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The “How to Guide” for Purchasing Health Insurance
Choosing the right health insurance plan can be simplified when you have the
right information available to you. The following table of contents lists each
important area when considering a private health insurance plan. This basic
information will help you choose the right plan. Also, once you choose the right
plan, with most of the companies that we represent, the application process can
be done right online or on the telephone. We want to keep you informed about the
important considerations while purchasing a health insurance policy.
Table of Contents
Getting Health Insurance Rates and Applying for Coverage
We represent several quality PPO health plans that offer several plans to
choose from.
Our quote system will show you rates for a majority of the plans that we
represent. Once you choose a plan, you can apply with us on the telephone.
Just a reminder, obtaining rates from an online service are based on
preferred or standard rates. If someone doesn’t meet the specific company’s
height and weight guidelines or is presently on a maintenance medication such as
high blood pressure or cholesterol control, the rates may be higher, depending
on the company’s guidelines.
If you think you fall into this category, give us a call and we will provide
the correct rates based on your situation.
I am just a phone call away to provide you with professional advice and
address your concerns. We will help analyze all of your options and make a
recommendation based on your interests and goals with health insurance. At this
point, when you have decided which option is best for you or your family, we
will assist you with the enrollment and application process.
How to buy Health Insurance
Simply put, compare the benefits and costs of the policy. Most major medical
plans offer hospital and surgical benefits. If you want a plan that offers
Doctor Visits, Rx Coverage and Wellness Benefits, you will need to compare
several plans to ensure that you are getting the best value for your hard earned
money that you spend. Another important factor of a major medical policy, the
maximum out of pocket features. You need to know your share of the total out of
pocket, before the company will pay the remaining claims, up to the policy’s
maximum coverage.
Get
an Instant Quote
Step # 1
Our instant quote engine will instantly show you quotes on several hundred
plans.
Step # 2
Decide the type of coverage you need. Our quote engine will show you PPO plans,
HSA plans and Traditional plans.
PPO plans offer a network of Doctors and Hospitals in your area. Most plans
offer a huge network. You will need to ensure that the network covers your
needs. Some companies will show the network online, while others will require a
telephone call to our office. PPO plans offer substantial discounts in what you
pay for your healthcare, even before you reach your deductible or co-insurance.
HSA plans offer lower premiums for many consumers. You will need to purchase
a high deductible plan that is coupled with an HSA savings account. The premium
savings can be substantial due to the fact these plans generally do not offer co
pays for visits or prescriptions.
Other important HSA factors are Tax Deductible Contributions, Pre Tax Medical
Expenses and Tax Deferred Growth.
Step # 3
After deciding on the type of coverage, you can use the drop down tabs at the
top of your quote results to filter your results by co pays, deductibles and
insurance companies. If you need more information,
download a
brochure from our website or see the At a Glance feature we offer on each
plan that we represent.
Types of Plans
There are many different types of plans to choose from.
Comprehensive PPO Plans
PPO Plans with Doctor and Pharmacy Co Pays. These plans are very popular. If
you want to pay a small co pay instead of meeting your deductible first, then
the PPO plan with co pay options may be your best bet. The most important
factor, what does the Doctor Co Pay cover? Does it cover just the visit, or is
routine testing such as lab work and x rays covered under the Dr Co pay? Is
there a wellness or preventive benefit covered under the co pay? Is there a
separate deductible to meet before the prescription co pay starts? These are all
the things you need to research if you are interested in a PPO plan with Co
Pays.
The "At-a-Glance" feature will show each specific plans benefits. Also, the
Download a
Brochure feature on our homepage can be a useful tool.
A five minute call to our office may save you valuable time.
PPO Plans with Doctor Visits that are covered under the plans deductible.
Most of these plans have Pharmacy benefits that are covered either under the
deductible or with a separate Rx Co pay card. Always find out the plans maximum
out of pocket. If you have a $50,000 claim, how much do you have to pay before
your plan pays the remainder of the covered claims?
HSA Plans
An HSA, or Health Savings Account, is a tax- favored savings account,
combined with a qualifying high deductible health insurance plan to provide
lower cost major medical protection, significant premium savings, immediate tax
savings and a long term investment vehicle. HSA plans are very popular among
consumers that are pursuing important tax savings.
HSA plans can be purchased as a comprehensive major medical plan or a plan
that covers Hospitalization and Surgical cost but not outpatient doctor visits.
These catastrophic HSA plans without outpatient coverage are generally less
expensive than the comprehensive HSA coverage plans. The rule of thumb, fewer
benefits equal less monthly premiums.
The At a Glance feature will show each specific plans benefits. Also, the
Download a
Brochure feature on our homepage can be a useful tool.
Again, a 5 minute call to our office may save you valuable time.
Catastrophic Plans
Catastrophic plans are very inexpensive in comparison to other types of
plans. They are the perfect plan for consumers that have the “I don’t want to
lose the farm” attitude.
The "At-a-Glance" feature will show each specific plans benefits. Also, the
Download a
Brochure feature on our homepage can be a useful tool.
Again, a 5 minute call to our office may save you valuable time.
Limited Benefit Plans
Limited benefit plans are another option for consumers that are willing to
buy low cost plans that have fewer benefits and some limitations. Limitations
can be covered expenses that are capped at a certain dollar amount, or
limitations such as how many doctor visits a consumer is allowed in a calendar
year.
The "At-a-Glance" feature will show each specific plans benefits. Also, the
Download a
Brochure feature on our homepage can be a useful tool.
Again, a 5 minute call to our office may save you valuable time.
PPO
Networks
Most Health plans are associated with a PPO network. These networks offer
discounted pricing. The savings can be tremendous, even if you haven’t met your
deductible or co insurance maximums. The easiest way to find out if your doctor
and area local hospitals are in the insurance company’s network is to simply
give us a call.
How to
apply for coverage
Once you decide on a plan, you can call us and we would do the application
with you right on the telephone using the insurance company’s secure online
application. It's as simple as that.
Approval process can be as soon as a few days or as long as 3 weeks or so.
The underwriter from the insurance company may request medical records. Physical
exams are not normally required by our companies, but if they are, the exam will
be at no cost to you. There are other reasons that underwriters request medical
records. Call our office if you have questions concerning this issue.
Also, remember that all rates online are based on standard or preferred
rates. If you think you have a height or weight issue or are taking maintenance
medications, call or email us to see if your rates are correct.
Eligibility
All individual health insurance applications in Florida go through
underwriting as part of the approval process. Some companies have pre-existing
condition periods that last for the first 12 or 24 months. Some plans may place
exclusion riders on conditions that the company will not cover for either a
specific period of time or for the life of the policy. If you have cancer, heart
disease or other serious health problems, call our office to see if we can find
coverage for you.
Most companies rate up policies for consumers that are on expensive
maintenance medications, or have certain medical conditions such as high blood
pressure or cholesterol, or do not meet the specific company’s height and weight
guidelines. Call us to find out if your rates are correct, or if you think these
guidelines could affect you.
You can also send us an e-mail with your eligibility questions.
How to Lower your Costs
How to lower your monthly premiums.
The cost of health care has skyrocketed in the United States. An appendectomy
or gallbladder surgery can cost over $10,000. A catastrophic illness or injury
could be financially devastating.
Consumers purchase health insurance to protect their savings and assets. Here
are some ideas that may help you keep monthly insurance premiums under control.
- Purchase PPO Plans. Individual health insurance plans allow you to
maximize your benefits by choosing doctors, hospitals and other contracted
providers in the vast network that the company is a part of. Doctors and
hospitals agree to special network pricing for covered insurance members.
This can save you money even before you meet your deductible.
- Purchase plans with high deductibles. The deductible is the amount you
pay before the insurance company pays on covered expenses. If you choose a
plan that has a doctor co pay, going with a higher deductible will be less
expensive. Here is another way to look at a higher deductible. $2,000.00,
$3,000.00 or even $5,000.00 is better than $50,000.00 or $100,000.00 if you
do not have insurance.
- Purchase plans with No Co pays. If you spend a small amount of time at a
doctor’s office each year, it may be better to purchase a plan that all your
doctor visits go towards the deductible, instead of having a co pay. If you
are with a PPO plan, you will still receive the PPO discounted rate, even
though you purchased a plan with no co pays. This can save you a lot of
money.
If you look at the monthly rates for a plan with co pays, compared to the
monthly rates for a plan without co pays, the difference over a year’s time
can be substantial. You can pay for a lot of visits to the doctor’s office
with the difference. You need to look at your personal medical situation.
How to choose an
agent and get the best help available
Shop the individual market. If you use us, you are getting an opportunity to
look at the best policies in Florida for individual and family needs.
What I can do for …
- I will give you our honest opinion on which plan is your best value,
based on your needs.
- From the time you apply for coverage, until your policy arrives in the
mail, I will keep you informed every step of the way.
- I will provide you with assistance when dealing with billing issues,
claims issues, and anything that we can help you with.
- I will treat you and anyone that you refer to our services, with respect
and will give 100% effort in resolving any issue you need help with.
- When renewal time rolls around, if your rates get to a point where we
need to do a policy review, we will shop the entire market to ensure you are
still getting the best value.
- Our agency is paid commissions directly from the insurance company. Your
premiums will be the same regardless who you apply with, an agent or
directly with an insurance company.
Please call or e-mail us with any of your questions.
What a Consumer Should be Cautious of !
The insurance industry is a tough industry for newcomers to make a living in.
Unfortunately, there is a high turnover rate when it comes to health insurance
agents. Some of the things that agents say or do, you need to be cautious of.
If an agent will not provide you with a company’s health plan brochure, run
as fast as you can. All plans have required brochures and if an agent won’t
provide you with one, this agent is not proud of what he or she is selling.
If an agent says the only way you can get information on the plans that they
are selling is to sit through a presentation with them, beware of this tactic.
If you ask the agent what the maximum out of pocket is for a particular
policy and you get all kinds of answers, except what the dollar amount is, this
is probably not what you are looking for.
Always ask the agent or representative who the underwriter is. Make sure that
the plan is an actual insurance company and not a discount plan that may leave
you unprotected in a catastrophic situation.
Please call or e-mail us with any of your questions.
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