You can find affordable health insurance in the private market!

In fact, let’s repeat that one, because a lot of people find it hard to believe: you can find affordable health insurance in the private market! Just because you’re getting health insurance as an individual instead of part of a group doesn’t mean you have to destroy your bank account every month. The secret is to realize that there’s not one magic bullet that can take health insurance from a giant money sink to just a small portion of your budget, but instead that there are a number of factors that will work together to make your health insurance affordable.

The first thing you should do is look into high deductible health plans. These insurance plans are a lot more simple than most types of health insurance: you have a deductible, and that’s about it. Before your deductible, you’re responsible for your medical costs. After your deductible, your insurance company will pay your bills. Simple! Because these plans don’t include a lot of bells and whistles (either you’re working on meeting your deductible or your insurance company is paying for everything), they’re affordable for the health insurance company – there’s just not a lot of stuff for them to worry about. That means that the savings are passed on to you, making high deductible health plans a very affordable form of health insurance.

If you decide to go with a high deductible health plan, making your health insurance more affordable is pretty simple. Raising your deductible will lower your monthly premiums, and lowering your deductible will raise them. One thing that you should always keep in mind when you’re looking at deductibles is how your particular insurance company defines a “family deductible.” Some companies will assign every family member an individual deductible, some will assign the family as a whole a deductible, and others will give individual deductibles but say that when either two or three family members meet them then the entire family’s deductible is considered met. Your agent will know how each individual company handles family deductibles.

The major thing that people worry about with high deductible health plans is the fact that office visits aren’t covered by a copay. In our dedicated article about HDHP’s we discuss why this isn’t as big an issue as many people think, but if an office visit copay is something you feel like you can’t live without then you still have ways to find affordable health insurance.

The first of these is to ask yourself how many times a year you actually go to the doctor. If it’s only three or four times, but you still really want a copay for those visits, then consider looking at limited copay plans. These plans offer comprehensive benefits and a copay for a certain number of office visits a year (usually two to six). The first few visits are covered by a copay, but after that you’ll be responsible for the full amount of your medical bills until you meet your deductible. Having a limited number of copays a year instead of an unlimited number will make your health insurance significantly more affordable.

The second big thing you can do is to raise your deductible. Having a slightly higher deductible can drastically lower your monthly premiums. This one is pretty self-explanatory: raising your deductible lowers the amount of financial risk the insurance company takes on, saving them money. Those savings are passed on to you in the form of more affordable health insurance.

The last thing is something you should do no matter what: work with an independent agent. There are no “broker’s fees” or anything like that when you work with an agent, so you’ll end up paying the same in premiums that you would going directly to the insurance company. And since independent agents work with several insurance companies, we know who has the best rates and best coverage for various situations. For instance, for the majority of people in Georgia, maybe Carrier A is the most affordable. But perhaps for people in a certain age range Carrier B has better rates, and for people with high blood pressure Carrier C has the most affordable premiums. Your agent, who will have the ability to shop around and work the system in your favor, will be able to find the most affordable health insurance premiums while not sacrificing coverage.

Affordable health insurance is out there, and now you know the easiest way to find it is to use an independent health insurance agent. Luckily, you’ve got an independent agent at your disposal right now! Head on over to our free health insurance quote page and find out just how much you could be saving!

Getting Affordable Health Insurance is a post from: Georgia Insurance Options

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In 1995, Congress passed the Consolidated Omnibus Budget Reconciliation Act, a law that gives employees the right to continue their group health insurance coverage in the event that they lose their group coverage. Basically, COBRA health insurance allows you to retain your group health insurance in the event that you lose a job with benefits. In other words, it’s a temporary measure to allow you to keep your group coverage until you can find new employment with a new group health plan. There are two big questions to answer when considering COBRA health insurance: how does it work, and it is it right for you?

The first thing you’ll need to figure out is if you’re eligible for COBRA health insurance. There are three criteria used to determine COBRA eligibility:

1. Plan Coverage: to be eligible for COBRA health insurance, you must be coming from a group health insurance plan held by at least twenty employees working more than six months out of the year. So if you worked for a very small group, or if the vast majority of your co-workers were temporary employees, you may not be eligible for COBRA health insurance.
2. Qualifying Event: this is the event that happened to cause you to become unemployed. If you leave your job voluntarily, have your hours reduced to part-time status, or become eligible for Medicare, then you become COBRA eligible. If you leave your job involuntarily (you’re laid off, downsized, or fired) then you’re probably still COBRA eligible. The only way you can be fired and not retain COBRA health insurance eligibility is if you’re fired for “gross misconduct,” but neither the actual text of the COBRA law or any court says precisely what that means. If you lost your job because your company went bankrupt or out of business, then chances are you’re not eligible for COBRA. To be eligible for COBRA, the group you’re coming from must remain in force. So if your former employer goes belly-up or just decides to discontinue group coverage, then you will be unable to elect COBRA.
3. Qualified Beneficiary: You can only go on COBRA health insurance if you were covered by the group health insurance plan the day before the Qualifying Event. If your spouse is the covered individual and you divorce or separate, you may be eligible for COBRA health insurance until you can get on your feet. If your spouse is covered and passes away, you are also eligible for COBRA health insurance.

Once you’ve figured out if you’re eligible, then it’s time for an unfortunate reality check: COBRA health insurance can be extremely expensive. When you have group coverage, your employer pays for a large portion of your monthly premiums (usually at least 75%). However, when you move onto COBRA health insurance, you become responsible for 102% of your premiums. That’s not a typo – you are responsible for the full amount of your health insurance premiums, plus a 2% service charge for administrative costs. COBRA costs can skyrocket quickly, and the sticker shock of the first premium payment can be a very harsh awakening. Your first 102% premium payment will come due 45 days after you first apply for COBRA health insurance. (UPDATE! The recent stimulus package has changed how COBRA payments work. Please see the end of this article for new information)

COBRA health insurance is retroactively effective (meaning, for example, if you get laid off, apply for COBRA, and get approved two weeks later, the effective date of your COBRA health insurance is considered the date of the layoff). This is a great thing, because COBRA is designed to keep you from having a gap in coverage. Not having a gap in coverage means that when you go onto a new group or decide to buy a private health insurance plan you won’t be subjected to a lengthy review of medical records and a series of phone interview – waiting periods that could easily be avoided.

As long as the original group policy stays in force, you can stay on COBRA health insurance for up to eighteen months, although there are a few exceptions. If, for instance, you become disabled during this initial eighteen month period, you can extend the coverage under OBRA (a sister law to COBRA) for an additional eighteen months, bringing your total time of coverage to thirty-six months.

That, in a nutshell, is how COBRA health insurance works. Now, how do you know if it’s right for you?

If you have any sort of significant pre-existing medical condition, then COBRA health insurance is probably a good bet. Things such as diabetes, cancer, or heart disease can make finding private health insurance a nightmare – most private health insurance plans just won’t accept that level of risk. Groups, however, give insurance companies a way of balancing out that risk with a pool of healthy individuals, and so they’re better able to extend comprehensive benefits to people with these conditions. COBRA health insurance is just an extension of your group health insurance, so your benefits under COBRA will probably be better than anything you can find in the individual market. Still, it doesn’t hurt to check – if you just want to know what your options look like with a certain condition, contact me using the link at the top of this and every page and I’ll let you know.

If you don’t have a pre-existing condition, then your best bet is to check out your options in the private market. The private health insurance world is a little different than the world of groups, but I do my best to walk you through it over at this article: Private Health Insurance When You’re Unemployed.

The bottom line is this: COBRA health insurance is fantastic if you’ve just lost your job with benefits and you need health insurance for a pre-existing medical condition. However, if you’re generally in good health, chances are your options in the private health insurance market are going to be better than what you could find with COBRA health insurance.

If you have any questions or concerns about COBRA health insurance, please use the contact link at the top of this page to send me an email and I’ll do anything I can to help. If your needs are more urgent, or if you just want to hear my happy voice, then feel free to call me at 404-660-1020, anytime!

UPDATE: COBRA UNDER THE NEW STIMULUS PACKAGE

Since the recent stimulus package passed, the way COBRA is funded has changed dramatically. Now, if you’ve lost your job between September 1, 2008 and December 31, 2009 and are eligible for COBRA health insurance, you’re only on the hook for 35% of the costs of your health insurance instead of 102%. The other 65% is still paid for by your employer, who is reimbursed in the form of payroll tax credits. This subsidy is available for the first nine months of eligibility, so after that things go back to the 102% mark.

The COBRA subsidy applies to group health insurance plans, as well as group dental, vision, and HSAs. FSAs are excluded from the subsidy.

This means COBRA coverage can be more affordable for folks using it as a temporary form of health insurance while between jobs. COBRA is still not a long-term solution, and it’s still a very good idea to compare the quality and cost of reduced-cost COBRA coverage with private health insurance plans.

For an official rundown of the COBRA changes, have a look at this extremely comprehensive look at the COBRA changes. If you have any questions that neither this article nor that page can answer, please feel free to contact me and I’ll help you in any way I can.

Is COBRA Health Insurance Right For You? is a post from: Georgia Insurance Options

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If you look around this website, you’ll find pages and pages of information about how wonderful it is to use an independent agent, how having an expert on your side can save you time and money when dealing with health insurance companies, and how having your own, personal agent on call to address your insurance needs can truly save you. But, there is one downside to using an independent insurance agent: we’ve got access to hundreds of different policies.

Now usually that’s a good thing. It means that you have a great deal of choice, that you’re not tied down to any one company or product line, and that your agent can just about always find a policy that offers the right combination of protection and monthly cost for your needs. However, that amount of choice can also get a little overwhelming and can make the task of narrowing things down to just one plan seem slightly daunting. Imagine walking onto the lot at a Carmax and just telling a salesman “I want a car.” He’d probably look at you blankly and have no idea where to get started, right? Even though that car salesman knows where everything is on the lot and knows the details and specs for all of his cars, he still needs you to let him know a little about what you want in order to help you find the right vehicle for you. So you go to the dealership armed with a little information, like how many passengers you want to be able to seat, what color you want, what kind of interior, and so on and so forth. Health insurance works in a very similar way – there are hundreds of plans out there, and the benefits are very different with all of them. Some cover well-care for children, while some have excellent accident benefits. Some have better copay structures, while some have an awesome health savings account component. If you know a little bit about what you want, you and your agent can work together much more effectively to find the policy that will work best for you.

So, how do you do that? How do you go about figuring out what type of policy is best for you and your family? You don’t have to have all of the answers, of course, since you’ll be working closely with an independent agent and he’ll be able to help you figure that out, but like we discussed a moment ago, it’s a good plan to have a basic idea of what your needs regarding health insurance will be.

In my experience, the best way to get started is to ask yourself three questions:

1. What do I like about your current policy?
2. What don’t I like about your current policy?
3. If I could design a policy from the ground up for yourself, what would you put in it?

Answering these three questions will just about always point you towards the right policy for you. There are a few things to keep in mind when you’re asking yourself these things.

When you’re thinking about what you like about your current health insurance plan, think about the past few times you’ve had to use it. Have you been to the doctor’s office or emergency room lately? Did you have a copay for either visit? Have you had to call your insurance company recently, and if so, were you satisfied with the level of customer service you received? What kind of deductible do you have now? How are your prescription drugs handled?

Thinking about these things will also probably reveal what you don’t like about your current plan. Maybe your current deductible is too high, or your prescriptions aren’t covered like you want them to be. Maybe you don’t have a copay and you want one – or maybe you do have a copay, but you never use it and want to lower your premiums by doing away with it.

When you get through thinking about what you like and don’t like about your current insurance policy, you should have a decent idea about how you feel about your deductible, your copay, and your premiums. Additionally, if you’ve had to use your health insurance lately, you’ll probably have an idea about any special circumstances you want your policy to cover (for instance, if chiropractic care is covered, if wellness benefits are included, and so on).

Now with that information, you’re ready to tackle the third question: if you could design a policy from the ground up, what would you put in it? This is where you get to make sure any special considerations you may have are taken care of. For example, do you want to make sure that your child under age five will have free well-care checkups? Do you want to make sure a certain prescription drug is covered? Do you want to have extra coverage if you have some kind of accident (known as a supplemental accident benefit)?

The next step is to take this idealized plan you’ve built and give it an unfortunate “reality check.” Personally, I want a health insurance plan that has a $10/year deductible, covers all of my office visits with a $2 copay, gives me free prescription drugs whenever they’re prescribed, sends me Chinese food on Fridays, and does it all for under $5 a month. That plan, however, doesn’t exist, which means you’ll need to identify which category you have more flexibility in: are you more willing to let your premiums go up a little to get the coverage you want, or do you want to increase your deductible and maybe eliminate your copay to get down to the monthly premiums you can afford?

Think about this: the difference between a $1500 and a $2500 deductible is $1000 a year, but if you save $84 a month by moving to a higher deductible, then you’ll have made up that difference just from your premium savings. That means you have that money in your pocket instead of sending it to the insurance company – and believe me, if you don’t meet that $1500 deductible, they’re not going to send any of your money back for “overpaying” them. Raising your deductible can put extra money in your pocket while still giving you comprehensive coverage, and is probably the area you should look at when you’re trying to figure out how to fit health insurance into your monthly budget.

Now, you’ve identified what you like about your current policy, what you don’t, and what you would change. On top of that, you’ve figured out what sort of deductible you’d like to look at, if you want an office visit copay, and any special things you want included in your new health insurance policy. Furthermore, you’ve figured where you can be flexible if you have to be: benefits, or premiums. The only thing that’s left is to sit down and start looking at policies until you find one that matches what you want.

Everything up to now has sounded harder than it really is. Unfortunately, this last part flips that on its head by sounding significantly easier than it is. There’s much more to the final step than writing down a deductible, copay, and premium amount and just looking at plans until one matches up. This is where your independent agent comes in. With access to hundreds of different policies, that choice that earlier looked overwhelming now just looks welcoming.

With the knowledge you’ve gained from reading and applying the techniques outlined in this article, you and your independent agent are now ready to sit down and figure out the exact policy that will work best for you. And remember, working with your independent agent to select your personal health insurance policy isn’t just a one-time interaction – you’ll be getting an expert on your side who will work for you for the life of your policy. But you’ve already read the article about Why You Should Use an Independent Agent, right?

When you’re ready to start working with your own independent agent, visit our free Georgia insurance quote center. You’ll be shocked at how easy it is to work with an independent insurance agent, and even more shocked at how affordable insurance can be!

How To Choose The Right Health Insurance Policy is a post from: Georgia Insurance Options

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As you know, when you have an independent insurance agent, you have access to all the health insurance companies that agent represents. And, as you know, this is the time of year when a lot of our policies are renewing, which also means a lot of our plans are seeing rate adjustments.

Unfortunately, the majority of the time those rate adjustments go upwards rather than downwards. It looks like this year won’t be any exception, especially with the way our economy is trending. Today, I’ve talked with several people who are reporting rate increases from Golden Rule and Blue Cross Blue Shield of Georgia, as well as less severe rate increases with Imerica and Assurant. My own research has borne this out — it looks like these companies are increasing rates across the board.

Keep in mind, this isn’t based on any official information from the insurance companies. This is just something I’m watching on my end, and I’m personally seeing a lot of higher premiums for the same coverage.

That being said, major kudos to Humana. From what I can tell, Humana’s rates are holding steady with no sacrifice of benefits. I’m keeping an eye on this, and I’m going to spend some time this week calling current clients to make sure that they’re still satisfied with their coverage.

Rate hikes, especially when they come out of nowhere, can really disrupt your monthly budget. That’s why I always, always recommend a twelve-month rate guarantee to my new clients. Locking your rates in for the first year adds an element of predictability to your plan, which is a great deal for a product that exists to provide asset protection.

If you want to evaluate your current plan against the shifting market to make sure that you’re still getting the best rate possible, check out our free Georgia insurance quote page to get your free, personalized, no-stone-unturned quote. You never know how much you could be saving until you get your agent to research the market for you!

Georgia Insurance Options: Rate Watch January 2009 is a post from: Georgia Insurance Options

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“I can’t afford health insurance!”

I can’t tell you how many times I heard that when I used to work in a doctor’s office as an insurance benefits specialist. Know what else I can’t tell you? How many people walked out of our doors followed by phone calls, letters, and eventually collections agents and bankruptcy attorneys. What these people truly couldn’t afford was to not have health insurance.

The cost of health care can be astronomical. Accidents happen, critical illness strike, and they generally don’t have the manners to call a week ahead of time to let you know they’ll be visiting. Are you one of the people who says they don’t have health insurance because they can’t afford it – but hey, it’s not like you plan on getting sick anytime soon, right?

Stop reading this article right now. Get in your car, go to the nearest hospital emergency room, and ask how many people there were planning on getting sick. Ask how many of them were planning on having an accident that day. See the guy with the appendix that’s about to rupture? He’ll be getting a bill for over ten thousand dollars in the mail before too long. The kid in the corner who fell off of his bike and whose parents don’t have health insurance coverage? That broken arm is going to cost at least a hundred bucks to evaluate, plus another $175 per x-ray (and they’ll probably do two or three), plus casting fees (triple the cost if the doctor deems a waterproof cast necessary), plus follow-up visits (at least one, at at least $125), plus cast removal (another $150 or more), plus physical therapy if he needs it. The thirty-five year old guy who didn’t realize he had an almost complete arterial blockage until he had a heart attack – forget it. If he survives, he’s bankrupt. If he doesn’t make it, his family will be.

If your budget is truly so tight that you don’t think you can afford health insurance, then take a close look at where your money is going. Ask yourself this: what is going to truly ruin our family, an extra set, steady charge each month that we can plan and budget for, or a sudden crush of medical bills?

I can’t emphasize this enough. You should be looking to save money on the cost of your health care, not your health insurance. Sure, you can adjust your deductible and coinsurance levels. You can eliminate a copay from your plan, like we talked about in another article. But you simply cannot afford to go without health insurance – it’s a gamble, and it’s one that may work for a while, but it’ll get you in the end. The bottom line is this: no matter your situation, you need health insurance. If you’re self employed or own your own business, the costs of a medical emergency can cripple your financial infrastructure and run your business into the ground. If you have a family, you owe it to your children and your spouse to protect them from financial devastation. Even if it’s just you, modern day hero, a healthy young man or woman going it alone, bankruptcy can ground your dreams and take years to claw your way out of. You don’t go broke because you have a monthly premium to pay. You don’t go broke because you’ve factored a set, predictable monthly cost into your budget. If you go broke, it’s going to be because you got slammed with a hundred thousand dollar medical bill and don’t have insurance coverage that will pay for it.

The reason many people think they can’t afford insurance is because they think health insurance is an all-or-nothing proposition. Either you get the $750 a month policy that covers absolutely everything at no cost past premiums or it’s just not worth paying for. This simply isn’t the case. Now, don’t get me wrong; if you have room in your budget for the high-end policy and you, with the counsel of your local independent agent, decide that that’s the level of coverage you need, then that’s what you should buy. But for the vast majority of people, a policy that robust simply isn’t necessary. What’s the point of paying for coverage you simply don’t need? Think about it this way: what’s the point of buying a Hummer with Swarovski crystal rims and velvet airbags when all you want to do is drive to McDonalds?

The reality is, you probably don’t need a plan that has a $10 co-pay for all services with no deductible, no out-of-pocket cost, and 100% coverage. The reality is, you can probably get the coverage you need at a lower price than you think! Your local independent agent will know what plans offer the proper level of coverage while still bringing an affordable price to the table. The fact is, no matter what your budget, there’s a health plan out there that will work for you. Think about your car insurance. It covers you in the event of an accident, right? Do you have car insurance for that day you have an accident, or do you have car insurance to cover your oil changes, new wiper blades, air in the tires, and the occasional wash? Can you imagine how much more expensive your car insurance would be if it covered those things? Health insurance works the same way! Eliminate the benefits you don’t need, put the money you save on premiums away, improve your financial situation, enjoy the peace of mind that comes with comprehensive coverage, and everybody wins.

Save money on the cost of health care, not by eliminating health insurance from your budget. It’s a gamble that you, your business, and your loved ones will pay for when – not if – you lose. Georgia Insurance Options is 100% dedicated to getting you the coverage you need at the price you can afford, so when you’re ready to protect your family head on over to our free Georgia insurance quote page and get your personalized health insurance proposal today.

The Unaffordable Health Insurance Myth is a post from: Georgia Insurance Options

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