February 21st, 2010 -- Posted in Health Insurance Companies |
Most people know the value of a good health insurance. The issue is not whether or not you should have such a insurance but rather which company should I choose that will give me the best deal? This question is hard to answer because it depends to a high degree on your preferences, values as well as you wallet. The worst scenario though might be if you one day should be in a real need of medical treatment and you find that you can’t afford it. Although we don’t talk about emergency treatment, many chronic diseases can cause more damage or even death if it’s not treated properly.
Health insurance companies are available in plenty in the country. It is a very difficult to choose a particular company for your requirements. You have to be an experienced person to locate that easily. Otherwise you have to do a lot of research on different companies before choosing one. Most of us do not know that every state has an insurance department. They would be able to guide you to the right insurance company. For getting more information from them you may visit the state department’s website. One other way is to ask others who have taken policies with the insurance companies.
The same applies to the health insurance in Scandinavia also. You can check the ratings given by J.D. Power and Associates for the insurance company. They collect data from the policy holders and accordingly rate the insurance companies. They consider a lot of factors like pricing, service provided by the representatives, claims handling etc., before they give a rating. Hence you can depend on them.
The other factor that you should consider is the financial strength of the insurer. This is very important since they should be able to settle the claims. Insurance rating companies like A.M. Best and Standard & Poor’s rate all the insurance companies and give a rating in their scale. For rating standards you can visit their website. These ratings earned by an insurance company play an important role in getting new policy holders. You can check these ratings before you take a health insurance policy from that company. If these tasks are tough for you, it is better to work with an agent who has more knowledge on insurance than you. You can approach an independent agent. These people do not work for a single company. So they won’t force you on a particular policy. They can guide you properly on selecting a health insurance policy that fits your need.
January 29th, 2010 -- Posted in Health Insurance Companies |
Health insurance is at the center of one of the most enduring and prominent social controversies in recent history. With costs rising year after year at an unprecedented rate, and the roster of uninsured continuing to grow as well, the health insurance quandary is at the forefront of the social and political dialog.
For those who are attempting to understand the nature of this controversy it is hard to know where to even begin to look. The health insurance debate spans so many aspects of society; from providers to customers, from hospitals to malpractice attorneys, and from the function of private markets to the role of government in healthcare. However, if one seeks to educate themselves on the many facets of the issue, then understanding health insurance companies is a logical starting point.
It has been over three-hundred years since the concept of health insurance had its genesis. The original health insurance business model was one where the focus was solely on disability. Only injuries that could leave the patient disabled were covered; everything else was paid for by the patient. Amazingly that basic arrangement remained in effect for the next two-hundred years. It wasn’t until the 20th century that the disability model of insurance was replaced with the more familiar, contemporary health insurance; hence, the modern health insurance companies were born.
The essential philosophy on which health insurance companies operate is that they enter into a contractual relationship with their customers. The customers pay insurance premiums, and in return the health insurance companies cover the costs of predetermined medical conditions such as most routine, preventive, and emergency medical conditions. In many cases some or all of the cost of prescription drugs is covered as well.
The obvious reason for people to purchase insurance is that despite the high costs of insurance, the high cost of medical care can be much greater if they are unfortunate enough to become sick or injured. And that scenario does hold true in reality, and health insurance companies frequently pay more in coverage than they collect in premiums for some individuals. To understand how they can do that and still remain profitable then you must understand the basic assumptions under which health insurance companies operate.
The first thing health insurance companies do when reviewing an application for coverage is review the individual’s medical history. The company knows that high risk individuals are likely to incur large medical expenses, and those individuals are generally rejected or offered coverage at an increased premium rate.
Of those who have medical histories that fall within normal parameters, they are offered coverage and become customers. The health insurance companies know that, with the help of some statistical calculation, they can determine the percentage of their insured clients who will become ill during the year, and they charge a sufficient premium that will not only cover those costs but allow for profitable operations as well.
Another way that health insurance companies control expenses and maintain profits is to make the customers pay for a portion of their service at the time it is rendered. That payment is in the form of a co–payment, which is the out-of-pocket expense for which the customer is responsible.
The purpose of the co-payment is multifunctional. Not only does it directly offset some of the expenses, it prevents people from abusing their coverage by seeking unnecessary treatment. If out-of-pocket expenses were very low, or non existent, people would be likely to go to the doctor or pharmacy for the slightest issue or problem; issues that in many cases do not require medical attention.
At the same time, health insurance companies know that if co-payment expenses are too high, people will put off seeking attention, and that could ultimately lead to even more serious problems for the customer and more expenses for the health insurance companies.
Ultimately, health insurance companies seek a balance in all things they do. They seek to find the right balance of price in co-payments and premiums, and they seek the ideal balance of patients who will require predictable needs and consistent premium payments.
They use enticements like exercise or smoking cessation incentives that may cost them a little now, but could save them much in the long run. It is a business model that has evolved over the centuries and continues to evolve to this day, but the basic principles on which health insurance companies operate remain relatively constant.
January 2nd, 2010 -- Posted in Health Insurance Companies |
The growing number of consumers taking up health insurance plans has led to the mushrooming of scam health insurance providers. These providers often target new retirees and the elderly individuals and small-business owners, who can’t negotiate better rates with legitimate insurers. Be very cautious before you invest in any health policy. Read on to get an idea about 3 ways in which your health insurance company can scam you.
1. Failure to pay claims
Usually fraud health insurance agents sign up a huge number of people quickly by offering them lucrative deals. These insurance providers keep paying small premium amounts and medical claims, but if there is a substantial claim amount or regulators catch them, these illegal companies vanish as if they never existed.
So, just beware if you are getting delayed payments or your service provider is offering fake excuses for the failure to make the payments. If you have signed up for these illegal plans, you may be liable for the medical bills of your employees as well.
2. Non-licensed health plans
If the company from which you have bought your health care policy is not licensed by State Insurance Commissioner, you can be in trouble. If all the protections of insurance regulation do not apply on your service provider, then the company may be phony. In this case your service provider is scamming you by selling non-licensed health plans.
Insurance agents are not allowed to sell any legitimate ERISA or union plan as federal law governs them. So, if your insurance agent tries to dupe you by selling an “ERISA” or “union” plan, report them to your state insurance department.
3. Unusual coverage offered at lower rates
If you are offered an unusual coverage irrespective of your health condition and that too at lower rate and much more benefits in comparison to other insurers, its time for you too hit the panic button. Do not get fooled by the lucrative offer, else you can be taken for a ride. The ‘scamsters’ aim to collect huge amounts as early as possible so, they try to sell maximum number of policies at attractive prices.