Monthly Archives: May 2014

No Health Insurance? Some Answers!!

No Health Insurance?    Some Answers!!

What happens if you do not have health insurance ( if you have to wait for the next Open Enrollment Period, for example or may have to wait for a Special Enrollment Period!!) – then various alternatives are available to help you with costs and which will also provide various types of coverage.

Short term medical and Voluntary benefits are the most often used.

STMedical will cover  you /your family for a month or any combination, generally up to 12  months and then generally can be renewed. However, they do not cover Pre-existing conditions ( any health condition for which you received treatment or were advised to have treatment for within the past 2-5 years- depending on the company) .

They will also have a Deductible which must be satisfied first before the insurance pays any benefits at varying co-insurance levels – 80/20, 70/30, etc whereby the insurance pays the 80% and you pay the 20% –(after the Deductible has been satisfied – you have paid  the amount of the Deductible  in health costs) to a Maximum Out of Pocket Amount when the insurance then generally pays 100% of the costs!

Voluntary Benefits usually are plans which generally pay you directly as the policy holder (such as Aflac- the duck company) as opposed to insurance companies which pay the providers- physicians, hospitals, etc.

The plans are various and include:-

1)- Hospital Indemnity which can include paying you for each day you’re in hospital,etc  or if you have  an operation or treatment pay you for doctors visit, ex-rays, various types of treatment at set $ rates for each occurrence.

2) – Accident- which can pay you a set $ amount for any accident, and various treatments plus hospital confinement, etc.

3) – Various specific illness Indemnity plans which pay specific $ amounts for defined major conditions such as Cancer, Heart Attack, etc.

4) They also can offer Disability and Critical Illness plans, Term/Whole Life and Dental and vision, etc.

All at very reasonable costs!

For further information contact:

Eric Walters.

Eric Walters Insurance Services,  14482 N 100th Place, Scottsdale AZ 85260

TeL: (480)-657-8595  FaX: (888)-739-0796  CELL: (602)-616-1660

Eric’s Insurance Website: http://www.ewconsultant.biz

Email:  ewinsurance@gmail.com

 

Another view of health insurance.

Another view of health insurance

One might assume that only the older generations and financially sound can afford it. Not planning on getting hurt or sick is not the most effective health plan. At the end of each year, see if your health insurance needs updating and see what new plans and benefits might be available..Watch out for any changes!

If you simply don’t visit the doctor enough for insurance to be cost effective, consider opening a Healthcare Savings Account (HSA). Any dollars you save towards deductibles, premiums and co pays can get saved in an HSA and applied towards future medical expenses.

The way you manage your health care insurance may actually earn you tax breaks around April. Lots of people don’t understand the premiums that you pay on your health coverage can be deducted off your taxes. You can also include all money paid for prescriptions, your deductible, doctor visits, co-pays and any other non-covered medical expense. Check your state tax guidelines to ensure you’re adhering to both local and federal rules.

Carefully evaluate each health coverage plan before choosing the one that meets your needs best.- as a broker I can certainly discuss  what alternatives might be suitable for you. You could choose plans that cover the areas you need now and hold off to purchase a full coverage when you possess the money to do so.

Are you unsure about something regarding the policy that you hold with your health insurance company? Your questions could be answered with a simple phone call to me. While a lot of health insurance companies make use of a number in which you can speak with someone knowledgeable about your policy- as brokers we are here to help as well- AT NO COST TO YOU!!

We can give you the information specific to your policy  and review it in detail with you!

Don’t expect your health care policy to be straightforward. Learn all the exceptions in your policy so that your insurance company won’t deny you benefits you thought you were entitled to. Read and understand your health insurance policy. Learn exactly what is and is not covered. Be prepared in advance to pay out of pocket for things that may not be covered, like physicians and/or specialist co pays, xrays,etc and certain medications or procedures.

Getting health coverage through a group or organization may be cheaper (depends largely on whether the employer is contributing it or not). But, if you’re self-employed, what can you do? You , of course , can always go to  healthcare.gov at Open Enrollment Periods if you are eligible for a Tax Credit to help pay the premium, etc- you can also check  on this web site or at healthcare.gov.,

Don’t forget -Outside of the Open Enrollment Periods there are Special Enrollment Periods for anyone who:-  gets married, gives birth, adopts, divorces, moves,changes their job, gets out of jail, loses their coverage,etc- so let us know asap as we can help-AT NO COST TO YOU!!!!

What type of Health Plan?

When shopping for health insurance, decide what kind of company is best for you. A PPO or Preferred Provider Organization will have a network of doctors to choose from (although you will still have to choose a Primary Care Physician) and you have to choose within them in order to avoid a much larger co pay or fee. A Point-of-Service (POP) plan has you choose a Primary Care Physician, but he can refer you outside of the network.

With an HMO, they have a Network of Physicians and providers who you can only choose from at set co pays and if you do go to another provider outside of the HMO Network, you will have to pay their fees with no contribution from the insurer. If you need a specialist, etc then you will need a Referral from your Primary Care Physician (PCP) and if you do not have one, then you will have to pay their fees yourself- again!

When you don’t fill out a claim correctly, there are some insurance companies that can actually refuse to pay or reject your enrollment or reject a claim if you are already enrolled before the discrepancy is discovered. Make sure you review your enrollment form before sending it. As brokers we go over your enrollment very carefully with you.

Keep a good credit rating to get great health insurance prices. The worse your credit score is, the more you may end up having to pay for quality insurance. It is possible for your health insurance to stop coverage completely. Look into improving your credit score prior to searching for new health insurance.

No insurance?   See my post on this site-

 No Insurance-  Some Answers!!

 For further information contact:

Eric Walters.

Eric Walters Insurance Services,

14482 N 100th Place,

Scottsdale AZ 85260

TeL: (480)-657-8595

FaX: (888)-739-0796

CELL: (602)-616-1660

Email: ewinsurance@gmail.com

WEB- http://www.ewconsultant.biz.

ACA Blog/Newsletter- http://www.azhealthinsuranceblog.com

COBRA ?-alternative available now!

Administration announces proposal to clarify availability
of Health Insurance Marketplace coverage to workers eligible for COBRA

WASHINGTON – The Obama administration today announced updates to model notices informing workers of their eligibility to continue health-care coverage through the Consolidated Omnibus Budget Reconciliation Act.

The updates make it clear to workers that if they are eligible for COBRA continuation coverage when leaving a job, they may choose to instead purchase coverage through the Health Insurance Marketplace.

“In many cases, workers eligible for COBRA continuation coverage can save significant sums of money by instead purchasing health insurance through the Marketplace,” said Assistant Secretary of Labor for Employee Benefits Security Phyllis C. Borzi. “COBRA continues to play an important role in helping workers and families maintain coverage after a job loss, and it is important that workers know that in some cases there is a Marketplace option as well.”

Workers and their families who are eligible for employer-sponsored coverage generally must be informed of their right to COBRA continuation coverage at the start of employment. They must also be informed of their right to purchase COBRA coverage when separating from a job. The proposed changes to the model notices would offer information on more affordable options available through the Marketplace, where workers and families may be eligible for financial assistance that would not otherwise be available for COBRA continuation coverage. In most cases, workers and their families eligible for, but not enrolled in, COBRA continuation coverage would be able to enroll in Marketplace coverage outside of the normal open enrollment period.

The Departments of Labor, Health and Human Services, and Treasury are also publishing frequently asked questions related to the proposed changes to model notices.

The FAQs are posted on the Department of Labor website at http://ww.dol.gov/ebsa/faqs/faq-aca19.html and the HHS website at http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs19.html. In addition,

HHS is publishing a clarifying bulletin regarding a special enrollment period in the Marketplace for individuals already enrolled in COBRA continuation coverage. The bulletin is posted on the HHS website at http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/SEP-and-hardship-FAQ-5-1-2014.pdf.

The updated model notices are posted on the Department of Labor website at http://www.dol.gov/ebsa/modelgeneralnotice.doc and http://www.dol.gov/ebsa/modelelectionnotice.doc. A related notice of proposed rulemaking on the COBRA notice requirements will be published in the May 7 edition of the Federal Register. The notice of proposed rulemaking can also be viewed here at http://www.dol.gov/ebsa/pdf/

Can I help you in anyway?

Eric

Cell: 602-616-1660

Email: ewinsurance@gmail.com

Insurance WEB site; http;//www. ewconsultant.biz