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What You Must Know Before Purchasing Health Insurance-NC
Do you understand how a health insurance “co-payment” works?
Do you know your health insurance plan’s “lifetime maximum”?
Do you know how health insurance companies deal with “pre-existing” health conditions?
Does your health insurance plan have adequate “co-insurance” provisions?
Do you understand that your health insurance premium could be lowered by increasing your “deductible”?
NC Health Agent Direct
(This Article Re-Printed from Insurance Maze Blog : Navigating The Insurance Maze)
Health Insurance-”Deductible”
In health insurance your “Deductible” is your share of the insurance risk. You may have already heard a health insurance agent tell you something like – “Well, the higher your health insurance deductible, the cheaper your insurance premium will be.” This agent is absolutely correct.
In health insurance, your “deductible” is your share of a health insurance claim. This is the amount you must pay first before the health insurance company will begin to pay on your insurance claim.
The “deductible” may be a flat dollar amount or a percentage of the insurance claim amount.
The more common places where “deductibles” will apply in health insurance would involve hospital admission and related expenses, emergency room treatment, specialized medical tests, and prescription drugs. There could be other areas.
Health insurance premiums seem to be constantly on the increase due to many things, including improved medical technology and losses experienced by health insurance companies.
It is not uncommon today for an individual or a family to purchase a high health insurance “deductible”, to keep the premium lower and then put aside money into a special account called a Health Savings Account (HSA).
IMPORTANT: If you are currently shopping for the right health insurance plan and comparing health plan prices, please make sure all the benefits, deductibles, exclusions, co-payments and lifetime maximums are the same. Never cancel an existing health insurance policy until the new health policy has been issued and is in full benefit.
Do you understand how a health insurance “co-payment” works?
Do you know your health insurance plan’s “lifetime maximum”?
Do you know how health insurance companies deal with “pre-existing” health conditions?
Does your health insurance plan have adequate “co-insurance” provisions?
Do you understand that your health insurance premium could be lowered by increasing your “deductible”?
NC Health Agent Dire
- What You Must Know Before Purchasing Health Insurance-NC
- Health Insurance-”Deductible”
- Health Insurance-”Lifetime Maximum”
- Health Insurance-”Co-Payment”
- Health Insurance-”Pre-Existing”
- Health Insurance-”Co-Insurance”
- Discount Dental vs. Dental Insurance
- Are you uninsured?
(This Article Re-Printed from Insurance Maze Blog : Navigating The Insurance Maze)
Health Insurance-”Lifetime Maximum”
With today’s ever changing and advancing medical technologies, the “Lifetime Maximum” provision of a health insurance policy is of extreme importance.
Once the “Lifetime Maximum” benefit has been met by your health insurance company, the plan will not pay another penny – ever.
“Lifetime Maximum” In Health Insurance Is All It Will Ever Pay
Unfortunately, there are health insurance plans out there with “Lifetime Maximums” of $ 500,000 or less. If these people should be so unfortunate as to develop some dreaded health condition, like Leukemia, the cost of all the required health care could reach into the millions of dollars.
We would recommend that your health insurance policy have a minimum $5 Million Lifetime Maximum and even more if you can get it and can afford it.
Do you understand how a health insurance “co-payment” works?
Do you know your health insurance plan’s “lifetime maximum”?
Do you know how health insurance companies deal with “pre-existing” health conditions?
Does your health insurance plan have adequate “co-insurance” provisions?
Do you understand that your health insurance premium could be lowered by increasing your “deductible”?
NC Health Agent Direct
- What You Must Know Before Purchasing Health Insurance-NC
- Health Insurance-”Deductible”
- Health Insurance-”Lifetime Maximum”
- Health Insurance-”Co-Payment”
- Health Insurance-”Pre-Existing”
- Health Insurance-”Co-Insurance”
- Discount Dental vs. Dental Insurance
- Are you uninsured?
(This Article Re-Printed from Insurance Maze Blog : Navigating The Insurance Maze)
Health Insurance-”Co-Payment”
Don’t get “Co-Payment” and “Co-Insurance” confused. Remember, “Co-Insurance” is a percentage (20%) of approved medical expenses that you pay and there is a limit (maximum out-of-pocket). A “Co-Payment” is completely different.
In Health Insurance A “Co-Payment” Is Not “Co-Insurance – Know The Difference.
If you take any prescription medications, you already know how a “Co-Payment” works – you may pay $10.00 for generic drugs and $20.00 for named brand drugs (whatever your health insurance policy requires).
Some health insurance policies are designed to require a “Co-Payment” for almost everything, like:
Each Hospital Admission – $ 500.00 Co-Payment
Outpatient Surgery – $ 250.00 Co-Payment
Emergency Room – $ 100.00 Co-Payment
Doctor Visit – $ 20.00 Co-Payment
Specialist Visit – $ 40.00 Co-Payment
Generic Prescription Drugs – $ 10.00 Co-Payment
Name Brand Prescription Drugs – $ 20.00 Co-Payment
Other health insurance plans may have the “Co-Payments” for doctor visits and prescription drugs and use the “Deductible” and “Co-Insurance” arrangement on all other approved medical expenses.
If your health insurance plan requires “Co-Payments”, these payments must be made each time that particular medical service is required. Remember, “Co-Payments” do not reduce your maximum out-of-pocket expenses.
Do you understand how a health insurance “co-payment” works?
Do you know your health insurance plan’s “lifetime maximum”?
Do you know how health insurance companies deal with “pre-existing” health conditions?
Does your health insurance plan have adequate “co-insurance” provisions?
Do you understand that your health insurance premium could be lowered by increasing your “deductible”?
NC Health Agent Direct
- What You Must Know Before Purchasing Health Insurance-NC
- Health Insurance-”Deductible”
- Health Insurance-”Lifetime Maximum”
- Health Insurance-”Co-Payment”
- Health Insurance-”Pre-Existing”
- Health Insurance-”Co-Insurance”
- Discount Dental vs. Dental Insurance
- Are you uninsured?
(This Article Re-Printed from Insurance Maze Blog : Navigating The Insurance Maze)
Health Insurance-”Pre-Existing”
The “Pre-Existing Condition” limitation or exclusion of a health insurance policy is probably the most misunderstood. In health insurance, a “Pre-Existing Condition” is not necessarily a disease or illness for which you have received medical treatment.
A “Pre-Existing” Condition In Health Insurance May Not Be What You Think
To better understand “Pre-Existing Condition”, here is the statement taken directly from a health insurance company’s health insurance sales brochure:
“A pre-existing condition is a sickness or injury which was diagnosed or treated, or which produced signs or symptoms that would cause an ordinarily prudent person to seek treatment, during the five-year period before the covered person’s effective date of coverage.”
This “Pre-Existing Condition” limitation will differ from company to company, so make sure you know your health insurance company’s terms and conditions.
Health insurance companies handle “Pre-Existing Conditions” in different ways. Some companies may:
Decline to issue the health insurance policy
Not pay benefits for pre-existing conditions for a period of time, like 12 months
May issue the insurance policy with a rider, which states that they will not cover that condition for a specified period of time, or never
Cover pre-existing conditions as long as they are disclosed on the health insurance application and accepted by the insurance company
When you complete an application for health insurance, be as honest and as accurate as you possibly can. It will save a lot of hard feelings and misunderstandings later on.
Do you understand how a health insurance “co-payment” works?
Do you know your health insurance plan’s “lifetime maximum”?
Do you know how health insurance companies deal with “pre-existing” health conditions?
Does your health insurance plan have adequate “co-insurance” provisions?
Do you understand that your health insurance premium could be lowered by increasing your “deductible”?
NC Health Agent Direct
- What You Must Know Before Purchasing Health Insurance-NC
- Health Insurance-”Deductible”
- Health Insurance-”Lifetime Maximum”
- Health Insurance-”Co-Payment”
- Health Insurance-”Pre-Existing”
- Health Insurance-”Co-Insurance”
- Discount Dental vs. Dental Insurance
- Are you uninsured?
(This Article Re-Printed from Insurance Maze Blog : Navigating The Insurance Maze)
Health Insurance-”Co-Insurance”
In health insurance, the term “Co-Insurance” is used to determine what part of medical expenses the health insurance company pays and what part you pay. This “Co-Insurance” is usually expressed in a percentage, like 80/20. In this situation, the insurance company will pay 80% of approved medical expenses (after deductible) and you will pay 20%, up to your maximum out-of-pocket expenses expressed in the health insurance policy.
Understanding “Co-Insurance” Is An Important Step In Understanding Your Health Insurance Policy
Let’s look at an example:
We are going to assume that your health insurance policy provides – 80/20 Co-Insurance, $500 Deductible, and a maximum Out-of-Pocket of $3,500.
You have just been discharged from the hospital and have accumulated $12,000 in approved medical expenses.
Approved Medical Expenses – $ 12,000.00
You Pay Your Deductible – $ 500.00
Remaining Approved Expenses – $ 11,500.00
You Pay 20% – $ 2,300.00
Remaining Expenses – $ 9,200.00
Insurance Plan Pays 80% – $ 9,200.00
What happens if you should be hospitalized again in the same year?
First of all, you have already satisfied your health insurance plan’s annual deductible, at least for yourself. In a family situation, you may be required to satisfy two or more deductibles in a year.
Secondly, you have met $ 2,800.00 of your maximum out-of-pocket expenses. In this example, we said that the maximum out-of-pocket was $ 3,500.00, so the most you would pay of these approved medical expenses would be $ 700.00.
In most health insurance plans, once you have met your annual deductible and your maximum out-of-pocket expenses, the plan would then pay 100% of approved medical expenses, up to your lifetime maximum stated in the health insurance policy.
This is an oversimplified example, but I just wanted to give you some idea how health insurance plans work.
Do you understand how a health insurance “co-payment” works?
Do you know your health insurance plan’s “lifetime maximum”?
Do you know how health insurance companies deal with “pre-existing” health conditions?
Does your health insurance plan have adequate “co-insurance” provisions?
Do you understand that your health insurance premium could be lowered by increasing your “deductible”?
NC Health Agent Direct
- What You Must Know Before Purchasing Health Insurance-NC
- Health Insurance-”Deductible”
- Health Insurance-”Lifetime Maximum”
- Health Insurance-”Co-Payment”
- Health Insurance-”Pre-Existing”
- Health Insurance-”Co-Insurance”
- Discount Dental vs. Dental Insurance
- Are you uninsured?
(This Article Re-Printed from Insurance Maze Blog : Navigating The Insurance Maze)
Discount Dental vs. Dental Insurance
There are probably as many discount dental plans available as there are dental insurance plans. Due to the high cost and limited benefits available in dental insurance, many employers and families are taking a serious look at the discount dental plans.
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Dental Insurance
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Discount Dental Plan
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Contact an Agent Now
- What You Must Know Before Purchasing Health Insurance-NC
- Health Insurance-”Deductible”
- Health Insurance-”Lifetime Maximum”
- Health Insurance-”Co-Payment”
- Health Insurance-”Pre-Existing”
- Health Insurance-”Co-Insurance”
- Discount Dental vs. Dental Insurance
- Are you uninsured?
(This Article Re-Printed from Insurance Maze Blog : Navigating The Insurance Maze)
Are you uninsured?
Thousands of people take a gamble every day — living without health and life insurance. You just can’t afford not to have it. But affordable insurance can be hard to find, particularly if you’re a hard working entrepreneur or if you’re working for a company that doesn’t offer benefits. Fortunately, we have a solution with our dependable, affordable health insurance plans for you and your family. Almost certainly, there is a plan that will fit your individual needs perfectly — at a price you can afford. After all, if you can’t pay the premium, all the insurance in the world is useless.
