Florida Health Insurance Newletter January 2007 * Affordable Florida Health Insurance
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Are you covered by an employer's group insurance plan? Do you have Medicare coverage in place? Are you currently self-employed? If you are one of the many Americans that fall under one of these categories, most likely, a health insurance plan is not readily available for you. What do you do? You must go out on your own and purchase a private health insurance policy.

With technological advances paving the way most insurance brokerages now offer you health plans on the Internet. There you will be able to view hundreds of various insurance programs from competitive insurance carriers. In many instances you can view different plans side by side and even apply for these programs through secure forms on the internet, all while sipping a cup of coffee from the comfort of your home. Most people ask the question.. How do I pick the correct Health Insurance Plan for myself or family?

What does this entail? Most individuals while shopping for health insurance on the Internet seem to get acquainted with the cheapest program they first see. Is this usually the program they purchase or should be looking at? Probably not, but it seems that human nature will insist that most people want to get by with the cheapest plan. How many times has an insurance agent or broker been asked, How do I get the best plan at the cheapest price? I guess a good rhetorical question would be, do you drive a Lexus or a Yugo? The bottom-line, like with any other product in a consumer driven marketplace, you get what you pay for. Sure you can get a cheap plan, but most likely you won't be happy once it is time to have your claims paid. Just make sure you come to some sort of educated decision upon buying your health insurance program.

Narrowing down what health Insurance Plan to buy?

The first step in choosing a health insurance plan is to make a decision in whether you would like a basic or comprehensive plan.

Characteristics of a basic, deductible based, or traditional health plan:

  • A deductible must be met before the insurance company pays out any claims for the calendar year (cyd). This means you pay everything with your own money until the deductible has been met.
    • Deductible could range from $500-$10,000
    • The higher deductible you choose, the more affordable your premium shall be, and the lower deductible will make it more expensive. Simple risk and reward scenario.
    • Coinsurance could be 100%, 80%, 50%
    • Coinsurance is the percentage that either you pay or the insurance company pays after your deductible has been met
    • Out of pocket maximum could be $0, $2500, $5,000
    • Your out of pocket maximum would vary based on the coinsurance level of the plan you choose.
    • Policy Lifetime Maximum could be $1,000,000, $2,000,000, $3,000,000, $5,000,000
    • This would be the amount of money the policy certificate would pay out for the lifetime of coverage. $3,000,000 would be a great choice, but wouldn't go below that figure

Basic, deductible based, or traditional health plans are very easy to understand. You could compare this type of plan to your car insurance deductible.

Q: Do you have a car insurance deductible?
A: Yes

Q: If your car was worth $20,000 and you had a deductible of $1,000 what would your car insurance company pay you in return for that car if totaled?
A: $19,000

Characteristics of a comprehensive health plan, copay health plans, managed care health plans:

A deductible must be met before the insurance company pays out any claims for major medical expenses during the calendar year (cyd) This means you pay everything with your own money until the deductible has been met for major medical services such as:

  • Hospitalization
  • In Patient Surgery
  • Out Patient Surgery
  • In Patient Testing
  • Out Patient Testing
  • Emergency Room

    Deductible could range from $500-$5,000

    • The higher deductible you choose, the more affordable your premium shall be, and the lower deductible will make it more expensive. Simple risk and reward scenario.
    • Coinsurance could be 100%, 80%
    • Coinsurance is the percentage that either you pay or the insurance company pays after your deductible has been met
    • Out of pocket maximum could be $0, $2500, $5,000
    • Your out of pocket maximum would vary based on the coinsurance level of the plan you choose.
    • Dr. Visit Copay could be $15, $20, $25, $30, $35, $40, $50
    • Co pays can vary based on if they are a primary care or specialist Dr. visit. In many cases these two types of office visit co pays will vary based on the fact that a specialist charges a great deal more money than a primary care physician
    • Prescription Copay could be $15, $25, $40, $50

    Most insurance carriers offer a copay for generic drugs without a deductible being met, but will make you meet a smaller deductible for your brand name drugs. This deductible for brand name drugs is usually $250 for the calendar year (cyd)

    Comprehensive health plans are very easy to understand. You could compare this type of plan to overages you have had in the past with an employer. Some good questions to ask yourself to differentiate between a basic and comprehensive plan:

    Q: Do I have a co pay for Dr. visits before my major medical deductible? A: Yes

    Q: Do I have a prescription program with copay before my major medical deductible? A: Yes

    If you answered yes to both of these questions you would be on track to purchase a comprehensive health plan. Make sure you understand the difference options when choosing a health insurance program for yourself or family. Every individual person has different ideas in what you should have or need for your health plan, you might have had an employer group plan your entire life, or you might have been self-employed. I assure you that these two people think very differently, one has had the majority of there insurance paid for and the other has always paid his premium in full.

    When choosing either a basic or comprehensive health program make sure to find out how your plan covers the following: What are the following?

    1. Deductible
    2. Coinsurance
    3. Out of pocket maximum
    4. Dr. Visit Copay
    5. Prescription Copay

    Some of you will want all five items and others might only one. Make sure to do your research and find the plan that fits your individual needs.

    Aquí está una traducción española:

    ¿Es cubierto usted por un plan del seguro del grupo de empleador? ¿Tiene usted el alcance de cuidado Médico en el lugar? ¿Es usted actualmente que trabaja por cuenta propia? Si usted es uno de los muchos Americanos cae bajo estas categorías, muy probable un plan de seguro de enfermedad no está fácilmente disponible a sus puntas del dedo. De modo que usted debe salir en su propio y comprar una política del seguro médico privado.

    Con los avances tecnológicos que preparando el terreno la mayoría de las corredurías del seguro ahora le ofrece planes de salud en el Internet. Allí usted podrá ver centenares de varios programas del seguro de portadores competitivos de seguro. En muchos casos usted puede ver el lado diferente de planes por el lado e incluso solicitar estos programas por formas seguras en el internet, todo al beborrotear un café del consuelo de su hogar. La mayoría de las personas hacen la pregunta.. ¿Cómo escojo yo el Plan correcto de Seguro de enfermedad para la Familia o para yo mismo?

    ¿Qué trae consigo esto? La mayoría de los individuos al hacer de compras para el seguro de enfermedad en el Internet parece ser informado con el programa más barato que ellos ven primero. ¿Es esto generalmente el programa ellos compran o deben estar mirando? Probablemente no, pero parece esa naturaleza humana insistirá que la mayoría de las personas quieran obtener por con el plan más barato. ¿Cuántas veces han sido preguntados un agente de seguro o corredor, Cómo obtengo yo el mejor plan en el precio más barato? ¿Adivino que una pregunta retórica buena sería, manejaría usted un Lexus o un Yugo? La última línea, como con cualquier otro producto en un mercado manejado de consumo, usted obtiene lo que usted paga por. Seguro usted puede obtener un plan barato, pero muy probable usted no será feliz una vez es tiempo de tener los reclamos pagados. Cercióresele apenas viene a la decisión educada de algún tipo a comprar su programa de seguro de enfermedad.

    ¿El restringir qué Plan de Seguro de enfermedad para comprar?

    El primer paso a escoger un plan de seguro de enfermedad es de tomar una decisión en si usted querría un plan básico o completo.

    Características de un plan básico, deducible, basado o tradicional de la salud:

    Un deducible debe ser encontrado antes de las pagas de la compañía de seguros fuera cualquier reclamo para el año común (cyd). Esto significa que usted paga todo con su propio dinero hasta que el deducible haya sido encontrado. Deducible podría recorrer de $500-$10,000

    El más alto deducible usted escoge, la más económica su prima será, y el más bajo deducible lo hará más costoso.

    El riesgo sencillo y recompensa el guión.

    El coaseguro podría ser 100%, 80%, 50% de Coaseguro es el porcentaje que o usted paga o las pagas de la compañía de seguros después de que su deducible haya sido encontrado Fuera de máximo de bolsillo podría ser $0, $2500, $5.000

    Su fuera de máximo de bolsillo variaría basado en el nivel de coaseguro del plan que usted escoge.

    El Máximo de la Vida de la política podría ser $1,000,000, $2,000,000, $3,000,000, $5.000.000

    Esto sería la cantidad de dinero el certificado de la política pagaría para la vida del alcance. $3.000.000 serían una gran elección, pero no bajarían esa figura Basic, los planes deducibles, basados ni tradicionales de la salud son muy fáciles de entender. Usted podría comparar este tipo del plan a su seguro de automóvil deducible.

    Q: ¿Tiene usted un seguro de automóvil deducible? Un: Sí

    Q: ¿Si su coche valió $20.000 y usted tuvo un deducible de $1.000 le qué pagaría su compañía de seguro de automóvil a cambio de ese coche si totalizado? Un: $19.000

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