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What is a Health Medical Plan Deductible?

Posted on July 1, 2019 in Uncategorized

A deductible is a specific dollar amount that your health insurance company requires that you pay out of your pocket each year before the health insurance company begins to make payments for claims. As an exception, not all health medical plans have a deductible such as an HMO or a zero dollar deductible plan. However, most PPO and Indemnity plans typically do require a deductible in their plans to keep premiums affordable.

The deductible is an annual amount per insured person; there will be a maximum amount of deductibles you will have to pay in a given year. In regards to family coverage in health medical plans, your family will have an out of pocket expense by an amount of two to three times your individual deductible to satisfy first before the health insurance company pays for your claims.

For example, if the per person deductible is $1000, and you have four people in your family covered under your health insurance, the maximum family deductible will usually be $3000. Once the people in your family have paid out a $3000 deductible, no more deductibles will apply to any member of the family for the remainder of the year.

The insurance company does have a maximum of per person deductibles per policy. This can very with each policy and company is different regarding their maximum deductible and out of pocket maximum. In some health medical plans the deductible does apply to the maximum of pocket, and in other polices it is consider separate from the annual maximum out of pocket. Please be sure to read the specifics of your policy with your health medical plans company.

Health insurance deductibles can vary and will be effect your insurance premiums. By adjusting your health medical plan deductible you premiums will either increase or decrease. Typically if you increase your deductible you will lower your premium. New High Deductible Health Plans can save you and your family premium dollars over time.

The federal government regulates the detail High Deductible Health Plans limits each year. In the year 2008, the minimum deductible amount for a High Deductible Health Plan is $1,100 for individual only coverage and $2,200 for family coverage. In addition, the maximum out-of-pocket amount for individual only coverage is $5,600 and $11,200 for families. A high deductible health plan typically offers a higher deductible in return for generally lower premiums. For more detail, please contact your health medical plans broker.

Mental Health Medication and Health Insurance – Are You Covered?

Posted on July 1, 2019 in Uncategorized

Insurance companies are now being mandated by many states to provide mental health coverage to their customers. However, having to provide this coverage doesn’t guarantee that customers won’t face rate hikes, stigmas, and other issues because they have mental healthcare services on their record. Insurance companies can see this history and often use it to label people as a higher risk to their insurance company because they have a medical history that is significant. When it comes to mental health, it seems like the risk is increased ten-fold, which is difficult for many people to handle.

When you are being treated for depression and other mental health issues, a common medication that is used is Prozac. However, this is one medication that may or may not be covered depending on your insurance company. If you do get prescription coverage for Prozac, it will likely be with strict regulation or some type of stigma that follows you for the rest of your insured life. Many therapists and psychiatrists will no longer accept patients that cannot pay cash, even on a sliding scale, because they don’t want to ruin their reputation when it comes to their health insurance coverage.

Mental health has become much more widely accepted as a medical issue that needs serious attention. However, the insurance companies are not so evolved that they can just hand out these medications to anyone without thinking twice. Between the stigma of mental disorders and the increased risk they present and the abuse of many anti-psychotic medications like Prozac, it is hard for insurance companies to justify taking such a risk to help out their patients. Whenever you are applying for health insurance or even if you already have coverage, you need to get a good look at the mental health coverage, including prescription coverage, that is provided to you with your policy.

Prozac and health insurance are kind of like oil and water in most cases. However, some people are more readily able to find the insurance that can give them the coverage that they need. Whether the solution is paying higher premiums or paying out of pocket, you have to explore your options for getting the mental health coverage and prescription services that you need to find the best possible solution. If you are already on Prozac and it is affecting your health insurance rates or coverage, you should shop around for a new policy.

If you need assistance in locating particular coverages at a pre-determined price, we can help you save up to 50% on your health insurance.

Making the Best Choice For Individual Medical Coverage

Posted on July 1, 2019 in Uncategorized

Once upon a time nearly everyone received health care coverage through employer group health plans, but these days many are turning to individual medical coverage to ensure they have access to the medical services they need. Issues such as unemployment, self-employment and companies cutting-out group health benefits are requiring people to brush up on their insurance knowledge so they can make the best decisions for themselves and their dependents.

With medical costs increasing, it is more important than ever to have the right coverage to meet medical needs. When you are in charge of selecting your individual medical coverage, how can you know if the plan is right for you? And is it even possible to find affordable health coverage outside of an employer group health plan?

It is worth your time to wade through the information to determine what individual medical coverage is best for you and your budget. To make it easier for you, below is a compilation of the information you need to make solid decisions about your coverage choice.

Breaking down the insurance lingo

While some of the insurance terms may be familiar to you, others may seem like part of a foreign language. Here are some terms you will likely need to know:

* Premiums-this is the money you pay to receive individual medical coverage. You may pay it monthly or yearly. Insurance companies base the amount of your premium on factors including age, level of health, medical history, lifestyle and occupation.

* Deductible-this is the money you will have to pay out of your own pocket prior to your medical coverage kicking in. Typically, you can select your deductible to fit your medical and financial situation. For example, a lower deductible requires a higher premium, while a higher deductible will allow you to keep your premiums low. Still, a high deductible isn’t always best if you know you will be using medical services often.

* Coinsurance-this is a percentage of the medical bill that you will pay. For example, some medical plans will offer a coinsurance rate of 75/25, which means you will pay 25% of the medical costs while the insurance will pick up the other 75%. Understanding the types of individual medical coverage plans

Once you are more familiar with the language of health insurance, you will want to familiarize yourself with the different individual medical plans offered.

These are the most common:

* HMO-Standing for Health Maintenance Organizations, HMOs are designed to be a more affordable health insurance coverage. They provide comprehensive medical coverage through a network of hospitals, doctors, clinics and health care professionals. If you have a particular doctor or hospital you prefer, it is important to make sure they are included in the HMO network, as these types of individual plans are quite costly if you go outside of the network for care.

* PPO-Standing for Preferred Provider Organizations, PPOs are different from HMOs in that you can have coverage from a variety of different doctors and specialists without referrals. Still, there is typically a PPO network of doctors and hospitals that offer you more coverage, but you have the freedom to choose outside of the network and receive partial coverage.

* FFS-Standing for Fee for Service, the FFS plan, also known as indemnity insurance, is a very simple, straight forward individual medical coverage through which you obtain the medical care you need from any doctor, hospital or health care professional, pay for the fees yourself, and then receive a reimbursement for a specific percentage of what you paid. This is not a comprehensive plan and it does not cover preventative care, but is one option for an individual who does not plan to receive a lot of medical care and cannot afford higher premiums.

* HSA-Standing for Health Savings Account, the HSA account offers coverage that works as a catastrophic medical plan with a high-deductible and lower premiums. The account also includes a savings account that is tax-free and allows you to save money to pay for the more routine medical care yourself.

Conducting a thorough health insurance plans comparison is a wise way to choose the best plan to meet your needs. It makes good sense to research the plans, so you are fully aware of the cost and coverage and know what to expect.

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