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Tips for Low Cost Healthcare Insurance
If you are searching for ways to lower your health insurance costs here are some tips to start with...
With health care cost always on the rise shopping for your health insurance coverage is critical. Shopping around for the best rates and insurance coverage assures you that you will get the coverage you need at a price you can afford.
There are four major types of medical insurance available to meet the different healthcare needs of individuals and families; these include
- Indemnity Fee-for-Service
- PPO Preferred Provider Organization
- POS Point-of-Service Plan
- HMO Health Maintenance Organization
The more that you know about how health insurance works and the variety of health benefits options that are available, the more likely you are to get the best health insurance coverage.
Review your health insurance policy
Review your health insurance policy and make sure you understand coverage restrictions and exclusions. For example, health insurance typically excludes most dental benefits. Understand that if you have a medical condition that results in damage to your teeth, while the medical condition may be covered, dentistry to restore your damaged teeth may not be.
Coordinate your family's health insurance plans.
You certainly don't want to be paying duplicate for the same coverage for any particular service so scour through your health insurance policies and make sure you only pay once.
Pick the health insurance plan that gives you the most bang for your buck.
The cheapest plan may not necessarily be the best value. If you're young and healthy, you might want to go for lower premiums and higher co-pays. But if you're older, have a chronic health condition, or have young children who make frequent visits to the doctor, you're probably better off with higher premiums and lower CO-pays
Strength in Numbers
There's strength in numbers, particularly when you're buying health insurance. As part of a group plan, you can enjoy a significant discount on premiums as well as comprehensive policies.
But if you leave that job — or start another one that doesn't offer health insurance — you may be surprised at just how expensive the same coverage is when you buy individual health insurance. ("Individual" means the insurance is not connected to a business or to the self-employed. You can purchase an "individual" policy that covers your whole family.)
People enrolled in individual plans pay premiums that are more in line with their expected health costs. In addition, there is no guarantee that an insurer will take you on. That's because unlike group plans, if you have health problems, individual plans are medically underwritten and the insurer may reject your application or attach exclusions to your policy. However, some states don't allow this practice and require that any insurer selling individual health plans must offer you a policy, no matter what medical problems you have.
However, your premiums are still likely to be substantially higher. People enrolled in individual plans pay premiums that are more in line with their expected health costs, so the premiums will be higher for those who are older or less healthy. To find out what your rights are, contact your state insurance department.
Know your health insurance plan's rules. Then follow them.
Remember, if you don't follow the rules, your insurer can deny your claim and you'll wind up getting stuck with the bill. For example, is your allergist included in your health plan's network of doctors or do you need pre-authorization for outpatient surgery.
Always double check whether the benefits, services, or providers you need are covered under your plan before you receive treatment. Do this by calling your plan's customer-service department. Then follow through by obtaining any necessary authorizations or by scheduling treatment with a doctor within your insurer's network of providers.
Plan ahead for emergencies.
If an emergency arises in the middle of the night and you don't know which hospitals in your immediate area are included in your health plan then you may be paying out of pocket for those emergency services and putting yourself or your loved ones at risk. Make sure you have the information available (near your phone) where to call for help or where to take someone in an emergency situation. You are paying the premiums get the most out of them.
Another factor to consider is if any of your family's doctors' offices are open on nights or weekends, their hours, and the co-payment for an after-hours visit. Although an after-hours visit may cost you more than a visit during regular business hours, it is probably cheaper — not to mention less stressful — than a trip to the emergency room. An emergency room visit can cost you a $50 to $100 CO-payment
Crunching the numbers
Pricing is probably the most bewildering aspect of individual health policies, so it's worth your while to shop around. For instance, the premiums for similar products from different insurers can vary by as much as 50 percent for the same person. What's more, the rules and regulations about individual health insurance vary from state to state, making comparison-shopping a bear for the uncertain consumer.
The first step is to evaluate your needs and understand your health insurance options.
If you're faced with finding individual insurance, don't let the confusion tempt you to go without. Even if you're healthy, you could fall off a ladder or have a serious car accident and be financially ruined. Plus, you'll lose your pre-existing-conditions coverage in most states if you go without insurance for more than 63 days.
Finding the right balance of coverage and cost can be challenging, but it's a necessity. So take your search one step at a time. The first step is to evaluate your needs and understand your health insurance options. For some, that may mean buying COBRA coverage from their former employer.
Out of Pocket Costs
Out of Pocket Costs are costs that you pay out of your own pocket when you get health care even though you are insured and have already paid a premium. When out-of-pocket costs are very low and there are no constraints on care provided, then insurance can be very expensive and inefficient. When out-of-pocket costs are very high and there are no limits on how much you might pay, then insurance can be almost worthless for reducing your financial risk. Intermediate levels of out of pocket costs are generally the best deals. For these reasons, you need to know what out of pocket costs a health insurance policy has.
Cut your pharmacy costs.
Most health plans have a three tier Co-Payment system for prescription drugs. On the high end typically the named brand drugs cost the most. The middle tier consists of drugs your health insurer considers to be "cost effective". The cheapest tier would includes generic drugs. Typically, you could realistically lower your pharmacy cost by $10 to $40 per prescription by asking your doctor to prescribe you drugs that belong in the first two tiers.
Another possibility is to ask your doctor the viability and safety of "splitting pills". This is where your dosage for a particular medication is 50 mg per day so you ask your doctor to prescribe the 100 mg tabs and you split them. NOTE: You must consult with your doctor on this as some medications require exact dosing and splitting can be very dangerous.
Take advantage of tax breaks.
Some of the most used health care services actually qualify for tax breaks. Dental and vision care count as reimbursable medical expenses under FAA arrangements, so don't forget to save your receipts for these services. FAA, flexible spending accounts, are very popular employer sponsored accounts that offer you ways to pay for certain out-of-pocket health care or dependent care costs on a pretax basis.
Other models to look into are health reimbursement arrangements (HRAs), and medical savings accounts (MSAs) — known collectively as health care spending accounts.
Quit smoking.
If you live in New York and have a one pack a day habit you will immediately save $7.50 per day ($218 per month). The lifetime health care costs for smokers vs. nonsmokers is one third higher on average. This, of course, drives up the cost of health care to everyone, not just lifetime smokers.
Lose weight.
Carrying excessive weight will add to your health care costs in a number of ways. You may simply not qualify for health care because of obesity and this could bankrupt you if a catastrophic event occurs and you have to pay out of pocket.
Exercise more.
The benefits of exercising are always compound. You gain better energy, self-esteem, emotional stability and your weight will stabilize and begin to normalize over time. This can literally change your life and all ways. Many studies show it's never too late to start exercising and that even small improvements in your fitness level can improve your health and longevity.
Seek out free or low-cost health screenings, checkups, and services.
If your HMO offers free blood pressure checks, take advantage of these lifestyle programs to help you stay healthy and reduce your doctor visits and medications. Do they offer Low-cost flu costs or nutrition, dieting, and physical fitness classes? These are valuable programs that not only help to optimize your health and pocket book but also feeds data to the HMO organization and allows them to monitor their memberships overall health.
Raise your deductible or CO-payment
Whenever possible and financially practical, lower your monthly health insurance premium by raising your deductible or Co-Payment But make sure that you have money saved to cover the deductible.
Haggle with your Doctor.
Believe it or not, you can still negotiate prices with your doctor. There's nothing new about people asking for discounts on medical treatments — there's a long history of patients negotiating with their providers for lower prices on elective procedures, such as laser vision surgery or psychotherapy. Establish the price that you believe is reasonable and stick to it.
Consider COBRA
When you leave a job, you don't necessarily need to leave your health insurance behind. Thanks to COBRA (the Consolidated Omnibus Budget Reconciliation Act of 1985), certain employers that provide a group health insurance plan must offer most employees who would lose their coverage the option to continue it for up to 18 months. The catch is that the employee will have to pay the full premium, up to 102 percent of the employer's cost. The extra 2 percent is an administrative fee.
COBRA is best seen as a safety net. You have 60 days to make a decision about whether to enroll in COBRA, and when you do, the coverage is retroactive. As soon as you know you will be losing your group coverage, start shopping for individual coverage. Go out and talk to independent agents who represent different companies. If you find a policy you like, apply for it. You should be able to find out if you are accepted within those 60 days. If you find a less expensive policy that meets your needs, buy it. If not, you can still elect COBRA.
COBRA covers all members of your family, so if you find an individual policy that works for you but won't cover your wife's pre-existing illness, go with COBRA only for her.
A pre-existing condition will make finding individual health coverage more complicated — and more pricey — but that shouldn't knock you out of the race completely. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) restricts the ability of insurers to exclude pre-existing medical conditions from coverage — but only if you were previously part of a group plan and meet certain other strict requirements.
Search for a subsidy.
If you are in a low income situation, uninsured, or disabled, you may qualify for low cost health insurance through a state or federal program such as Medicaid or Medicare.
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Important Disclaimer: Answers on Insurance advice are not a substitute for professional advice. For reliable information of any sort you must consult an officially qualified professional in your area.
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