Health Insurance
Insurance that covers medical expenses. The policy owner pays a premium, which is the cost of the insurance. Most policies cover the cost of routine, preventive and emergency health care services and prescription drugs.
Health insurance comes in the form of group plans and individual plans. Group plans generally are purchased through a business for their employees, while individual plans are purchased by an individual for themselves and/or family.
Health insurance is expensive. Most companies I represent for are not for profits,
and the premiums are a direct reflection of the health care costs. The high cost of
health care can be attributed to the aging population, mandated benefits, and/or increased
utilization, but the bottom line is that it is expensive. Here are a few examples of medical
procedures and their costs:
- Repairing a torn ACL, $25,000
- Replacing a hip, $65,000
- Open heart surgery $150,000
What to Look For
Here are a few key tips for shopping for and buying insurance:
- The most important thing to look for when shopping for medical insurance is the integrity of the company.
- Deductibles should always be per year, not per occurrence.
- You should look for your maximum out of pocket expense. Out of pocket expenses are the point where the insurance company pays 100%.
- What are the exclusions in the plan? Is the coverage 24 hours per day, worldwide? Or does it exclude occupational injury, sickness or disease?
The choices now available to individuals are amazing. From a time when individual coverage was almost impossible to get to today where we have a wide variety of good products ranging from relatively low deductible plans to fully HIPAA compliant high deductible health plans that are not catastrophic only coverage.
There are some bad choices and plans to be sure. NASE, Alliance, MEGA, and plans that are built to protect the insurance company and not the consumer.
And there are good plans from reputable companies that do the right thing, protect you. Many times an easy way to at least get an idea if a plan is legitimate is to visit your State's Office of the Insurance Commissioners web site, in Washington visit http://www.insurance.wa.gov. If a company is not there it may be the first indication that something is not right.
Today the goal is to get you to the correct plan for you. To me that means the best value, cost versus benefits. We all want the same thing, great benefits at no or little cost. The reality is that benefits and protection come at a premium, let's work together to get that right for you. If you rarely use health insurance, a Health Savings Account may be best suited for you.
More Information
For more information our Frequently Asked Questions or contact us.