Tips for Buying Health Coverage

Submitted by Bruce Meckem, United Insurors

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When purchasing health coverage it is important to have a local agent that can provide customer service when you need it the most. You may want to consider an independent agency that works for you, not the insurance company. The following are things to consider when purchasing health coverage for you and your family.

•    Are you in between jobs or is your Cobra premium too high?
If you answered yes, then short-term major medical coverage may be the answer for you. You can purchase up to six months of coverage for a fraction of the cost of a permanent policy or what a Cobra Premium would cost you. Although, if you have a pre-existing condition that will require on going treatment short-term coverage will not fit your needs.

•    What to ask before purchasing Family or Individual Health Insurance
What amount of premium can you afford a month for health care?
What is the highest deductible you would be most comfortable with?
Do you want coverage for office visit services and prescriptions or just major medical?
Is your preferred medical provider participating on the provider network?
Do you need a child only policy for a child between the ages 6 months to 18?
Do you need other optional benefits such as life, accidental death, dental, vision or supplemental accident benefits?

Individual health insurance programs are designed for individuals and families who cannot obtain health insurance through an employer.

•    Things to be aware of when purchasing a policy:
Often the most overlooked and most important thing to understand is the exclusions and limitations of the policy. A few things that may be overlooked are pre-existing health conditions, maternity and waiting periods for certain conditions – are there limitations for these? 

Some policies have a limited number of office visits covered by the insurance co-pays per calendar year others are unlimited. Ask about prescription formulary and prescription plans. Does the policy only cover generic prescriptions and is there a separate deductible for your prescription?

•    Are you uninsurable in the standard market? IS your COBRA Benefit running out?
If so, you may consider Missouri Health Insurance Pool.  If you have been uninsured for 6 months or more you qualify for the Federal High Risk pool.

•    Employer Sponsored Group Health Plan
Group health plans are guaranteed issue for group sizes ranging from 2 to 50 employees. Flexible spending benefits are available for health care and child care costs to be withheld pre-tax, as a benefit to your employees. Section 125 pretax premium only plans benefit the employer by reducing the amount of Social Security, Medicare, and other taxes they would obligated to pay.

•    Medicare Supplements:
Open enrollment for prescription and advantage plans for 2012 is Oct. 15 to Dec. 7. The open window to change your advantage plan is Jan. 1 to Feb. 14.
The advantage plans are funded and administered by Medicare, in order to qualify you must be enrolled in Medicare A&B and must live in certain counties that the advantage plans require.
True Medigap plans are guaranteed issued at your anniversary date and the plans range from options A-F.

Due to the continually rising cost of medical care, it has become more important to provide health insurance for you and your family.  So take these things into consideration before you purchase health coverage.

Bruce Meckem is the President of United Insurors in Lebanon, Mo.


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