Finance Tips

In case you are not familiar with the market of insurance in general and healthcare coverage in particular, it can be quite confusing at first. But do not worry, as it is far simpler than you may think. Here’s a short recap of the most important things to know when shopping for health coverage plans. Of course, it’s not that profound to make an insurance specialist out of you in a single read, but it sure will help you find a decent policy with good coverage and low price.

Your options

Individual health policies – it is the most obvious option for most people, especially when not provided with healthcare coverage through their employers. You can find many insurance companies providing individual health plans. There are different regulations in every state regarding individual health coverage so make sure to learn more about your state before actually getting the policy. The best source for this information is your state’s insurance department.

High risk pools – these specific pools are the best solution in case you have been denied ordinary individual insurance due to a pre-existing condition. Not all states have high risk pools, but if your state allows them you will want to look better into this option. They typically have higher rates if compared to usual individual coverage, but it’s far better than having no healthcare coverage at all.

HIPAA coverage – in case you have recently been canceled of a job-base group plan and all COBRA coverage does not apply to you anymore, there’s a thing called HIPAA coverage that may be useful to you. HIPAA (Health Insurance Portability and Accountability Act) coverage is available in all states and can be of a use for people who can’t get individual coverage due to pre-existing conditions. This way HIPAA coverage is a good option in states where high risk pools do not exist. But even if there are high risk polls in your state you should consider both possibilities. Consult with your insurance agent to see what’s more appropriate in your case.

Whom to address

Insurance agents – an insurance agent is the person that will connect you with the insurance company, so it’s better to ask him or her about your options. But before you ask questions, make sure the agent is licensed for providing health insurance in your state. To do so, you can address your state insurance department and check the status of the agent you’ve been talking too. If the person is licensed, their experience in the domain can help you find good health coverage.

Department of insurance – besides giving information about state regulation and agents’ license, your state insurance department can also be a very valuable source of information on the whole health insurance market in your state. Don’t expect any recommendations to be made, though, as the workers are restricted from making any commercial claims. Use the department as your info source to know what companies are working in your area and then contact them directly.

Websites – there are many websites dedicated to health insurance out there and they can be a very good source of information to use. Many sites also provide free online quotes and state-specific data so you won’t have any problems with finding the right deal from a local provider.

The widely-discussed reform of healthcare industry in the US owes much of the stir around it to the simple fact that having your health insured in our country isn’t affordable for millions of people of different demographic groups. In other words, it’s just too expensive to be within the family budget of most US citizens. But how much does it cost to get your health insured these days, anyway?

This strongly depends on several factors that may vary your cost significantly. Things like your health condition, age, workplace, location, income and other live factors play a very important role in shaping your final rates. Not to mention the provider you’re getting your coverage from. The form in which you get your health insured also plays a crucial role, because getting your insurance in a group from your employer usually costs less than if getting it on your own.

But what comprises the final insurance costs?

Many people get confused by the fact that there are more elements to insurance costs than just the rates you seen when quoting your price. Here are the most important of them:

Premiums

Premiums are periodic fees (usually, monthly) that have to be paid to the insurance company for receiving any medical services under your plan. If you have an individual plan then you are paying your premiums on your own. If you are covered under a group plan at work, your employer pays the premiums, usually requiring you to pay a small part of this amount. Premiums depend on your health condition, your age and your income status. Premiums also vary significantly between insurance companies, so you’d better spend some time on comparing health insurance quotes before you sign your plan.

Out-of-Pocket expenses

Out-of-pocket expenses are all the additional costs of health insurance plans that are extended beyond premiums. These usually include deductibles, co-payments and co-insurance. With some plans these expenses can be limited to a maximum amount, while other plans have no limitations at all, so be on the lookout for that.

Deductible is the amount of money you have to pay on an annual basis before your actual coverage kicks in. You will most commonly encounter them in PPO plans for the services received outside the network. And as with other types of insurance products, you will have to pay lower premiums if your deductible is higher.

Coinsurance is the part of the medical cost you have to meet after paying the annual deductible. It is usually 20-30% of what you pay for the services when going to the doctor.

Co-payments represent a fixed fee for certain services within your plan. In many HMO and PPO insurance plans co-payments are set for things like doctor’s visit or prescription medications.

And what are the average costs?

• Across the US, the premium is $2,985 for individual health insurance and $6,328 for a family plan.
• The annual premium differs significantly between states. If a family in New York had to pay $13,296 as an annual premium, the very same plan in Iowa was worth $5609.
• The amount of deductible paid has a strong effect on the annual premium. A family plan that had no deductible had a premium of $12686, while a $10,000 deductible shed this amount more than in half, with $5380 to be paid.