Personal Finance Tips

Health insurance market sure looks confusing to those who have to deal with it for the first time in their life. But as with anything that seems complicated at first, health insurance is quite easy to understand when you take some time to learn the basics of it. Of course, don’t expect to become an insurance market specialist overnight but the following tips will certainly help those inexperienced with health insurance shopping to get a decent policy for a fair price.

What you can get?

Individual insurance plans – the most common option for people with normal income, especially those who aren’t offered with group insurance by their employers. The vast majority of insurance companies offer such policies and the diversity of coverage options is very wide here. However, make sure to learn what are the requirements in your state and check if the insurance company is licensed in your area before getting the plan.

High risk pools – some pre-existing conditions will make it hard for you to get typical individual health insurance. That’s where high risk pools may come in handy. Such plans are available only in certain states, so make sure to learn if there are any in your area. If yes, then it would be a good option for those who are considered to be a high risk policy-holder. The rates are relatively high here, but for some it may be the only option for adequate coverage.

HIPAA coverage – this type of insurance best appeals to those who have been recently dropped of employer sponsored group coverage and don’t fall under COBRA coverage too. Health Insurance Portability and Accountability Act (also known as HIPAA) health insurance can be purchased in any state and is particularly useful to those who have pre-existing conditions. Thus, it’s a good alternative to high risk pools or an option where the pools are unavailable. Speak to your insurance agent to decide which option is better for you.

Where you can get it?

Insurance agents – these are independent individuals that provide health insurance quotes and plans from numerous companies. Each insurance agent has his own selection of companies he provides services of, and if there are any question he is the person to ask. However, first make sure that the agent you’re speaking with is licensed to work in your area before getting any services or signing policy contracts. You can do that at your state’s insurance department.

Department of insurance – while not being a direct seller of health insurance, the state insurance department can give you valuable information on local agents and providers you can buy from safely. If there are any complaints about any particular provider, this is the place to learn about them.

Online sellers – the recent trend in many insurance companies going online, as well as the development of independent sources can be a very helpful and easily accessible source of information regarding health insurance. It is very easy to get health insurance quotes online with these sites and shopping for a plan takes you only a couple of minutes.

When dealing with a health insurance plan, whether a new one or the one you have already purchased, the specific language of its contents can be confusing for most people. All these provisions, coverage options and payments make little sense unless you are an insurance expert. And it’s not that rare that a person asks what does their policy provide even after having it for some time. Don’t worry, we are here to help you. Below you will find the most commonly used health insurance terms you will find in any policy with brief and comprehensive explanation that will help you understand your insurance policy better.

Deductible

Deductible is the sum of money the policy-holder has to pay out of pocket before the policy benefits will kick in. This amount is typically set on an early basis, meaning that a certain part or the whole deductible in the current year, this amount will be renewed in the next one. Certain services provided by the insurance policies such as physician visits are available free of deductible. If you have your family members included into your policy, there’s usually a separate distinction between individual and group deductible amounts.

Co-insurance

The sum of money you have to pay on your own before your policy starts covering you in addition to the plan’s deductible. Certain plans will require only co-insurance payments for some types of services without requiring you to pay the deductible.

Out-of-Pocket

It’s a general term denoting all payments that you have to make on your account before the policy coverage kicks in. This usually refers to deductibles, co-payments and co-insurance. When speaking of annual out-of-pocket maximum this term refers to the overall costs of the insurance policy during the year minus the premiums.

Lifetime Maximum

This term refers to the maximum sum of money you can receive with your insurance policy in the course its entire duration period. Most health insurance plans have separate lifetime maximums for individual and group purposes so pay attention when reviewing the policy or getting health insurance quotes.

Exclusions

As you can guess, these are provisions that your health insurance plan won’t cover.

Pre-existing Conditions

This refers to all health conditions that you were diagnosed with before purchasing the policy. Certain insurance companies will not cover such conditions, while other companies will. Learn about this option when you getting health insurance quotes especially if you have certain health problems you want to cover.

Waiting Period

This is the period of time the policy-holder will have to wait before receiving any benefits from the insurance policy.

Coordination of Benefits

In case the policy-holder has source of coverage additional to the present policy the benefits received from all the policies will be coordinated in order to make sure that the person does not receive double coverage.

Grace Period

The period of time starting after the premium payment due date that the person is still able to pay without risking the policy to be void.