Bite-Sized tips from 23-year Insurance Veteran

Insurance Copayment Vs Deductible What Is the Difference?

Filed under: health insurance — Alston @ 00:14 January 31, 2011

If you don’t know how a health insurance policy works, you can’t make good decisions about your coverage. If the only thing that you are sure about is how much you pay each month, you may be very unpleasantly surprised if you ever have a significant medical expense.

There are three major health insurance cost shares. Not all policies have all three, but many do. The cost shares are:

  • Deductibles
  • Copayments or Copays
  • Coinsurance

It is important to understand all three if you are to make good choices when it is time to purchase your next health insurance plan. You need to know your potential benefits as well as costs.

A health insurance deductible is a specific amount you have to pay before your insurance company pays for certain expenses. On some policies the deductible may apply to hospital stays, but not to doctor visits and not to medications. On other policies your deductible may apply to all medical expenses regardless of the type of provider except certain preventative care costs.

On most policies the deductible is based on health care expenses incurred during a twelve month period. This twelve month period may begin on January first or on the effective date of the coverage and its anniversary.

You can reach your deductible buy paying toward the cost of one major expense or by paying for several smaller ones.

Coinsurance is not based on a specific dollar amount. Coinsurance is stated as a percentage. The typical coinsurance percentage is 20%. However, many policies have 10% coinsurance. Some have 50% coinsurance.

Coinsurance, usually applies to the same types of expenses that your deductible applies to. However, typically you don’t pay coinsurance until you have met your deductible.

If you have a $1,000 deductible, 20% coinsurance and eleven doctor bills of $100 each, you will pay for the first ten visits and pay 20% of the eleventh visit.

Coinsurance is typically limited by your out-of-pocket maximum. Your out-of-pocket maximum may also be known as your stop loss. This can make a big difference in what you need to pay if you have a long-term hospitalization.

The out-of-pocket maximum limits what you have to pay in coinsurance over the course a period of time. That period of time is usually a year.

Copayments are usually smaller dollar amounts that you have to pay whenever you have specific types of medical expenses such as medications. You may have a $20 copayment for each prescription that you fill. You may have a $30 copayment when you have a doctor’s visit.

Copayments are often larger dollar amounts. You may have a $500 copayment for each day in the hospital or a $100 copayment for each visit to the emergency room.

Sometimes the larger copayments are limited, but typically there is nothing in the contract that limits the number of copayments you have to pay. Your out-of-pocket-maximum is not likely to limit your outlays for copayments.

When comparing policies, be sure to learn what expenses the deductible, the coinsurance and copayments apply to. Policies are often very different but often use similar language. Also be aware that not only are companies different, but even health care policies offered by the same company can also be very different. Be sure to ask your agent about anything that you are unsure about.

Finding the Best Health Insurance for Children

Filed under: child health insurance — Alston @ 03:55 January 24, 2011

Finding good health insurance for children got more difficult after the health care reform mandates of September 23 2010.

Group and family medical insurance policies are available, but private health insurance companies selling individual policies are, almost without exception, unwilling to insure children on standalone policies. They may insurance a child on a policy with a parent, but will no longer insure a child or children who need coverage on their own.

This is an unfortunate side effect of a law that attempted to provide universal health care for all children regardless of their medical history. The mandates backfired because insurance companies never want to take on all comers.

Mandating that an insurance company insure everyone is similar to mandating that banks lend money to everyone. No bank, no matter how big would be able to survive under a mandate like that.

Insurance companies cannot provide insurance for everyone who applies unless everyone applies. One unhealthy person can cost a company hundreds of thousands of dollars. Raising the rates to attempt to spread the cost of insuring the unhealthy to other policyholders would result in rates that would drive the healthy people away.

Since the more healthy would be more likely to risk not being covered by medical insurance, the rates would continue to escalate. Eventually only those who could afford extremely high premiums would be covered.

How To Cancel Insurance

Filed under: insurance tips — Tags: — Alston @ 01:01 November 24, 2010

You should always call your insurance company or agent to find out what you need to do to cancel your insurance. However, this post will include some standard information regarding how to cancel insurance policies.

Most insurance policies can be cancelled by fax. A few can be cancelled by phone. Some may still require a letter in the mail.

You can use this letter to cancel insurance if you decide to cancel by fax or postal mail. You can use this text to cancel insurance. It should be accepted by most companies. Either should be accepted by most companies.

Some policies can only be difficult to cancel or change unless you do so on the anniversary date or during the open enrollment period, but most individually purchased life, health and disability policies can be cancelled at any time.

If you have a private health insurance policy, chances are you can cancel at any point in the year. They may make you wait until the end of the month, however.

If you are able to make your request before the date you need your policy terminated, you will probably just need to make your request in writing. If the company receives your request before the date you want the policy cancelled, they will probably honor your request without any additional documentation.

If you need your insurance cancelled as of a date that is in the past, it can be more difficult. Some companies will only cancel your policy as of a future date. However, many will cancel your policy retroactively if you send them a copy of documentation that proves that you had another policy in force on the date that you want your policy to end.

Letter to Cancel Insurance

Filed under: insurance tips — Tags: — Alston @ 00:47

If you are wondering how to cancel insurance by fax or letter, you can use the following text to cancel your policy. You can hand write the verbiage or type it. So long as they can read your handwriting, they shouldn’t care which option you choose.

You can print out this letter to cancel insurance or copy the text below.

Letter to Cancel Insurance:

[your name]

[your address]

[city, state zip]

[Date]

[insurance company name]

[your address]

[city, state zip]

To whom it may concern,

Please accept this letter as my formal request to cancel my insurance policy.

Please cancel my insurance policy as of [enter date].

My policy number is [enter number].

Please contact me at [phone number] If you need any additional information to honor my request.

Sincerely,

[signature]

[printed name]

Home and Auto Insurance and Theft of Cash

Filed under: car insurance,Tricky Insurance Questons — Alston @ 01:28 November 15, 2010

This tricky insurance question is about homeowners and auto insurance and the theft of cash.

If cash is stolen from your car while parked in your driveway, what policy covers it or is it covered at all?

Avoiding Health Insurance Denial – Deny Insurance Information

Filed under: pre-existing conditions — Alston @ 14:54 November 8, 2010

Until all the health care mandates go into effect, we can still be denied health insurance due to our health histories. Although some insurance denials are unavoidable, many are avoidable.

It is very important that you never cancel an existing health insurance policy until you have an approval for the new one you applied for. Doing so can mean that you if you are denied coverage by the new company, you will be unable to be covered by the old policy either.  This is especially true if you need health insurance for a pre-existing condition.

You can do this by applying early. Request an effective date that is 2 weeks or a month away from the date you applied. This way you are likely to hear about your approval early enough to cancel the old policy and not double pay for coverage.

Getting an examination just before applying for a new health insurance policy can backfire on you. A condition that is discovered during your examination may result in a denial for the new policy.

Of course there are health reasons why you should get an exam sooner rather than later. A malady we are unaware of can hurt us. However, we need to weigh the benefits of having an exam as soon as possible with the potential negatives that come with having a medical record of the condition just before we need to change our coverage.

You may be able to avoid being without health insurance coverage by applying with a second company if you are denied by the first. Shopping around for insurance should not only apply to price and benefits, but also coverage specific to pre-existing conditions. You may find that a condition that causes you to be denied by one company will not be a factor when you apply with another company.

In 2014 the health care reform mandates will be in effect. Hopefully at that time concerns about medical insurance denial will be a thing of the past. For now, we may need to be thoughtful when it is time to change our health insurance coverage.

How Do Health Insurance Brokers Make Money?

Filed under: Tricky Insurance Questons — Alston @ 01:45 November 6, 2010

Many people are afraid to work with an insurance broker and go out of their way to buy directly from insurance companies. This often results in their paying more money rather than paying less.

Medical Insurance brokers do earn commissions. However, these commissions are paid by the insurance companies because when a broker brings a client to an insurance carrier, the insurance carrier has limited marketing costs associated with that transaction.

Labor costs are also affected. Often an insurance carrier will pay a staff person a commission for other sales. When an insurance broker brings a client to a carrier the carrier doesn’t have this other commission to pay.

By state law, health insurance agents are not allowed to charge commissions to their clients. Insurance companies are not allowed to discount health insurance policies when those policies are sold directly to consumers. Insurance premiums are filed with the state and are not affected by who your agent is or whether you use an agent.

Using an insurance broker can often result in your saving both time and money. A broker will often represent several carriers and will know the strengths and weaknesses of each of their policies. An agent can often help you find the lowest cost policy and often it is a policy that you might have overlooked.

Using an insurance broker to help you purchase a policy usually results in a lower cost to you instead of a higher cost.

Does Homeowners Insurance Cover Property Stolen From Your Car?

Filed under: Tricky Insurance Questons — Alston @ 03:45 November 5, 2010

Your homeowners insurance policy covers a lot more than just damage caused by fire. It also includes coverage for theft of most of your personal property.

Your homeowner’s insurance policy and not your car insurance policy will be the policy most likely to cover the theft of items stolen from your car. In fact, coverage for most personal property is part of your homeowner’s insurance policy and the coverage extends worldwide.

Coverage for certain types of personal property is limited and coverage for certain types of property is totally excluded from coverage. The standard homeowner’s policy limits coverage for jewelry and cash. It excludes coverage for most motor vehicles.

You can purchase additional coverage for jewelry either in the form of a rider or as a separate policy. Your cars can be covered for theft by your automobile insurance policy if you have other than collision coverage.

It is important to know what is covered and not covered by your insurance policies. Knowing something is covered means that you have the opportunity to file a claim for the loss. Knowing that something isn’t covered gives you the opportunity to either purchase additional insurance or take other measures to protect yourself.

You can get quotes for auto and homeowners insurance by completing the form at the top of this web page.

If I Am Pregnant Can I Still Buy Health Insurance?

Filed under: Maternity Insurance,Tricky Insurance Questons — Alston @ 11:59 November 4, 2010

Although maternity insurance may be available in limited circumstances, buying health or life insurance will be difficult for not only a pregnant woman, but for the other parent as well. For this reason, it is important to have the insurance you need in place before you conceive.

One of the events that makes people think about their insurance is the birth of a child. However, the need for additional insurance probably starts much earlier than the actual birth.

Parents can die before a child is born. This can mean the child is born into poverty or at least into a family with a very strained budget.

Getting appropriate amounts of life, health and disability insurance before your child is conceived is important. Neither the mother-to-be nor the other parent is likely to qualify to add to their life or health insurance when they are expecting.

Fathers-to-be may not expect that they will be ineligible for health and life insurance. Why would they be? They are not carrying the child.

The reason that both parents may be ineligible is that many policies include a provision that forces the company to insure any newborn children of the primary insured or spouse.

Parents who learn that their unborn child has a medical problem would be more likely to purchase policies than other parents. This would result in “adverse selection.” This means that the insurance company would suffer a disproportionate number of claims if they allowed parents-to-be to purchase medical or life insurance coverage.

It is important that life, health and disability insurance policies be updated before a child is conceived. In order to protect your child, you have to start early or wait until the child is born. This means that you may have 9 months without the protection your child deserves unless you plan ahead.

Insurance Against Theft

Filed under: home insurance — Alston @ 03:18 November 3, 2010

Your car insurance and homeowners insurance both provide protection against theft.

The protection provided by your car insurance policy is part of the “other than collision” coverage. You may know this coverage as “comprehensive.” This coverage is optional so you may not have it on your policy.

If you have “other than collision” insurance, your auto is covered against theft. The items that might be in the car are not covered by your car insurance however.

You may be surprised to know that homeowners insurance covers your possessions against theft, even if they are in your car when they are stolen.

Your homeowner’s condo or renter’s insurance policy provides coverage for theft of most types of personal property. Your personal property is covered all over the world against theft.

There are limitations, but the coverage provided by house, condo and renters insurance policies is probably a lot more robust than most people think. Most people realize that their house will be replaced or repaired if they have a fire, but few people realize that their possessions are covered from theft all over the world.

The theft coverage on both your auto and homeowners policy will probably be based on the actual cash value of an item. This means that you will not be paid enough to replace an old item with a new one. The insurance company will try to estimate the current value of a stolen item before paying a claim.

Your payments will also be reduced by the amount of your deductible. A lower deductible will give you better coverage, but it will also increase your premiums. Most people do better in the long run when they have moderate or higher deductibles.

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