There are hundreds of health care plans available from the nation’s biggest insurance companies. But which plan is best for you? And how much does it cost? Naturally, the answers are complex, since they depend on your individual needs, budget and how much risk you are willing to take. Another important factor is the cost and availability of an employer-provided policy.
Your work coverage may be very basic with a high deductible placed on all claims. Or it may be a “Cadillac” type plan where you have no out of pocket costs. Of course, those types of options are rarely offered any more, especially from smaller companies.
Group Medical Insurance
Group medical insurance (also referred to as “employer-sponsored) is available from most large and small companies. Typically, the larger the size of the company, the bigger the contribution by that employer towards its employee health care costs. Often, group health insurance rates much are more expensive (because of lower deductibles on major claims) than personal health care coverage. Thus, if the employer is not paying a large portion of the premium, purchasing coverage yourself may be an option to consider. And if you are near an “open enrollment” period, it’s always a good idea to make sure no major changes are coming, especially if benefits are going to be eliminated.
However, when filling out an application for an individual health plan, it’s important to consider the rate, coverages and what exclusions (if any) will be placed on the policy. When applying for coverage, if you are being treated for an existing condition, it’s possible that your rate could increase and a specific coverage will be removed or altered. The final determination will be provided in writing, and before accepting the offer, a comprehensive comparison should be made between the personal and group plans.
Usually, when you are accepted, you have a window (perhaps 10-60 days) that allows you to study and compare your new policy and decide if you wish to keep it. But if you wait too long, you probably will be required to submit a new application to verify your insurability. And there’s always a chance that the premium will have increased.
Limited Benefit Insurance
Limited benefit plans provide somewhat affordable medical options to persons with multiple or major health conditions. Often, the plans offer very basic office visit and prescription coverage and extremely high out of pocket expenses on hospital stays. They should only be used with caution and of course, the “fine print” should always be read at least twice! If you’re not sure if you have this type of plan or are being quoted this type of contract, simply ask us. Assurant, a very reputable carrier, does offer a few limited benefit options that may be appropriate in some circumstances.
Limited benefit policies tend to have very high turnover rates and often charge you an application fee, which is another reason we don’t like them very much. The application fee is sometimes loosely described and not available for a refund. But the major concern is that these plans are not designed to pay large medical claims, just a portion of them. But if you can’t qualify for other benefits, this may be your best choice.
Medical “discount plans” are readily available online and are not considered to be “credible coverage.” Often, the coverage descriptions are vague and large applications are required to activate coverage. Although they are “guarantee issue” policies, we strongly advise against their purchase, since it is likely you’ll pay a large amount of money if you have a catastrophic claim. In fact, you might even pay quite a bit for a smaller claim! That’s why it is always important to have an experienced broker review the contract with you.
Providing unbiased assistance is our specialty and we’ll be happy to help you choose which policy best matches your needs. When you “request a quote” from our website, you’ll be able to easily compare the options that work best for you. That’s the purpose of our website…to be consumer-friendly and offer health care plans at the lowest available rates. We’ll find the plan that’s best for you, not the insurer. And I know we have said before, but it’s important…You never pay any fees by using our website!