Posts Tagged ‘Deductibles’

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Health plan catches to look out for November 21st, 2011

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There are many sides of having your health insured and it’s certainly a good thing because it allows to tailor a plan to your exact needs and make it as adequate as possible. But as with all things there are also negative aspects of this diversity that can lead you to misunderstanding and unnecessary spending if you aren’t aware of them. And these days additional spending could seriously harm an average family budget. If you’re trying to optimize your costs knowing about some common insurance traps is necessary in order to keep your costs as low as possible. So if you don’t want to become a victim of misunderstandings that will cost you money keep in mind the following health coverage traps when getting medical care:

Avoid going out of network

The vast majority of insurance plans you’ll find on the market are managed care plans. Whether group or individual these plans offer good premiums in exchange for certain limitations. One of such limitations is the place you can get medical care from. Each insurance provider has a network of medical facilities and specialists you can get your services from and have your bills covered. But once you choose to visit a doctor who doesn’t make a part of the network you will end up paying the entire bill out of own pocket, which is certainly not very convenient assuming the current medical prices. So the first advice would be sticking only to in-network specialists and facilities if you want all your services to be covered properly. Otherwise it really doesn’t make any sense having health insurance since you will end up paying for the larger portion of your medical bills.

Keep an eye for co-payments and deductibles

Co-payments, co-insurance and deductibles refer to virtually the same aspect of any health insurance plan. These are the payments that the customer has to make out of own pocket for getting the service he needs before the coverage starts to apply. These can be doctor visit fees or any other additional costs that you will typically find in a medical facility. Now, you have to be very careful with these payments since they can make up a good sum of money by the end of the year comparable to your premium. Usually they are higher in plans with lower premiums, however it’s not a necessary condition. So it’s highly recommended to check the co-payments and deductibles when assessing a health plan besides the usual premium comparison, since it adds up to the final cost of the policy in the long run.

Don’t get the first plan offered

One of the most common mistakes an inexperienced customer makes is that he or she buys the very first health insurance plan offered. The probability that this plan will be both affordable and adequate to your needs is very low, so don’t risk this way since it’s your money you are going to spend. Instead, take your time to consider all your options, shop around online, determine which plan type best appeals to your needs, compare quotes from different providers and only after doing some research buy the plan that appeals to you the most. You can save really good this way so don’t rush with your decisions if you have some time to compare different offers.

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More about the deductible November 17th, 2011

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Most of the research shows up to 90% of all policyholders renew automatically. Only the remaining 10% actually consider the possibility of changing insurer and a variable percentage then makes the change. With such a low level of “churn”, insurers have little need to change their products to make them more attractive. There’s no real competition between them to force an improvement in the terms. As a result, insurers tend to act unilaterally, changing the terms with little or no warning given to their policyholders. Although some states have given their Insurance Commissioner the power to intervene, the majority of these changes are waved through. Everyone in “authority” assumes this is a perfect market where you are free to switch to a different supplier if you feel unhappy with the level of service.

So beware changes in the deductible. Up to two or three years ago, almost all insurers offered discounts if individuals opted between deductibles in bands up to $1,000. That’s no longer standard. State Farm is leading the way in forcing an increase in the minimum flat deductible. This is no longer a choice. It’s imposed as a condition of doing business with the company. So, in some states, a single family occupying a home will now be required to pay a minimum of $2,000 towards every claim made. If families bundle home and auto insurance, this is reduced to $1,000. When asked to explain the reason for this increase, the company was remarkably honest. It intends to deter claims. Most people decide not to claim, but pay for their own repairs when the deductible is high. This reflects the fact that most claims are for relatively small amounts and, if claims are made, insurers often retaliate by increasing the premium rate when the policy falls for renewal.

When other companies were asked to justify their increases of both rates and deductibles, the majority spoke about the increasing number of claims made because of adverse weather conditions. This last two years has seen more damage due to winter storms, and spring and fall have seen major tornado and hurricane damage. Indeed, last year saw record payouts by the insurers and this year will see last year’s record broken. If the companies are genuine about having enough cash in hand to repair or replace damaged homes, more money needs to be collected in and less paid out for the smaller claims.

These increases in the deductibles would not be so bad if the insurers were reducing their premium rates. If you deter small claims, there’s a cost-saving to pass on to the policyholders. Sadly, this is not happening in the majority of states. Even more depressing is the number of insurers imposing a change from flat-rate to percentage deductibles. So, if you own a $300,000 home, you could find the deductible ranging between $6,000 and $15,000 for some of the perils covered. Curiously, very few home insurance policyholders have lodged formal complaints with their local Insurance Commissioner. Either they feel powerless or they have yet to realize the change which is not always obvious when the home insurance quotes or renewal notices come in. If you are affected, shop around to find any local insurers who have yet to increase their deductibles.

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Cheap health insurance may be underinsurance June 5th, 2010

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Perhaps this is an unnecessary statement of the obvious, but the point of insurance is to give people a financial safety net. Should an emergency or disaster strike, money you would struggle to find is paid out by your insurance company. But the squeeze has been on for the last decade as medical costs and the prices of essential drugs have been rising fast. In fact, so fast that the insurers cannot pass on all the increases to their policyholders. It was hard to raise premium rates while the economy was doing well. It became impossible to raise premiums when the recession hit without there being investigations by each state’s Commissioners for Insurance and complaints from everyone else. There comes a point when the insurer cannot get any more blood from the stone and has to sacrifice profits. This has left the medical profession, the hospitals and clinics in a winning position, while the pharmaceutical industry’s profits have continued to rise despite the recession. At the other end of the spectrum, the patients are the losers. There are some who discover the small print in their policies denies cover for the very illnesses they have. There are others whose savings are not enough to pay the deductibles and co-payments. And then there are those whose policies are cancelled when they make a claim for a chronic disease or disorder.

There is a new piece of research from the Commonwealth Fund, an independent, non-profit body. In 2007, it carried out a detailed survey among 2,600 people aged between 19 and 64. When their coverage was analysed, 20% were found significantly underinsured. Why was this happening? Because they were already spending more than 10% of their income on health coverage, whether as premiums, deductibles or both. When the underinsured were added to the uninsured, this represented 42% of adult Americans. Like the uninsured, this forces the underinsured to think twice before they have treatment with more than half either refusing treatment or struggling with debt because of treatment.

In the push for healthcare reform, the focus has been on the uninsured. But this fails to recognize the injustice suffered by the underinsured. No one should be forced to choose between refusing needed treatment and potential bankruptcy. It is therefore going to be an interesting year in prospect as the reform slowly comes into force. Both the poor and the middle class need access to cheap health insurance with reasonably comprehensive coverage. This will further squeeze the insurance industry because it will be denied the right to refuse coverage to those with pre-existing conditions and will be forced to establish group health insurance for those who have struggled to find affordable plans. In all of this, the key to success will be the ability of government and the insurers to impose more control over costs. President Obama has negotiated with the pharmaceutical industry and there is some agreement to hold down prices for those in Medicare and Medicaid. The for-profit healthcare industry also sees some self-interest in moderating its price increases and has given undertakings to the Administration. If some of the pressure is removed from the insurance industry, premium rates will stabilize and the reforms should offer a more fair system to all with a health plan. We can only hope for the best while we wait and see what happens.

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The cheap health insurance of an HMO or the more expensive PPO? May 19th, 2010

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One of the more annoying features of the insurance world is its habit of distilling options down to simple sets of letters and then failing to clearly explain what the letters mean. In other words, insurers hide behind jargon and prefer not to explain clearly what you are buying. You are expected to assume the insurer has your interests at heart and pay over your money without a second thought. In many cases it works. Over the years, we have given up the unequal struggle and just say prayers we never fall sick. But, as premium costs have risen and the recession has cut back our spending power, trying to understand the options is back on the menu. So let’s start with an explanation of HMOs and PPOs. In fact, they both rely on a network of physicians, clinics and hospitals, but they differ significantly in the detail of how they deliver healthcare to you and your family.

A Health Maintenance Organization (HMO) is a network of healthcare professionals that enters into a contract with an insurance company. The insurer offers a captive group of people to refer to the network and, based on the expected volume of business, the network agrees a fixed fee for all the main services on offer. In theory, this works well for everyone. The fees are discounted because of the volume of business, so the insurer saves money and charges lower premiums. This is usually the cheapest form of health plan with very low copayments and, often, no deductibles. But there are problems. HMOs are very reluctant to accept people with existing conditions requiring expensive treatments. They prefer most of their patients to be reasonably healthy. The reason is basic economics. Every physician has to meet a quota of patients in a day. This means spending the shortest possible time on each consultation. Long diagnostic sessions disturb the quota and can result in penalties to both the doctors who miss their numbers and the patients who have slowed down the queue. There are also significant restrictions on patient choice. A nominated primary care doctor decides what referrals shall be made and to whom. HMOs are the cheapest form of care, but you have little control over the treatment you or your family receive.

A Preferred Provider Organization (PPO) uses the same basic approach but, because you pay more, you buy greater control over the treatment. The copayments are around 20% and there are usually deductibles. But, you have freedom to choose your own doctors. So long as you go see a physician in the network, you are covered. If you want to see someone outside the network, you usually only pay the difference between the network rate and the actual fees your choice collects.

 

So, when it comes to cheap health insurance, an HMO is the better option. But if you have the money and a health problem likely to need more extensive treatment, you should opt for a PPO. It always comes back down to your own personal needs and what you can afford. Cheap health insurance always comes with limitations. Read the small print before you buy into any plan and see exactly what you can and cannot do before you agree to buy the policy.

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Should you rely on cheap car insurance? May 18th, 2010

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Do you remember the Blues Brothers? They were unstoppable. They were “on a mission from God”. Seems like almost everyone standing behind the counter in the rental agency is a Blues Brother when you come into collect the vehicle. They always want to sell you something, usually additional insurance. The most common special offer is loss damage waiver (LDW). It sounds such a good idea to have complete cover against any loss caused to the vehicle while under your control. The magic word is “waiver”. You are excluded from liability even if you drive the vehicle off the end of a pier and it sinks without trace (hopefully without you still inside it). The only problem is this good idea can seriously damage your bank balance when the final bill comes in. That hourly or daily rate just got heavy. So when should you add LDW? The answer is deceptively simple. If you do not own another vehicle and have no insurance cover in place, it may be a good buy. But most insurance policies on your own vehicle cover you while driving a rental. So it all comes down to the extent of that cover on your own vehicle.

To get the maximum discount in these hard economic times, most people have been pushing up the deductibles. In many cases, the potential losses can be managed to keep to the low end. It’s your vehicle. You can talk to the repair shop and get all the work you want done at the best price. But when it’s a rental vehicle, everything is out of your hands. The rental company has no interest in protecting your bank balance. It pays top dollar to get the vehicle repaired and sends you the bill. No searching around to find the cheapest replacement parts and lowest price body shops. Everything is top of the range and then comes the kicker. It’s called the “loss of use” charge. You are expected to cover their estimated loss of profit while the vehicle is off the road. And guess what. If you are paying their loss of profit, they have no incentive to rush the repairs. They can take their own sweet time and, in most cases, you pay – most private policies do not cover loss of use charges. Some credit card companies offer limited cover, but read the small print before relying on it. Limited cover means very little actual money will ever be paid out.

If you are only renting for a few days, it’s probably worth paying for LDW. It may not be cheap car insurance, but it protects you. But if the end bill is going to be too high, trust to luck and your own insurance policy. Hopefully, your own cheap car insurance policy will give you enough of a buffer against claims Remembering, of course, that only the best private policies cover you against the dreaded loss of use charges. If nothing else, all this bad news should give you the incentive to drive like your wheels are passing over egg shells. Drive as safely and carefully as possible. If you are going to break some eggs, make sure the damage is minor and the losses are small.

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