7 Key Health Insurance Terms You Always Need to Know

Forget Obamacare. It is falling apart fast and in the process of being replaced by Congress and the President. 

Affordable health insurance is coming soon and knowing the meaning of key health insurance terms is essential whether you are comparing policies, or need to know what to ask an agent.

Below is a list of key health insurance terms to help you understand more about what your health insurance plan has to offer.

1. Deductible
The deductible refers to the amount of money that you need to pay before any benefits from the health insurance policy is paid. This is usually a yearly amount. Consequently, when the policy starts again, usually after a year, the deductible would be in effect again. Some services, like doctor visits, may be available without first meeting the deductible. Usually there are separate individual deductible amounts and total family deductible amounts.

2. Co-insurance
This is usually a percentage amount that is  your responsibility to pay. A common co-insurance split is 80/20. This means that the insurance company will pay 80% of the procedure and you are required to pay the other 20%.

3. Co-payments
Co-payment is a fixed amount that you are required to pay at the time of service. It is usually required for basic doctor visits and when buying prescription medications.

4. Out-of-Pocket
This is the cost you would pay out of your own pocket which can refer to how much the co-payment, coinsurance, or deductible is. Also, when the term annual out-of-pocket maximum is used, it is referring to how much the insured would have to pay of their pocket, excluding premiums, for the whole year.

5. Lifetime Maximum
This is the most amount of money the health insurance policy will pay for your entire life. Pay attention to individual lifetime maximums and family lifetime maximums as they can be different.

6. Exclusions
The exclusions are the procedures that the insurance policy will not cover. 

7. Pre-existing Conditions

This is something you had before obtaining the health insurance policy. Some plans will cover pre-existing conditions while others may completely exclude them. Then again, some health insurance plans will cover pre-existing conditions after a certain time period.

Any comments or questions? Leave them below.

Forgotten Health Care Coverage You Need to Include

When shopping for health insurance, disability insurance is often forgotten. You you need health insurance and it remains the most important coverage for you and your family. Anyone can become sick or hurt unexpectedly.

Whether you are employed or a small business owner, you can become sick or hurt, unable to generate an income, and find yourself financially devastated. Disability insurance is what's necessary.

Protection of Disability Insurance
Disability insurance is designed to protect you from such a dire situation. According to the Social Security Administration, 70% of the private sector work force has no long term disability insurance. Moreover, 3 on 10 workers entering the work force today will become disabled before retiring. Without a doubt, most people own life insurance to provide income for their loved ones in the event of a premature death. However, death due to the big three: hypertension, heart disease, and diabetes have dropped by 32%. Disabilities due to these conditions are up by 55%.

Features of  Disability Insurance
How then can disability insurance provide the type of protection you need. The benefits for this type of insurance will help cover monthly living expenses when you are sick or hurt and unable to work. If you are a small business owner, disability insurance will cover your monthly business overhead expenses until you return. This premium is tax-deductible for the small business owner.

Here are three important things to consider when pondering the purchase of disability insurance:

1. Age is a primary factor in determining the premium
2. Most disability policies are issued for clients between the ages of 18 and 60.
3. And, depending on your case, financial documents may be required.

Knowing this ahead of time will make the process move smoothly and satisfactorily.

Call (773) 614-3201 for a free consultation or leave your e-mail address to learn more about disability insurance or a medicare supplement plan. if you are receiving Medicare.  

5 Ways to Protect Your Family's Financial Independence

If you have a growing family, you probably realize that it has a way of outgrowing everything, especially their income and that there is a need for financial management.

While you are working towards achieving financial independence, think also about simultaneously implementing steps for protecting it. 

Having the right types of financial insurance and proper estate planning helps to relieve you of concerns associated with protecting your family's financial independence should a negative, unexpected event happens.

Consider these 5 financial management strategies for doing so:

1. Purchase long-term care insurance (LTCi) 

Long-term care Insurance is available to cover you if you acquire a chronic disease or disability and relieves your family of the burden of providing for your personal care. As I said in an previous post on long term care insurance, this type of policy covers the possibility of you not being able to perform at least two activities of daily living, without assistance, with the expectations that it will last at least 90 days. 

It includes a wide range of healthcare and social services such as day care, custodial care, home health care, hospice care, intermediate care, respite care, and skilled nursing care. LTCi does not cover hospital care.

2. Maintain appropriate levels of life, auto, home, and health insurance benefits.

Life insurance is one of the most important products you must consider obtaining in order to provide financial security for your loved ones. Auto accidents can cause financial and economic havoc to you and your family. Besides, in most states it's legally required. 

3. Homeowners insurance is especially a necessity for both homeowners and renters if you want to ensure that your possession are protected in case of a fire, theft, liability, or any other disaster. And, if you have ever been sick or injured, you know that it is important to have the right type of health insurance

4. Evaluate the need for an umbrella policy to help protect you from lawsuits. A serious personal liability lawsuit can reach catastrophic levels for the party defending the law suit as the judgment may potentially exceed the insurance policy liability limits. 

Once the liability limits are exhausted, the insured is often forced to pay a substantial amount out-of-pocket. Depending on your occupation and situation, you may require increased protection against catastrophic lawsuits.

5. Make sure your estate planning is up to date. The field of estate planning is a very complicated. It requires a focus on wills, taxes, law, and life insurance. 

Achieving and protecting your financial independence goes together. While it would be a shame for you to lose a substantial amount of of your money by gambling or taking a chance on risky stocks, it is equally a shame to have to pay out a substantial amount of money on a major hospital bill, for care in a nursing home, or through losing a court suit. After all you worked for it, why not keep it and pass it on.

I'll be delving into estate planning in a future post. 


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Know These Three Health Care Terms Before Obtaining Obamacare

Until Obamacare is repealed and replaced, you are stuck with it unless the new President is a Republican. 

If Hillary becomes President, Obamacare will continue and both the cost and the penalties will just get worse along with your choice of doctors and hospitals being seriously diminished. 

Nevertheless, here are the three health insurance terms you need to know before buying an Obamacare policy or just a regular health insurance policy.

Premium

The total amount paid to the insurance company for health insurance coverage. This is typically a monthly charge. Within the context of group health insurance coverage, the premium is paid in whole or in part by the employer on behalf of the employee or the employee's dependents. Unearned premium is the portion of a premium already received by the insurer under which protection has not yet been provided. The entire premium is not earned until the policy period expires, even though premiums are typically paid in advance.

Deductible

The amount of loss paid by the policyholder. A specific dollar amount that your health insurance company may require that you pay out-of-pocket each year before your health insurance plan begins to make payments for service or claims. Not all health insurance plans require a deductible. As a general rule (though there are many exceptions), HMO plans may or may not typically require a deductible, while most Indemnity and PPO plans do. In general, the bigger the deductible, the lower the premium charged for the same coverage.

Coinsurance

The amount that you are obliged to pay for covered medical services after you've satisfied any co-payment or deductible required by your health insurance plan. Coinsurance is typically expressed as a percentage of the charge or allowable charge for a service rendered by a healthcare provider. For example, if your insurance company covers 80% of the allowable charge for a specific service, you may be required to cover the remaining 20% as coinsurance. After paying 80 percent of losses up to a specified ceiling, the insurer starts paying 100 percent of losses.


Call (773) 641-3201 for answers to your health care questions or to get a quote. 

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