Sickinsurance

Finding Low Cost Health Insurance In New York

23rd July, 2010 - Posted by Admin - No Comments

In the state of New York, you may qualify for low cost health insurance whether you are a small business, sole proprietor or individual.

In 2000 the NY Legislature enacted regulations in response to the Governor’s proposal to make available comprehensive insurance coverage for New York workers and their families who are uninsured. The name of the program is Healthy NY.

This program helps the small business owners (businesses with 50 or fewer employees) to provide health insurance to their employees and their families. Additionally, Workers who are unable to purchase insurance through their employer because the employer doesn’t offer insurance and the sole proprietor may purchase coverage directly though Health NY.

All HMO’s in the state of New York offer standardized health benefit package that is made affordable through the sponsorship of NY State. This makes it more affordable for small employers and uninsured employees.

There are certain eligibility requirements for each section:

Small Employer

Business must be located in New York
The business must have 50 or less eligible employees
30% of employees must earn 34,000 or less
The business must not have provided group health insurance to employees in last 12 months (with certain stipulations)
50% of eligible employee participation and at least one earns 34,000 or less
Employer must contribute 50% of premium
The employer must offer plan to employees working 20 hours or more and earning 34,000 or less

Individual and Sole Proprietor guidelines:

The individual must live in the state of New York
Must be currently employed or have been within the last 12 months
Employer does not provide health insurance
Have not health insurance for past 12 month period
Ineligible for Medicare
The annual household income must meet the Healthy NY Income Guidelines

Please see our recommended sources for insurance quotes and low rates. These websites are aslo great sources for information about rates and coverages in the lower 48 states.

A New Idea To The Health Insurance Crisis In America

16th July, 2010 - Posted by Admin - No Comments

A New Idea To The Health Insurance Crisis In America

Lack of health insurance coverage for over 41 million Americans is one of the nations most pressing problems. While most elderly Americans have coverage through Medicare and nearly two-thirds of non-elderly Americans receive health coverage through employer-sponsored plans, many workers and their families remain uninsured because their employer does not offer coverage or they cannot afford the cost of coverage. Medicaid and the State Childrens Health Insurance Program (SCHIP) or HAWK-I here in Iowa help fill in the gaps for low-income children and some of their parents, but the reach of these programs is limited. As a result, millions of Americans without health insurance face adverse health consequences because of delayed or foregone health care and extending coverage to the uninsured has become a national priority. -(Information taken from kff.org)

The number of people that are forced to go without health insurance is nothing less than a crisis in this country today. We have fallen into a vicious cycle over the last few decades in which health insurance premiums have become too expensive for even a middle class family to afford. This in turn results in the inability of the uninsured to cover medical costs which often times results in the financial ruins of the family, and in turn results in the continuing loss of income by the medical community, which in turn drives the cost of medical expenses higher, finally cycling back to the insurance company which then must drive the premiums of health insurance higher to help cover the rising cost of health care.

Many proposals have been tossed around by politicians on both sides of the isle ranging from socializing health care comparable to the Canadian system, to endorsing health savings accounts and cracking down on frivolous law suits against the medical community. Many of these proposals have good points, but along with whatever good points they bring they also bring major downfalls. For instance; a socialized national health care program would eliminate the need for health insurance all together and the cost would be taken on by taxes, which in theory doesn’t seem like a bad idea. However, the downfalls to this system include a deficit in new doctors willing to get into the field due to the inevitable decline in income while the demand would grow due to no personal responsibility. In short if people didn’t have to worry about deductibles or copays that would normally keep the person from seeking medical treatment for minor things, they would simply go to the doctor every time they had an ache or pain. So now we have waiting lines for people with major health problems since everyone is scheduling an appointment while at the same time we are loosing doctors due to lack of incentive.

The current battle cry by the republican Bush administration is to push HSA’s (Health Savings Accounts) which reduce premium by taking a less expensive high deductible health insurance plan with a tax deferred savings account that earns a small interest on the side that you contribute to along with your premiums each month. Any money withdrawn from the savings account for qualified medical expenses are taken “tax-free”, and unlike a flex spending account like many people are familiar with in employer based plans, you don’t lose the money you put into the account that you don’t use. Basically if you never used any of that money in the savings account you could withdrawal or roll it over into another vehicle once you turn 62 12 penalty free to be used for retirement. This is a viable option for some people, however for many the premiums for these plans are still too expensive, and the problem remains that if you need major treatment in the first few years of the policy you will not have a big enough amount in the savings account to help cover the gaps leaving that person responsible for a large portion of the cost out of pocket.

Now we come to what I believe is one of the biggest problems from a health insurance agent’s point of view, which is the inability for persons with pre-existing health conditions to obtain coverage. From the number of people that contact my office searching for health insurance coverage, I would have to say that about half of them have a health condition that will either result in an insurance company declining that persons application, or result in an amendment rider which basically excludes coverage for any claims related to that condition. An example of a condition that I run across constantly is hypertension or high blood pressure. This condition will sometimes result in a company declining an application all together if other factors are involved, but most generally result in an amendment exclusion rider. You may think that this isn’t that big of a deal, after all, blood pressure medicine is about the only thing they would have to pay for out of pocket, but what many people don’t realize is that this rider will exclude ANYTHING that could be considered part of this condition including heart attacks, strokes, and aneurisms which would all result in a huge out of pocket claim. Consider the fact that my father had a double by-pass surgery recently that ended up with a final bill of around 150,000. This whole amount would have had to come out of pocket had he had a hypertension rider on his health insurance policy, not to mention the added cost of 2 months off of work thrown into the mix. On a modest income of 40,000 per year this would have ruined him financially.

So what how do we fix this problem? Obviously the proposals thus far have been flawed from the beginning, and even if one of these plans gained support from the American people chances are it would never be passed into law simply due to political infighting. One side wants to keep health care privatized while the other wants to socialize it, which as we discussed before both have upsides and downsides. It seems that we are doomed on this issue and there is no real ideas or light at the of the tunnel right? Maybe not, let me tell you about a client I had in my office a couple of years ago.

A young woman came in wanting to compare health insurance plans to see if there were any options for her and her family. She had several children and had been on Title 19 Medicaid and had been going to college paid by the state. She had recently graduated from college and had gotten a job with the local school system, however for whatever reason she was not eligible for health insurance benefits. Obviously she still couldn’t afford 5 or 6 hundred pounds per month for a plan so she went back to the aid office and explained her situation. They ended up working with us to find an acceptable private health insurance plan and reimbursed her for a percentage of the cost which I didn’t even know was possible!

This got me thinking, consider how many more people would be able to obtain coverage if they could be reimbursed by the government a percentage of the premium according to their income. For example; take a young married couple in their 20’s with one child, let’s say that their family income is 25,000 and that the average premium for a 500 deductible health insurance plan for them is 450. Just as an example let’s say that the government determined that a three person family with an annual income of 25,000 is reimbursed 50% of their premium taking the actual cost to the family to 225 per month. This is now an affordable enough premium for the family to consider.

With this merging of private insurance with government assistance we get the best of both worlds. Of course the next question goes to cost, how much more would this cost the American tax payer and how much would this raise taxes? I don’t think that it would cost the tax payers much more an here’s why I think that: First off we would bring down significantly the amount of uninsured people that are unable to pay for the medical care they get in turn driving down the total cost of health care. Secondly the number of people that are forced into bankruptcy and driven to Medicaid Title 19 assistance due to medical bills stemming from catastrophic medical conditions that don’t have health insurance coverage would be significantly reduced. This is important to keep in mind considering that once someone is on Medicaid they are receiving health care basically 100% covered by the government so there is no more incentive to not seek treatment for minor or non-existing conditions. On the flip side many conditions that would have not been caught before they became severe because a person didn’t seek treatment due to not having insurance coverage would now be caught before they turned into a catastrophic claim. Finally, if the government allocated a certain amount of money to help cover claims by people that have pre-existing conditions the private insurance companies could do away with exclusions and declines due to already existing health problems, this is already done is some states such as the HIPIOWA Iowa Comprehensive Plans which insures Iowa residents that can not obtain coverage elsewhere.

You may be sitting there thinking that this is all just wishful thinking and that these ideas could never be implemented, but all of these ideas are already being implemented. The problem is that only some states do some programs and not even most health insurance agents know that some low income families can get reimbursed for health insurance premiums. If these programs were all standardized and put into effect on a national well publicized level I believe it would put one hell of a dent in the uninsured population in this country. Now I don’t pretend to know what the reimbursement levels should be for what income levels but I do know that anything is better than nothing, and in my opinion this is the best middle ground we could find. The Democrats would be happy with the socialized aspect of the reimbursement, and the republicans should be happy that health care remains privatized giving this solution a better chance at a by-partisan backing.

I have faxed this idea to several senators and congressmen but always received the same type of standard response about how they are concerned with health care and that they are working hard to find a solution knowing full well that no one really even read my letters. The only way to get these ideas out into the public is for you that read this to pass it on to others by word of mouth, by email, or by linking your websites to this webpage. If enough buzz is created than these ideas would get the consideration that they deserve, and if enough people like you and I demanded that a solution be found than perhaps enough stress can be placed on the politicians to get something done. The number of uninsured Americans is only going to go up, the cost of health care is only going to go up, and the cost of health insurance premiums are only going to go up if something isn’t done now! Until then the only thing that I as a health insurance agent can do is to compare all of the options out there and present you with the lesser of all of the evils, which in too many cases the option that is chosen is the biggest evil of going without coverage.

Does Your Student Health Insurance Make The Grade?

9th July, 2010 - Posted by Admin - No Comments

A growing number of colleges and universities have instituted a new requirement-student insurance.

However, when they attempt to comply, some students find that the insurance plan offered by their college may be less than adequate or that they are no longer eligible for coverage under their parents’ health plan. Others find that their school is outside the HMO or PPO region or their parents’ plan.

An alternative is purchasing insurance coverage through a plan designed specifically for college students.

When selecting such a plan, it’s wise to compare the cost of a college-sponsored plan against other policies and to find one that’s really designed to fit a student’s lifestyle. You might be surprised to learn that a college-sponsored plan isn’t necessarily the most affordable or comprehensive coverage available. What’s more, the plan should accommodate travel and stay in place should a student transfer to another school. Also, the coverage should be in place year-round, not just during the school year, and be priced to fit a student’s budget.

Experts say one policy that fits these criteria is Student Select from Assurant Health. This permanent, renewable, individual medical insurance plan is designed specifically for college students under the age of 30. Students must be under the age of 30 when they apply but they can keep renewing the plan when they are no longer in college and keep it up to the age of 65.

Since the policy is not an HMO plan, you can visit the doctor or hospital of your choice. No referrals are needed, no non-network penalties are incurred.

The plan can be paid for on an annual or semiannual basis. The company offers two convenient payment methods of credit card or personal check. Both the annual and semiannual payment options are available with the credit card payment method.

If you are not satisfied with the plan, you can return the contract within 10 days of delivery for a refund. If a cancellation request is received after the 10-day period, a prorated refund will be provided as described in the contract.

Different Types of Health Insurance in California

2nd July, 2010 - Posted by Admin - No Comments

Whether you buy group or individual health insurance in California, the options you have regarding the different types of health insurance are generally the same. In some groups you can even choose from available plans. These different types are traditional health insurance, health maintenance organizations (HMOs), and preferred provider organizations (PPOs).

California goes beyond the Federal requirements for offering health insurance to its residents. Examples of this include Industry Advantage plans (IAHP), short-term health policies, Insurance for high risk Individuals and special plans for children and teens.

Additional Health Insurance in California
The traditional health care delivery system is based on a fee-for-service type of arrangement. In a fee-for-service system, you pay or each itemized medical service you receive. In the days of the frontier, “Doc” often received a chicken as payment. Today, physicians are paid with money, lots and lots of it. Fee-for-service health insurance recognizes this practice and is designed to reduce or even eliminate your duty to pay directly for your medical care. Traditional health insurance comes in three parts:

California has four basic options for choosing a health care plan:

1. 1. Health through an employer or association
3. 2. Health Insurance through Income eligibility such as Medicaid
5. 3. Health care for high risk individuals such as those that have had cancer or a heart attack
7. 4. Private Insurance
8. Hospitalization
   Hospitalization covers defined expenses incurred while in the hospital. Generally, the insurance will pay for all of the covered services rendered by the hospital staff. However, if the insurance benefit is an indemnity payment, the payment will be for a fixed sum regardless of the actual expenses incurred. This fixed sum will usually be far below the daily charge actually made by the hospital.

   Medicalsurgical
   This part of a traditional health plan covers the expensive costs of medical care other than the bill from the hospital. Services such as doctor visits, treatment charges, etc., are covered here. Medicalsurgical usually has a deductible and requires co-payments by the insured (payments you make for charges not covered by the insurance), typically 20 percent of the doctor’s fee.

   Catastrophic or major medical
   There are usually lifetime maximum payments that hospitalization and medicalsurgical plans will pay, after which the well runs dry. Unfortunately, these maximums may not be sufficient to pay for all of the care required if a major illness or injury should strike, since such afflictions can eat up hundreds of thousands or even millions of pounds worth of health services. Thus, catastrophic coverage adds to your umbrella of protection in an amount sufficient to protect you from the horrendous expenses of such serious and prolonged illnesses. These policies also fill in some of the gaps not covered by hospitalization or medicalsurgical.

   Health Maintenance Organizations or Private Insurance in California
   The health maintenance organization (HMO) is a relatively new player in the health insurance game, although it has been around in a limited fashion since the 1930s. The idea behind an HMO is to pay one premium and receive all of your health care at no or a nominal additional cost. The point is to save money compared to traditional health plans that cost more to purchase and require more out-of-pocket payments from the insured. What you, the insured, give in exchange for reduced cost is a substantial loss of your freedom to choose who will take care of your health needs.

   Preferred Provider Organizations
   Preferred provider organizations (PPOs) seek to give both the benefits of traditional health plans and the money savings of HMOs. They do this by paying higher benefits as a reward for your using the doctors or hospitals they preselect for that purpose.

   Disability Insurance
   Disability insurance does not pay for health care; rather it pays for lost wages caused by a disabling injury or illness.

   How Health Insurance Is Priced
   Ask anyone how health insurance is priced and you will get a simple answer: expensively! Beyond that, there are underwriting criteria used by health insurance providers, whether they are for-profit or, like Blue ShieldBlue Cross, nonprofit.

   Underwriting Criteria
   Age
   The older you are, the more likely you are to get sick; therefore, the higher your health insurance premiums will be.

   Number of people covered
   Many people buy family coverage rather than individual policies. This means that there will be adults as well as minor children protected by the same plan. Some companies will charge based on the size of the family. Others charge a basic family rate without regard to the number of members.

   Gender
   Unlike life insurance, where women get the better end of the bargain than men, in health insurance women often pay higher premiums. This is based on health insurance industry statistics which indicate that the female of the species tends to need medical care more often than the male.

   Health history
   Insurance operates on statistical probabilities. If you have had a poor health history, statistically you are more likely to have a more expensive health care future. This, in turn, means that you will pay higher premiums-if you can get health insurance at all.

   Occupation
   The more likely you are to suffer injury or illness because of the work you do, the more likely the health insurance industry will be to charge excessively for benefits. This may be well and good for professional deep-sea divers. But the industry has begun to stretch the concept into areas that have nothing to do with the inherent danger of the work.

   Lifestyle
   In your application for health insurance you will be asked questions about your personal habits. Your answers will have a lot to do with the cost of your premiums. If you smoke, you will probably pay more for health insurance. If you drink to excess, you will probably pay more for health insurance. If you are known to be under a great deal of stress, you may pay more for health insurance. California does reward the health care Insurance consumer with lower premiums if they have practiced good health policies.

   One of the most important things you can do as a health care consumer is to engage in preventive care. Not only will you be able to spot serious diseases at an early stage, thereby increasing your chances of effective treatment and cure, but you should be able to save money as well, since it is usually far less expensive to treat a disease when it’s a molehill rather than a mountain.

   About The Author:

   Medical-Ins.com is a leading broker of health insurance in California. We provide detailed information and cost breakdowns of Blue Cross, PacifiCare California and many more. Visit our site for a free quote and to help sort through the various health insurance plans to find the more affordable option for your family.