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.

Don't Buy Health Insurance Until You Read This

Keep Regular Dental Visits

It has been said that the best health insurance is moderation. 

However, even though you may be conscientious enough to get a regular physical examination, you may unexpectedly experience symptoms that may require you to get an urgent examination to find out what’s going on and to get treatment.

If hospitalization is necessary, then you have to get admitted. To meet these expenses without insurance can wreck havoc on your bank account.

According to the National Association of Health Underwriters, only 5 percent of Americans get their health coverage from an individual health insurance policy. Individual health insurance is a type of health care coverage that is provided to individuals rather than to employers or organizations. It can be sold to an individual or to a family.

There are 4 major advantages to choosing an individual health insurance plan rather than employer-based coverage:

1. You can customize your coverage, where employer-based coverage may provide limited options.
2. You have the freedom to pursue better rates with other companies.
3. Depending on your circumstances, it may be more affordable than employer-based health insurance, particularly if you're paying for coverage via COBRA.
4. It's not dependent on an employer. Individual health insurance plans protect you no matter where you work.

Maintaining health insurance coverage doesn't have to cost a fortune and neither does dental insurance. Here are a few ways to help keep your health insurance premiums low:

1. Costs can vary widely depending on the insurer, sometimes by as much as 50 percent for similar plans. Make sure you shop around.
2. The higher your deductible, the lower your monthly premium. You'll be responsible for more out-of-pocket costs should you need to file a claim, but the money you save on your premium may be well worth the risk.
3. Keeping yourself healthy can save you money on health insurance costs. Excess weight or tobacco and alcohol usage will drive up your premium.
4. If a member of your family isn't in perfect health or is of advanced age, it may be more affordable to purchase separate health insurance plans.

Protect yourself and your family with the health insurance coverage you deserve.

Any comments? Leave them below. For a free consultation, call (773) 614-3201 or e-mail me a bwillbar@gmail.com.  

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.  

How to Choose the Best Medicare Supplement Plan for 2018

The Medicare Supplement Plans, sometimes called Medigap Plans, were required in August 1, 1992 to become standardized. 

That means that all companies that sell these Plans have to sell the exact same type of Plan.

Original Medicare has significant deductibles and coinsurance features that you as a Medicare recipient are required to cover.

What Med Supp was Designed For 
If you don’t have adequate personal finances to do so and you experience a serious illness and have to be hospitalized, you may find yourself in bankruptcy. The Medicare Supplement Plans were designed to address this type of situation.

After the recent revision in 2010 of the Medicare Supplement Plans, the new Plans are identified by these numbers – – Plan A, B, C, D, F, G, K, L, M, and N.

Take these factors into consideration when you make your choices. The most popular Medicare Supplement Plans for 2018 are Plan F, N, and G.

Plan F Medicare Supplement Plan
The best Medicare Supplement Plan is Plan F. This Plan pays 100% of the gaps in coverage left by Medicare and covers you quite well. With this Plan, and there are no co-pays, no deductibles, and no coinsurance. You also have the ability to go any doctor or hospital in the U.S. that accepts Medicare.

Plan G Medicare Supplement Plan
The second best Medicare supplement plan is Plan G. Plan G offers all the same coverage as Plan F, although plan G has an annual deductible, it often costs about $300 less per year in premium, so the savings can be worth it if you don’t mind paying the deductible each year at your first doctor visits.

Plan N Medicare Supplement Plan
The third popular plan for 2018 is Medicare Supplement Plan N. This Plan is similar to Plan G in that it also has a deductible. But it also requires a co-pay for office visits and a co-pay for ER visits. However, the ER co-pay can be waived if you are admitted to a hospital.

Plan G - The Best Medicare Supplement Plan
I think that the best Medicare Supplement plan overall for 2018 is the Plan G. Plan G offers you the best value for your money. After the annual deductible Plan G gives you the convenience of no co-pays and no other out-of-pocket costs, as well as ability to choose your own doctors and hospitals.

Moreover, in that this is not the most expensive plan, it will allow you to save as much money as possible while still maintaining good health care coverage. Now the next steps in securing your family's financial independence.

If you would like to learn more about the Plans and prices available in the Chicagoland area, call me at (773) 614-3201. Looking forward to hearing from you.

Medicare Fundamentals: Part A and Part B

Over 47 million seniors age 65 and older, and people with certain disabilities and medical conditions, get their health care coverage through Medicare. While Medicare covers many health care services, it does not cover everything. Below is what you should know.

If you have Original, Fee-for-Service Medicare, the following applies to you:

Medicare Part A ("Hospital Insurance") does over: 

Inpatient care in a skilled nursing facility for a limited number of days, following a qualifying three-day minimum inpatient hospital stay for a related illness or injury

Home health services as ordered by a doctor (or other health care provider), including nursing care; physical, speech or occupational therapy; medical social services; home health aide services and medical supplies for use at home

Hospice care if you have a terminal illness with a life expectancy of 6 months or less, as certified by doctor, at home or facility where you reside. Limited coverage for stays in a hospice facility, hospital or skilled nursing facility for pain or symptom management

Services Medicare Part A does not cover include:

Custodial care or long-term care in a skilled nursing facility or nursing home. Custodial care includes non-skilled personal care, such as help with  bathing, dressing, eating, getting in and out of a bed or chair, or toileting.

Medicare does not pay for room and board costs or non-skilled personal(custodial) care in a nursing home, or long-term care or assisted living facility. It does cover Medicare-approved medical care and services, ordered and rendered by a Medicare-enrolled health care provider, such as a doctor or physical therapist, to the beneficiary who is a resident.                                                                            

    Services Medicare Part B ("Medical Insurance") does cover:         

• Doctors' visits, services and tests; outpatient care and services; some home health   services       not covered under Part A; Medicare-cove red durable medical equipment (DME), prosthetics, orthotics and supplies
• Medicare-covered services provided by non-physician health care providers, such as nurse practitioners, physician assistants, social workers, psychologists, physical therapists, and other
• Many preventive services and test
• Outpatient mental health care
• Kidney dialysis services and supplies
• Ambulance transport for medically-necessary services (limited)
• Chiropractic services (limited)
• Eyeglasses (limited to after-cataract surgery that implants an intraocular lens)
• Some prescription drugs (i.e. injections in doctor's office, certain oral cancer drugs
• Transplants and immunosuppressive drugs

Things that are not covered by Medicare, under either Parts A or B, include: routine dental care, dentures, hearing aids and exams for fitting hearing aids, cosmetic surgery and acupuncture.

For those who get coverage through a Medicare Advantage Plan (Medicare Part C), the story is a bit different. Medicare Advantage Plans are offered by Medicare-approved private insurers, and must cover all the services covered under Original Medicare, except hospice care, which continues to be covered by Original Fee-for­-Service Medicare even when a person is enrolled in a Medicare Advantage Plan.

These plans, which may charge a premium, deductible and co-insurance, may include extra benefits and services not covered under Original Fee-for- Service Medicare, such as dental and vision care, glasses, hearing aids and health and/or wellness programs. Most plans also include prescription drug coverage, available to those in OriginalMedicare under Part D.

 E-mail your Medicare questions to me at Ask Will at wwillbar@gmail.com