countless television stories and newspaper articles scream the need for change. As the never-ending inflation of medical services and prescription drugs rises, the bureaucracy of the insurance providers keeps pace by increasing premiums, and lowering quality of coverage for most Americans in their health plans. Drug companies are under constant scrutiny to offer more competitive pricing, but face little regulation compared to the foreign countries who have elected to impose cost controls endemic to their individual society’s perceived needs.

So in the face of such a negative equation, how does a capital-driven society like the United States of America re-vamp its health care system, and still maintain the theology of “choice” and “capital market competition”? And how do we do it without killing more Americans?

To answer these questions it is necessary to take in to account what works and what doesn’t in both American society and other societies where socialized medicine is the norm. The problem that Uncle Sam and many self-made American business folks have with socialized programs is the ability of such programs to denigrate a societies progress, and step away from our independent roots, both financially and health-wise. In order to continue to allow health insurance providers to shore up their billions of investment dollars ( a key pillar in our financial framework) and still take care of every American who is sick requires us to radically change the way the risk of such health problems is transferred, but to still collect regular premiums from taxpayers to fund the collective system. My proposed solution will be spelled out in this article in relatively simple terms forming a base architecture which will allow independent insurance providers to remain, independent hospitals and doctors to remain independent, and drug companies to remain competitively profitable while still insuring every American.

Proposal Architecture

I would propose a three-tiered system for Health Insurance, Prescription Drugs, and Medical Providers of all types:

I. Insurance Method

In order to keep insurance companies profitable and provide 100% base health coverage to all Americans at the same time, you need a combination of the net effect of socialized medicine and American free trade. A fund must be created by the federal government which closely mimics a Re-Insurance Company. Most insurance companies whether in the health field or commercial insurers have large re-insurance agreements and policies with major funds. A classic example is Berkshire Hathaway’s “General RE” which underwrites some of the largest global policies in the world in their niche. For description purposes, the federal government needs to take the opposite approach of a non-profit, heavily taxed medicare and insurance system by creating the world’s largest re-insurance vehicle. The re-insurance department is funded by A) a percentage of all health care premiums from all health insurance companies, and B) a 1.5% federal income tax increase across the board for all Americans. From this point forward, all health insurance providers are required to have a BASE INSURANCE LEVEL on all policies which will include a) full prescription coverage included, b) all doctor visits covered, and c) full major medical coverage with no deductible.

From an actuarial standpoint, what you are doing is not eliminating health insurance premiums for Americans. All working Americans who earn more than $16,000.00 per year must pay a scale-adjusted premium of the same category and type for the “base policy”. The scale for premium is driven by total income per individual or household based on their current employment. However, you have just turned the entire insurance industry in to one big “group plan” where the risk is spread out over the entire country. Using the proportion of healthy Americans to those requiring services at any given point, this simplistic approach lowers the premium for the base policy to affordable levels for all wage earners, and gives the base policy for free to low income individuals and families. Those people who meet the low income standards get the same base insurance as everybody else, and are required to file with a private insurance company of their choice for insurance. The federal RE fund pays all insurers a minimum base amount equivalent to what they would get from a paying client. The “Federal RE” model receives 30 to 35% of the private insurance company’s base premiums for all policies. The base premiums and the amount each individual must pay is determined by an actuarial committee of the new federal RE fund, but should be adjusted very rarely. Once the percentage is set, it becomes law, and the 1.5% tax increase across the board is primarily a cushion for the low income and poor.

Insurance companies then endeavor to differentiate themselves by adding features to the base policy for their clients for their marketing and packaging. They do NOT differentiate themselves by providing sub-standard insurance, as it is not optional. The base policy for all is a major medical insurance policy based on California Standards, and covers all co-pays and deductibles 100%. In order to make additional insured dollars, the health insurer must provide more elite services to guarantee a client who is willing to pay for additional features an even better position than the base position. This enables the following to occur in logical order:

* The federal government actually makes money on investing insurance premiums the way insurance companies do by their re-insurance department. Risk is spread out over each American that can afford to pay premiums. Premiums are minimal because of the inflated group size and reduced insurance company risk. The combination of a small federal tax increase to hedge dollar volume and beef up the account combines with receiving the RE premiums and investing them makes this federal program slightly profitable, and with the ability to adjust policy when needed.

* Insurance companies lower their risk, and are able to simplify and streamline their base coverage for major medical. Since all rules apply to all insurers (new or old) they can compete based on important but “ancillary” products to improve the insurance quality of those that can afford extra benefits. Major payouts will be largely reduced due to automatic RE participation on the policy’s base components.

II. Prescription Drug Costs

By making Federal RE the “co-payer” in most medical transactions for both medicine and medical services, you have also created a need for a private-style approach to controlling the cost of drugs and other prescriptions. This is a sticky area, because development costs for drugs are hyped as being out of control if they cannot be later recouped with high prices.

Since the federal government in the form of Federal RE is now a payer/customer of the pharmaceutical companies, prices for medications must find a happy medium to allow for development and free trade, but with sane maximums for purchase. It is the job of the federal government to prevent monopolies. A monopoly is not defined as a single producer of a product (or drug) being the only source for a given product. A monopoly is defined as that single-source-producer charging an amount which hurts our society, and potentially prevents competition. (generic drugs) Standards must be developed for the maximum payment amount allowed for each category of medicine and medical supply. This will be an ever-changing exhaustive piece of work, done on a very ongoing basis by employees of Federal RE. The purpose is never to set prices, but to determine the maximum the fund will allow an insurance company or itself to collectively spend on a medication, taking into consideration all aspects of the newness of a product by using fluctuating actuarial and monetary scales. If a Pharmaceutical supplier will not meet these maximums, then unfortunately, the medicine will not be available until they are willing to bend. This is a flaw in the ointment than cannot be fixed any other way due to the way drugs are really developed in the United States. Americans who add to their “base policy’ with supplemental insurance that covers expensive cutting-edge medicine could receive the medicine, but not the base-only policy holders. Drug companies will therefore be forced by demand to reduce their charges at least to the point of scale, in most normal scenarios. This portion of the plan cannot be altered to appease any particular party, because if you do the entire buying system falls apart. However, groups currently involved in assisting low-income victims could shift their focus to those precious few who are not able to get the most cutting edge product in time. The money simply cannot be covered by Federal RE. That does not mean another vehicle cannot be refocused, whether private or public, to assist in those few cases percentage-wise which require the latest cutting edge medications not charted as buy able.

III. Medical Treatment under Federal RE conditions

Medical treatment at this juncture is now available for all Americans, and in almost all cases their prescriptions are covered also. But now that we are prepared to fill up every clinic and major hospital with patients, how do we control the clinically insane costs of running that clinic or hospital? We can stave off socialized prescriptions via creating a powerful buyer in the market Through Federal RE, and having simple cost-overrun standards that are non-negotiable and consistent. But the clinics, hospitals, and emergency rooms didn’t get any cheaper. Since all Americans (at a minimum) are covered by the best type of major medical insurance money could previously buy, the billing systems and related bureaucracies are naturally streamlined over time. But sadly, medical charges have very little to do with the actual cost of a procedure, and everything to do with what the various hospital and clinical administrations CAN charge in each situation. If we govern the pricing of each procedure too closely, then we are mimicking the socialized policies of countries who we do not wish to be.

I would argue that the same way maximums were set in item #B above, a geographically mapped system to avoid over-charges could be applied. What constitutes an overcharge is again decided by committee at Federal RE in much the same way that pharmaceuticals are banned when costs are unreasonable to both the insurers and the government. Because 100% of the American population is insured with Basic (unless they foolishly “opt out”) the CUSTOMER is now the dual processors of Federal RE and the private insurance company involved in each case. If cost controls are unreasonable by today’s standards to any given clinic, the quality of health care will suffer tremendously when the operating units do not get to charge whatever they want, or whatever they used to feel an insurer will pay. But when medical organizations get 100% continuity in payments through a single-payer style system with few errant delays in the simplified processing, they will actually make far more money than they do now in the world of constant claim disputes, and zero consistency. The monitoring committee, as with the prescription committees, are comprised of qualified professionals at Federal RE who understand the true economics of a hospital or clinic. Severe overcharges that are way beyond scale cannot and will not be honored. Plenty of money will still be spent for procedures (especially at the onset when the system is brand new) but the whole key to controlling price is actually not price controls as the system matures…but rather the lower cost of running a hospital and clinic when the payments are made for services with lightening speed. That’s right..there is no reason to hold up funds under the new program once the services are provided. Medical billing will be a snap, and the incredible amounts of money spent on corrective systems can be lessened for each institution. Speed of payment to medical facilities is a major factor for overall success. So is having a fairly large and very intimate accounting system to track abuses. Frequent audits will replace much of the former aggravation of charging insurance companies, and will be a much more regular event at hospitals. A strong governmental role in auditing each facility regularly is actually a pillar of this plan, and will be gone in to more detail in later articles as to who and how this occurs, and how frequently.

The American dream is still a wonderful thing. We do not have to take away the profit motive from professionals who seek their fortune through honorable health industries, medical jobs, and insurance work. We simply need to define the rules of a new system that uses the age old insurance RULE OF LARGE NUMBERS to create a national group. The same talent required to be a preferred doctor, dentist, or insurance provider still exists in a more comprehensive form. State programs and the endless bureaucracy that encompasses them are eliminated and replaced by the new system. Welfare mothers and low-income households are fully sponsored for the coverage they really need, and the investments of Federal RE: over long period of time pay for most of the built-in deficiency. Hospitals, clinics, insurers, and drug companies all have to compete on the basis of quality and product provided instead of what HMO or PPO they belong to, or what “level of care” is minimally chosen. You will find that in practice it is an absolute fact that Federal RE will actually show a small profit when the smoke clears away, and medical care will improve through TRUE COMPETITION, not the bureaucratic version of it most of us suffer with today.

Health Insurance Terms

One of the biggest problems for most people is simply understanding the health insurance benefits that they have. For the most part, health insurance policies try to be user-friendly in their wording, but many people are just not familiar with medical and insurance terminology.

Most health insurance policies also provide something similar to a cheat sheet which gives the basic outline of policy coverage and covers the most common medical services. However, you need to be sure that you understand the different things that are excluded under your plan. Many health insurance plans provide limited benefits for services such as mental health, chiropractic services, and occupational health. Even physical therapy and home health care are often limited to a certain number of visits per year.

Co-payment or Co-pay

A co-payment is a pre-determined amount that you must pay a medical provider for a particular type of service. For example, you may be required to pay a $15 co-payment when you visit your doctor. In this instance, you must pay $15 to the doctor’s office at the time of the visit. Normally, you are not required to pay any additional fees — your health insurance company will pay the rest. However, in some cases, if your health insurance policy specifies it, you may be responsible for a co-payment and then a percentage of the remaining balance.

Deductible

A deductible is the amount of your medical expenses you must pay for before the health insurance company will begin to pay benefits. Most health insurance plans have a calendar-year deductible which means that in January of every new year the deductible requirement starts over again. So, if your calendar year deductible is $1500, as long as your medical expenses for the current year do not exceed $1500 the insurance company pays nothing for that year. Once January of the new year starts, you have to begin again to pay for $1500 of your own medical expenses.

Coinsurance

Coinsurance (or out-of-pocket expense) is the amount or percentage of each medical charge that you are required to pay. For example, you may have a $100 medical charge. Your health insurance company will pay 80% of the charge and you are responsible for the additional 20%. The 20% is your coinsurance amount.

Coinsurance accrues throughout the year. If you have a large number of medical charges in one year, you may meet the coinsurance maximum requirement for your policy. At that point, any covered charges will be paid at 100% for the remainder of the calendar year.

Stop loss or out-of-pocket expense limit

Sometimes you will hear the out-of-pocket expense limit referred to as your stop loss or coinsurance amount. Basically, this is the amount you will need to pay out of your own pocket per calendar year before the health insurance company pays everything at 100%.

You will need to check your policy because many policies that require co-payments do not allow these co-payments to go toward the out-of-pocket amount. For example, you may have reached your out-of-pocket maximum for the year, so if you are admitted to the hospital you may pay nothing. However, since you have to pay a $15 co-payment every time you visit the doctor, you will still have to make this co-payment.

Lifetime maximum benefit

This is the maximum amount that the health insurance company will pay toward your medical expenses for the lifetime of your policy. Generally, this amount is in the millions of dollars. Unless you have a very severe condition, you will not likely exhaust this amount.

Preferred Provider Organization

A Preferred Provider Organization (also known as a PPO) is a group of participating medical providers who have agreed to work with the health insurance company at a discounted rate. It’s a win-win situation for each side. The insurance company has to pay less money and the providers receive automatic referrals.

In most health insurance policies, you will see different benefit levels depending on whether you visit a participating or nonparticipating provider. A PPO plan provides more flexibility for the insured person because they can visit either a participating or nonparticipating provider. They just receive a better price if they use a participating one.

Health Maintenance Organization

A Health Maintenance Organization (also known as an HMO) is a health insurance plan which restricts you to only using specified medical providers. Generally, unless you are out of the area of their network, no benefits are payable if you go to a nonparticipating physician. Typically, you are required to select one main doctor who will be your Primary Care Physician (PCP). Any time you have a health problem, you must visit this doctor first. If they feel that you need it, they will refer you to another network provider. However, you cannot just decide on your own to visit a specialist; you must go through your PCP.

Medically necessary

You will see this term in all health insurance policies, and it is a frequent cause of denied claims. Most insurance companies will not cover any expenses that they do not consider medically necessary. Just because you and/or your doctor consider something medically necessary, your health insurance company may not. For this reason, you always need to verify that any costly procedures you are considering will be covered.

Routine treatment

Routine treatment is generally defined as preventive services. For example, a yearly physical examination that you have on a regular basis is generally considered to be routine. Many of the immunizations that children and adults receive fall under this classification. Some insurance companies provide limited coverage for routine treatment; others provide no benefits at all.

Pre-existing condition

A pre-existing condition is a condition that you acquired and/or received treatment for prior to the effective date of your current health insurance policy. Health insurance companies vary on how they treat pre-existing conditions. Some companies will not give you coverage at all if you have certain chronic pre-existing conditions. Others will give you coverage but will not provide any benefits for a period of time — usually from 12-24 months. Still, other health insurance companies will specifically exclude a pre-existing condition from a policy and will never provide any benefits for that condition.

Be sure that you are very clear on the pre-existing limitations of your policy so that you are not unpleasantly surprised when you visit your doctor.

Explanation of Benefits

This is the form that the health insurance company sends you after they complete the handling of your claim. It details the bill they received and how they processed it. It is commonly called an EOB.

Coordination of Benefits

If you are eligible for benefits under more than one health insurance plan, your various health insurance companies will need to coordinate benefits. This insures that no more than 100% of the total charge is paid. There are many variations on how this situation can occur. In general, the primary company makes their payment first. Then you file a copy of the charges with the secondary company along with a copy of the Explanation of Benefits (EOB) from the primary company. The secondary company usually picks up the remainder of the bill.

Participating provider

A participating provider is a medical provider who has signed a contract with a health insurance company or health insurance network to charge pre-determined rates to patients who are in the network.

Nonparticipating provider

A nonparticipating provider is a medical provider who does not have a contract with a particular health insurance company or network. If you use a nonparticipating provider, you will generally pay a larger portion of the bill. In some cases, you may be responsible for the entire bill.

Limited benefit plans

These are not considered to be comprehensive medical insurance plans. Instead, they provide very specific, limited benefits for different types of services. For example, they may provide a flat rate for each day you stay in the hospital or pay a limited amount for each surgical procedure that you have.

Typically, they are marketed toward people who cannot afford or are unable to obtain more comprehensive coverage due to pre-existing health conditions. Or, they may be geared toward people who have high-deductible plans. The good thing about these plans is that they generally pay in addition to any other coverage you may have. Therefore, no coordination of benefits is required.

If this is your only coverage, be aware that you will usually have to pay a large portion of any bill as these limited plans do not usually pay large amounts per day. For example, it may actually cost you $1000 a day to stay in the hospital. If your limited benefit plan pays you $200 a day for each day you spend in the hospital, you will be personally responsible for the remaining $800 per day.