Individual Health Insurance

Health Plans Help Promote Healthy Lifestyle Choices

A big part of the Health Reform discussion has been the rising costs of medical care. In fact, rising medical costs are often the number one strain on families, employers and taxpayers. That’s why health insurance plans are important because they provide protection against catastrophic medical expenses, and incorporate cost-containment strategies while handling negotiations with health care providers to really stretch your health care dollars. So if you can budget to cover yourself and your family, if you have one, your health plan can do a lot for you.

 

In addition, many health plans offer prevention and wellness initiatives to help keep you healthy in the first place. For example, fending off heart disease and type 2 diabetes, starts with losing weight.  So health insurance plans encourage fitness and preventive screenings. Celtic health plans offer the Healthy Lifestyle Program, which will cover fitness club memberships, smoking cessation and weight loss programs at 25% up to $300 annually for everyone insured. This goes for dependents too. Kids who play organized sports, take gymnastics lessons or do karate can take part in the cash-back incentive as well, helping ensure an early fight against childhood obesity.

 

These programs help the young and the getting older stay healthy, and ultimately a healthier nation is the best strategy for making health care more affordable for everyone. Take a minute to learn more about Celtic’s Healthy Lifestyle Program.

Individual Health Coverage for the Here and Now

In her last post, Melissa urged individual health consumers not to wait until health care reform is completed before getting coverage. I'd like to build on this by sharing some hard numbers from a survey sponsored by eHealth, Inc., which measured consumer expectations following the passage of legislation.

eHealth's Health Reform Survey found that 39% of the uninsured respondents would wait for health reform legislation to be fully implemented before researching and buying health insurance, and 44% believe there is "no risk" in going without health insurance coverage until government programs become available.

Additionally, a substantial number of the uninsured respondents expect the following reforms to be fully implemented in 2010:

• 62% expect to have access to private insurance regardless of any pre-existing medical conditions
• 56% believe the government health insurance exchanges will be up and running
• 56% expect to receive subsidies to help cover the cost of health insurance

It's critical for consumers to understand that the timeline for implementation of the various health reform provisions span through 2014, and some reforms are slated for 2015 and beyond. Delaying the important task of buying health insurance puts uninsureds at tremendous risk - to their physical and financial health.

 

That's why there remains a need for individual health insurance. People need coverage to protect their physical health and financial stability, and waiting until health care reform is completed is not the answer. While health care reform in imminent, there's a need in the here and now for coverage.

Health Insurance for Unemployed Individuals – Part II

With the door for COBRA subsidies closing for employees losing their jobs after May 30th, finding an affordable health insurance plan is very important. COBRA, without any subsidy, remains too expensive for many individuals and families. And complete health reform implementation - which provides plans on a guarantee issue basis for adults - isn't scheduled to begin until 2014. 

 

It's really important to understand that there are many, many provisions in the health reform legislation. People cannot wait until government programs become available to have their health insurance needs met. The timeline for implementation of the various health reform provisions span through 2014, with some even slated for 2015 and beyond, -- so you're putting yourself at risk by waiting.

 

You need coverage to protect your physical health and financial stability, and waiting until health reform is complete is not the answer. There are affordable plans available. Talk with an agent - you can find one on our site. Or, look through the plans we have and run a quote. Consider a high deductible or 70/30 coinsurance as ways to have a low monthly payment. Have health coverage - yes, it's important to us, but more importantly, it's important for you.     

 

Finding the Right Individual Health Insurance Plan, Part 3: More Questions to Ask

You've purchased an individual health insurance plan with the right combination of benefits that works you're your budget. When it comes down to using your plan and managing your health care dollars, becoming more engaged in medical decisions and asking questions helps ensure you're maximizing your budget.

Since you'll be paying for many of the medical services covered by your plan until you reach your deductible, you'll probably want to make sure your treatments are cost-effective. If you have a PPO plan, you'll automatically receive negotiated discounts by using network providers and hospitals. But that doesn't mean you shouldn't ask questions about how your health care affects your out-of-pocket costs, such as:

"Is this doctor in my PPO network?"
"Can this procedure be done on an outpatient basis?"
"Is this really an emergency?"
"Is there a generic available in place of this brand-name drug?"
"How much does this treatment cost?"

You may find the answers to these types of questions result in your finding more affordable alternatives. They might even open up additional dialogue with your health care providers in which you'll learn more about how services are priced, how payments can be negotiated, and how you can budget for various future health care costs.

Asking questions and getting more involved in your health care decisions will impact more than the bottom line. You'll also gain a better understanding of your body, medical conditions, treatments and options. This will naturally improve the quality of your care - and that gives you peace of mind that doesn't have a price tag.

For more information on being an empowered patient, visit the U.S. Department of Health and Human Service's Agency for Healthcare Research and Quality website.

 

 

Graduating and Need Health Insurance?

We're quickly approaching graduation season. It's a time of transition usually marked by a change in residence, a change in employment, and a change in health insurance plans. You or someone you know might be losing dependent status on a parents' group health plan. Or, you may be starting your first job in the "real world" and have a waiting period before group coverage begins.

This is a great time to consider individual health insurance.

The type of individual health plan that most easily fits the needs of young adults is a basic benefit plan. It's budget-friendly and provides the essential major medical benefits many young adults are looking for. Plus, web-savvy twenty-somethings like how fast and easy it is to apply for coverage online!

Basic benefit plans are designed to be affordable while covering the "basics" - hospitalization, Rx drugs, PPO office visits, and preventive care. To keep monthly premiums low, these plans have higher annual deductibles as well as additional deductibles for certain medical services like emergency room, inpatient and outpatient hospital visits. Many young consumers appreciate their low monthly premiums and are willing to pay more out-of-pocket when the need for medical services arises.

Make sure your health insurance needs are met while you're in school, during your first few months after graduation, or if your first job doesn't offer health insurance coverage. Individual health insurance is a great way to protect your health and budget while you're taking your first steps in the "real world."

Health Insurance for Unemployed Individuals - Part 2

 

Based on an April 2, 2010 Bureau of Labor Statistics' press release the total number of unemployed remains little changed, at 15 million workers.  And 6.5 million workers have been unemployed for 27 weeks or longer.  So it's understandable that even though it may seem like a long time, you may still be without work.

And while your priority is finding a job, having health insurance remains an important factor in your future planning. COBRA coverage with its extended benefits might be the option you've taken. These benefits may be running out for you or possibly were too expensive for you to even consider in the first place.

In my last post "Health Insurance for Unemployed Individuals," we talked about temporary coverage with short-term plans. You may be at the point that a low-cost permanent plan suits your needs better.  A major medical health plan stills allows you to pay monthly and protects you from financial ruin should you have a costly unforeseen illness or injury.

Monthly premiums are kept low on basic benefit individual health plans today, by providing high deductibles, covering important benefits while making less used benefits as options on the plan, and offering preventive care visits to help keep you healthy. So it's okay to start with the monthly rate you think you can pay for health insurance and then run some quotes for major medical plans -- I think you'll find a good fit, pretty easily.  

Finding the Right Individual Health Insurance Plan, Part 2: Assessing Your Budget Needs

In my last post I gave some tips for determining what benefits you need in an individual health plan. By now you probably have an idea whether you need a plan with basic benefits, a plan with a wider range of benefits and options, or a HSA-compatible plan. Now it's time to take a look at your health care budget so you can get this coverage most affordably.

Monthly premiums are the first cost to consider. Basic benefit and HSA-qualified plans are designed to have low monthly premiums, and more comprehensive plans with richer benefits are generally going to cost more. It's a good idea to see how different coinsurance and deductible choices affect a plan's monthly cost - you can choose a higher annual deductible to reduce your monthly premium.

Next, consider your other out-of-pocket expenses. Choosing a plan with cost sharing elements may bring down your premium. (Examples of cost-sharing include doctor's office visit copays, Rx drug copays, annual deductibles, coinsurance, out-of-network or emergency room deductibles, etc.) Many people who need basic coverage appreciate their low monthly premiums and are willing to cost-share when they utilize their health plan. On the other hand, some would rather pay higher premiums for a plan that offers more first-dollar coverage.

This is why it's important to check your plan for first-dollar benefits - these are medical services your insurance policy will pay for without first requiring you to pay out-of-pocket towards your deductible and/or coinsurance. For example, your plan may pay up to a certain dollar amount for preventive care services before you participate in any cost-sharing. Or you may have a Rx drug copay with no deductible to meet.

Finding the plan with the right benefits and price takes some research and numbers-crunching, but it's a worthwhile effort to find the plan that fits best. To learn more about individual health insurance costs, see Mary K's post "Individual Health Insurance Basics Part 2" our read Celtic's Individual Health Insurance Guide Choosing the Right Individual Health Plan.

Is Being Uninsured Worth the Risk?

A friend of mine, "Mike," is about to change jobs. He has a waiting period of three months before coverage under his new employer's plan begins. That means he has a three-month period in which he'll either pay to extend his benefits under COBRA, buy individual health coverage, or go uninsured.

At first, Mike was inclined to go uninsured, save the money, and "hope and pray" no big medical expenses arise. He doesn't plan on going to the doctor during his hiatus from coverage, and his wife is covered through her job and they have no other dependents to worry about.

He knows I work in the health insurance industry so he asked me for my opinion: "Do I really need insurance before my new group coverage begins? Can't I pay out-of-pocket for any medical expenses that come up?"

"Not so fast!" I warned. Being uninsured can cost a lot more than paying health insurance premiums. Mike may be able to pay for a doctor's visit or prescription out of his savings, but what if he's in a serious accident or develops a serious illness? Without major medical coverage he'd be responsible for paying all of these unexpected - and costly - medical bills on his own.

Mike decided it's not worth the risk. He doesn't want to become a cautionary tale. He's purchasing a short-term individual health plan to fill the gap. It's less expensive than COBRA, and far less expensive than taking on the risk of huge, unexpected medial bills he's not planning for.

If you, like Mike, find yourself between jobs, ask yourself if being uninsured before your new group plan takes effect is a risk you're willing to take. Individual health coverage can provide peace of mind during this time.

Visit Celtic's Individual Health Insurance Learning Resources page to learn more about how individual health insurance can meet your coverage needs.

Health Insurance for Unemployed Individuals

If you're unemployed, health insurance becomes an important matter. If you had a group plan at your old job, you may first consider COBRA coverage, which guarantees health benefits for people who've lost their jobs.

But COBRA rates are expensive because you are now responsible for paying the full amount for your healthcare coverage. Whereas when you were employed, your employer paid a significant portion of the cost of your group plan and you paid a much smaller amount.

So if COBRA is too expensive, there are alternatives. Over the next few blogs we'll take a look at some different individual health plan solutions.

Short-Term insurance is a great product to consider first. It's inexpensive and helps fill a temporary need. You can pay on a month to month basis for your coverage and often qualifying for coverage is a little easier. Since unlike COBRA, with individual health plans you have to qualify/be underwritten to be accepted for a plan.

Short-Term plans often have several different deductibles to choose from. If you take a higher deductible, it will really keep your monthly rate down, while keeping you protected from an unforeseen accident or illness. For healthy people on a tight budget, Short-Term health insurance is ideal. 

You can get coverage starting tomorrow, by learning more today.

Finding the Right Individual Health Plan, Part 1: Assessing Your Benefit Needs

If you're considering individual health insurance coverage, you have to do some comparison shopping to find a plan with the right benefits and price to fit your needs. You'll find there are many plans available to choose from: lower-cost basic benefit plans, more comprehensive benefit-rich plans, HSA-compatible plans and short-term temporary plans. How do you know what's right for you?

This is the first of three blog posts focusing on helping you assess your needs so you can make a sound decision. First, you'll want to answer the question "What health benefits will I use?" so you'll have an idea of how much coverage you need in a plan.

It helps to break the question down into smaller parts:

• Do I need to utilize PPO network doctors and hospitals?
• How often do I or other covered individuals visit a primary doctor? Specialists?
• Do I need coverage for prescription drugs?
• Do I want supplemental accident coverage?
• Do I want other optional benefits?
• Do I need coverage primarily for the "big ticket items" like accidents and illnesses?

Compare your plan alternatives side-by-side to see which plans offer the level of coverage you're looking for. You'll see that some plans offer very basic coverage while others provide a wider range of benefits and more flexibility with plan choices and benefit options. You may like the benefits on one plan more than another's, but you may find its price to be outside of your comfort zone. That's why the next step is to think about how each benefit affects the plans' cost.

In my next post, I'll give some tips to help you find a plan with the right coverage and price. There are some tricks to getting the benefits you need while staying within your budget. Prepare yourself to answer this question:

"How much can I afford to spend?"

In the meantime, visit Celtic's Consumer Learning Center to learn more.