Insurance Blog | RF Insurance Masters

Pregnancy and Individual Health Insurance

Posted October 28th, 2009 in Views by rayfreer

Individual Health Insurance and Pregnancy:How can you find a way to get insurance coverage to help pay the costs to having a baby? Careful planning is necessary to help limit your financial exposure for this joyous event. If you can plan this event, this would be the best way to go to maximize your coverage. I would recommend consulting with your insurance agent about your options. I will share how we work with our clients when they are ready to start a family.

The customers I talk with come to me for help in one of the three situations:

1.Preparing to have a baby – looking for ways to minimize cost

2.Pregnant now with Individual Health Insurance that does not cover maternity

3.Pregnant with No health coverage – What do I do?

I will share my approach to the customers in this situation.

Preparing of Pregnancy – Review Your Current Health Coverage

The best way is to ensure you have an individual insurance policy in place before you become pregnant. This may not cover costs associated with pregnancy, but will give you protection for a complication with pregnancy. If you take time to discuss with us we will suggest plans in your area that can offer enhanced coverage for pregnancy. We have a few products that will cover pregnancy and some that will offer the prenegotiated rates for the insurance company and a maternity deductible. This approach will have some cost savings for the client.

I am Pregnant Now with Individual Health Insurance that does not cover maternity

If you are prepared and do have health insurance in place and do find out that you are expecting, then we have some suggestions to help reduce your out of pocket expense. We typically recommend in the first trimester to prepay/negotiate the costs with the doctor and hospital. We have seen prepaying can offer substantial savings. When you are pregnant, you cannot change health insurance companies as you not have an un-insurable condition. This mean you and your spouse will be denied when applying for health insurance due to the fact that you expecting a baby. Maybe President Obama will fix this problem with the health insurance changes. You will need to keep you existing policy to cover you for any complications with the pregnancy.

If you are in this situation where you do not have maternity coverage, you could be looking at a medical bill $8,000 to $17,000 depending on geographic location. This can be negotiated some and prepaying helps as well. I usually recommend a guarantee issue product along with your current health insurance plan that is an indemnity plan that will pay a set dollar amount for an event. This plan I have been recommending has no preexisting condition waiting period, so you can add this plan when you will need it. The highest end plan has a couple of benefits that will help offset some of your expenses. It will pay a $1,000 on hospital admission, and $1,000 a day for hospital confinement benefit. If you stayed in the hospital for 3 days, they would pay you $4,000 benefit. This would help pay a good portion of the costs. You can view the benefits of this plan from Homeland HealthCare. Call us with any questions.

I am Pregnant with No Health Insurance

I talk to customer in this situation every day. They just found out they are pregnant and do not have any health coverage and they are looking for help. I listen to their situation and try to offer suggestions to them. If they are in a place in life where they are not earning much money, they could be eligible for Medicaid to help them with their pregnancy. This may be a good option for some to get the coverage they need and make this very affordable for them, and let them focus on have a healthy baby.

For others, they are earning too much and they are trying to decide how to handle this from a financial perspective. I would still recommend the guarantee issue product for them to help offset the costs. The plan does have some benefit for doctors visits, 5 per year and they will pay $75 for each visit and the above mentioned benefits. This may provide some relief to those that have been surprised by pregnancy. This plan will even pay some benefit for newborns in the first 30 days. You can see the benefits of the Homeland HealthCare Product. Call us with any questions.

Final Thought

Your Pregnant and need advice, talk with us or your insurance agent about your options. This should provide you some advice to help you relax and focus on being healthy. Sometimes your insurance agent does not have the answer you want to hear, but they should be a trusted source for you to help you navigate health insurance options through your pregnancy.We are here to help you.

Avoid being Denied for Individual Health Insurance

Posted October 19th, 2009 in Views by rayfreer

You can avoid being denied for individual health insurance by working closely with you health insurance agent. They will be able to direct you to the best carrier and options based on you medical conditions. The agent will be able to do an underwriting pre-screen with the insurance company before you apply to avoid the denial letter from the insurance company. Should you find that you have applied and have gotten a denial letter, talk with your insurance agent on your options.

Your medical history plays the role in determining your insurability. All insurance companies today have a list of deniable conditions that automatically will result in a decline of coverage from them. You can as well be declined for a combination of conditions that can make you fall into the same category of declinable by the insurance company. Deniable conditions for example are build (height/weight), diabetes, cancer, heart attacks, heart issues, bi-polar, and sleep apnea just to name a few.

This is a common issue of people that have some medical history or a few medical issues concurrently find out individual health insurance is different than group plans. While the individual was on a group plan they never would know that their previous diagnosis could be problematic for them in the future. You can avoid this issue of being denied coverage by working close with your personal health insurance agent. The difference between the Group Plan and Individual Plan is that the Group Plan needs to accept all the employees even with medical conditions, the individual plan does not. This is one thing that President Obama is trying to address.

Why do people move from group to individual coverage? This change occurs when changing jobs, or losing ones job for example. Some employers do not offer group health insurance and would require the individual to obtain their own health coverage. Before you apply, consult with you agent and you can have them do a underwriting prescreen for you. It is always best to approach it this way to prevent the insurance company issuing a denial.

What Can You Do if You have Been Denied Coverage?

I would recommend you talk to your health insurance agent if you have not already talked with them. They will be able to listen to your particular situation and recommend the best options for you. The best option would be to obtain coverage from your State High Risk Pool. If that is not an option for you there are limited benefit plans available, but beware these are not health insurance. Careful consideration should be taken before you purchase a limited benefit plan and ensure you understand what you are purchasing.

In Texas, we have the Texas Health Insurance Risk Pool (TRP) if you are not living in Texas check to see if your state has a Health Insurance Risk Pool available that will offer coverage to anyone who has been denied coverage by an individual insurance company. This is major medical coverage that can be obtained by individuals once they have exhausted all COBRA benefits offered. This is required before you apply for your Texas Risk Pool coverage. The Texas Risk Pool premiums are determined by your age, location (zip code), and tobacco use. These are current Texas Health Insurance Risk Pool Rates.

Limited Benefit plans offer an indemnity plan (set amount per situation) to help you with medical expenses, and they are NOT HEALTH INSURANCE protection. The major medical plan provides protection to a lifetime Max of $2,000,000, the limited benefit plan is limited coverage. This option may be a good solution if you were not able to afford the Risk Pool costs and you are looking at going without any protection. Please be sure you understand what you are buying and what limitations the policy has. There may be a pre-existing condition waiting period for 12 month. Be sure that you look carefully. We have found a guarantee issue plan that has no preexisting conditions clause. This allows for this guaranteed issue product to offer coverage to everyone without a waiting period to get things covered. If you are interested in this product you can check out the Homeland Health Care link and the AWA NPX 1-4 products. Before you purchase please consult with us or your agent to ensure this is the best option for you.

Bottom Line

Your personal health insurance agent will offer you the best solutions for your particular situation. Do not go it alone without your agent’s advice and guidance to help you through this stressful time of having to find individual health insurance for you and your family. The strength you will get with working with an experienced insurance agent has the knowledge to help you navigate through the health insurance system. They will provide a level of personalized service you cannot get through purchasing through a web site link. They will know your situation when you call and you will be able to talk to the same person anytime you have a question or need help.

Looking for ways to save money? Have you checked what you are paying for your Health Insurance?

Posted October 7th, 2009 in Views by rayfreer

I have many customers that review their homeowners insurance and auto insurance every 6-months and change carriers to save $50. One of the areas people seem to overlook or hesitate to review or change is their health insurance coverage. This could be because there is a underwriting process that reviews the medical history of the individuals requesting coverage. People who have been with their current health insurance company for a few years have the largest chance for savings. Before you make any changes to your health insurance plan make sure you work with your agent/broker to have them help you review your current coverage and situation.

There are some people who may need to stay with their current health insurance is they are currently being treated or have had illnesses that would prevent them from changing insurance companies. These conditions would cause the client to be considered un-insurable, such as heart attack and cancer for example. If this was the case and you have seen rate increases on the entire family, you may be able to move some of the family members to a new policy to help save money. Working with your agent/broker they will be able to advise you on the best approach.

To have your agent review your health insurance policy does require you to share some personal information on your medical history. It is important to disclose accurately to allow the agent to properly advise you and even do some pre-screening with the health insurance companies to help provide an accurate health insurance quote to you. The agent may suggest some options that may reduce your monthly premiums.

Customer and agent relationship is important interaction to ensure you understand the plans benefits. The agent is there to help you through the process and works closely and personally with you to ensure the plans meet your expectations and budget. An agent should begin to build your trust as he deals with you personally. An agent will be accessible and will know your particular situation when you call. The agent values your business and will be there to help you whenever you need it.

I would suggest you review your current health insurance coverage once a year to ensure your rates are still competitive. The agent can help prepare the detailed quotes for you and review/compare the plans to your current coverage. We will suggest ways to save on your health insurance by changing the deductible and adding some supplemental coverages.

RF Insurance Masters can help you perform the review of your current coverage. The process is simple, just submit the Free Quote form. An agent will work with you on a personalized quote that will help you evaluate how much you can save on your monthly premium. Contact us today to see how much you can be saving.

Can you afford to be without Health Insurance?

Posted September 26th, 2009 in Views by rayfreer

Sometimes customers will decide to not get any health insurance. They take a look at the monthly premium and think that it is too expensive and they will be just throwing those premium dollars away.

I had a neighbor who decided not to purchase health insurance to save money. I was surprised at this thought, but was not able to change his mind. A few months later, he called me one morning and asked for help to take his children to school. When I arrived at his house he was getting put in an ambulance because he was having a heart attack. He ended up getting a stent put in, and his bills were in the $50,000 range for this issue.

The thought of not paying premium for health insurance is great if you do not have any medical emergencies, you will save money, the bad think is that you cannot predict when something will happen, like a heart attack, cancer, or an accidental injury. Not having coverage of any kind can cost you 100 times more than the premium you might have paid. For example a heat attack can cost you about $180,000 to $200,000 in medical bills and lead you into a debt that could have been reduced with medical insurance.

If you look at medical insurance as a limit to your costs in the event of an accident or illness. RF Insurance Masters always recommend you purchase the higher deductible plans to save you money on your monthly premiums and it will limit you medical liability to $5,000 – $20,000 depending on your deductible plus your coinsurance out of pocket.

I understand those numbers may seem high, but without it those number are much greater. RF Insurance Masters usually recommend supplemental policies to help cover your out of pocket in the event of an accidental injury or critical illness. These policies can be selected to match your deductible, $2,500, $5,000 or $10,000 of coverage. The supplemental accident will have a deductible per accident of $100-$250 and cover up to the face value of the policy. The critical illness plan will pay face value in the event of being diagnosed with a critical illness, such as a heart attack, cancer, stroke for example. The cost for the high deductible health insurance policy with the two supplemental policies are usually less total monthly premium than a lower deductible health plan alone.

If my neighbor had the 3 policies, for example a Health Insurance Policy with a $10,000 deductible, a 80%/20% coinsurance after deductible and an coinsurance out of pocket max of $3,000. And he had bought the supplemental policies such as an accident with a $10,000 coverage with a $100 deductible per accident with a $10,000 critical illness policy. For the same heart attack with the stent surgery, he would have had to pay a total of $3,000. This liability would be $47,000 less expensive for him.

We have found with the 3 policies, high deductible health insurance, supplemental accident and the critical illness policy you are very well covered. Though it does leave a gap in the event of other medical problems where you can be exposed to paying some money for an illness – i.e. kidney stones, gall badder, etc. However, you are far more protected than not having any health coverage at all.

If you need some help finding the best options for you to help you save if you have health insurance or if you have been living without health insurance give us a call or fill out the Free Quote form and we will work with you to build a plan that can meet your needs and budget. We are here to help and want to work with you.

How does HIPAA Laws Affect You?

Posted August 4th, 2009 in Views by rayfreer

Are you aware of the medical privacy laws? The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule, the Privacy Rule, a Federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information. These laws definitely protect your privacy, but they can as well keep your family from getting medical information on you in the event of an emergency. Even a spouse or eighteen year old child, without proper paperwork in place can leave you in the dark as far as their medical condition. Consider getting the appropriate paperwork in place before you your family have a condition that can cause you stress during medical emergencies. There are a few documents that can be executed that can allow your medical information to be shared with your loved ones.

1. HIPAA Disclosure Document – Specifies who can be disclosed your medical information.
2. Medical Power of Attorney – Specifies who can make medical decisions on your behalf
3. Living Will – Specifies your wishes regarding prolonging life medical treatments

You can contact Julia Nickerson Attorney at Law to help you with these documents and give you suggestions to help you plan for your family.

Testimonials

Ray Freer has been our insurance representative for two years. Right from the very beginning we felt comfortable with Ray handling our insurance needs. He talked with us and got to know us. My husband and I are small business owners so cost is a concern to us. Ray gave us several options and explained the policies thoroughly. He helped us during the application process always going the extra mile.

We would say that customer service is Ray's number one goal. He always answers and returns phone calls and e-mails. He is always prompt and follows through when he tells you he is going to send information. Ray has considerable knowledge about the policies he represents. We chose a health insurance policy with a larger deductible and keeping our interests in mind, Ray reviewed an accident policy with us. I am so glad he had taken the time to get to know us and suggested this policy. I had an accident three weeks ago and this policy is going to save us about $7,500.

When you become Ray's customer, it isn't the end of your relationship, it is the beginning.
Dave and Theresa Rupp
River Oaks Custom Homes, Inc.