That, obviously, is a gross oversimplification, but you can get the full treatment at our original Georgia life insurance article.

Now we need to talk about a third, and more complex, type of Georgia life insurance: universal life.

The key thing to keep in mind when talking with a Georgia life insurance agent about universal life insurance is this: make absolutely certain that the policy is guaranteed. This is because things aren’t as cut and dry with a UL (universal life) policy as they are with a WL (whole life) policy.

To put it as basically as possible: with a whole life policy, as long as every premium is paid the death benefit of that policy is guaranteed to pay out when the insured passes away. With a universal life policy, on the other hand, the policy will “lapse” (meaning your death benefit will vanish) if the premiums and cash value aren’t enough to cover what’s known as the COI, or Cost Of Insurance. For that reason, it’s vital to make sure you’re getting a guaranteed UL. With a guaranteed policy, also called a no-lapse policy, it’s written into your contract that if you make certain premium payments that the policy will be guaranteed not to lapse until a certain age. Generally, that age is 121, meaning you’d have to be very old indeed to outlive your policy.

When it comes to Georgia life insurance, you’ll find that UL policies are less expensive by far than WL policies. This makes a UL policy an attractive choice to a Georgia life insurance shopper, but again, you must be aware that without a guarantee written into the policy that your premium payments may not be enough to sustain your coverage in the future.

So which Georgia life insurance shoppers should be looking for a universal life policy? If you’re looking to get longer lasting protection than term life insurance can provide for not much more in monthly premiums, then a universal life policy might be right for you. Georgia life insurance shoppers should also have their eye on a UL policy if they’re looking for something that will build a cash value, but don’t want to pay the super high premiums of a traditional whole life policy.

As you can see, UL policies can provide great advantages to Georgia life insurance shoppers. However, there are a few pitfalls that you need to look out for, which is why I firmly believe you should work with an agent to figure out just what Georgia life insurance product is right for you. Now that you’ve started learning, why not set up your no-cost, no-obligation conversation with your personal Georgia life insurance agent today? Getting started is as easy as requesting your free Georgia life insurance quote.

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Aetna coverage is a hot commodity right now, and with good reason – Aetna coverage is among the most affordable types of health insurance available in Georgia today. There are several different types of Aetna coverage, so let’s have a look at what’s on the market.

Aetna Coverage Option One: Managed Choice Open Access & PPO First Dollar 30

The first thing you’ll notice about Aetna coverage is that the plans have frightfully long names.

The Managed Choice Open Access & PPO First Dollar 30 plans are the top of the line when it comes to Aetna coverage. There’s no deductible on these plans – instead, with this Aetna coverage option, you’ll pay 30% of your bills until $7500 comes out of your pocket. After that point, you’ll pay nothing and your Aetna coverage will pay 100%. Office visits are handled by a $30 copay ($40 for specialists). Visits to an urgent care center will run $50 under this Aetna coverage plan, and visits to the ER will cost you $300 flat-fee (unless you’re admitted, in which case this Aetna coverage waives the $300 and goes back to charging you 30% until you’ve reached your annual $7500 out-of-pocket limit). 

Prescription drugs are subject to a $500 deductible. Generics are a $15 copay (deductible waived), so only preferred drugs ($40 copay) and non-preferred drugs ($60 copay) are subject to the deductible with this Aetna coverage.

The Verdict: This Aetna coverage is pretty magnificent, but it carries a magnificent price tag, too. If you want to spend this much on your health insurance, why not limit your out-of-pocket exposure a little more and get a Copay Select plan with Golden Rule?

Aetna Coverage Option Two: Managed Choice Open Access & PPO First Dollar 40

This Aetna coverage is essentially the same as the first, with the following modifications

• This Aetna coverage pays 40% of your bills, not 30%
• The maximum out-of-pocket is $12,500, not $7500
• Office visit copays are each increased by $10
• Brand name drugs are not covered

The Verdict: The lack of prescription benefits with this Aetna coverage really kills it. As always, I never recommend a plan with less than full prescription benefits.

Aetna Coverage Option Three: Managed Choice Open Access & PPO 1500

This Aetna coverage is more in line with what most people think of when they think “health insurance.” Here, we’ve got a $1500 deductible – once that’s met, this Aetna coverage will pay 80% of your bills and you’ll pay 20% until an additional $1500 comes out of your pocket. At that point, your Aetna coverage will pay 100% of your bills.

Office visits with this Aetna coverage are handled by a $25 copay ($35 for specialists). Generic prescriptions cost $15 without meeting any deductible. After a $250 prescription deductible, preferred drugs cost $35 and non-preferred cost $50. 

The Verdict: This Aetna coverage is just about top-of-the-line and carries Aetna’s trademark affordability. This is an excellent option.

Aetna Coverage Option Four: Managed Choice Open Access & PPO 2500

This Aetna coverage is the same as the PPO 1500 with the following modifications:

• There’s a $2500 deductible, then 20% coinsurance to an additional $2500 out-of-pocket (our previous Aetna coverage had $1500, 20%, and $1500)
• Office visit copays are $30 ($40 for specialists)
• Prescription drugs are handled in the same style, but this Aetna coverage carries a $500 prescription deductible instead of $250.

The Verdict: A more affordable version of the 1500 Aetna coverage without any significant holes. Again, an excellent option.

Aetna Coverage Option Five: Managed Choice Open Access & PPO 3500

Again, this Aetna coverage is the same as the PPO 1500 and 2500 with the following modifications:

• There’s a $3500 deductible, then 20% coinsurance, then a $6500 out-of-pocket limit, making the total liability for this plan $10,000
• Office visit copays are $35 ($45 for specialists). 
• Prescription drugs are handled in the same way as with the PPO 2500 Aetna coverage.

The Verdict: This Aetna coverage includes a $6500 out-of-pocket limit, making the total liability on this plan a little too high. The price difference between this Aetna coverage and the PPO 2500 is not large enough to justify the difference in liability.

Aetna Coverage Option Six: Managed Choice Open Access & PPO 5000

Once again, we have a plan that works the same as our previous few options with a couple of modifications:

• This plan has a $5000 deductible, 20% coinsurance, and then a $5000 out-of-pocket limit. This means that the total liability is the same as with the PPO 3500 option, but the deductible is larger.
• Office visits are handled with a $40 copay ($50 specialist).
• Prescription drugs have a $500 deductible and work the same as our last two Aetna coverage options.

The Verdict: If your budget restricts you to this or the PPO 3500, the 3500 will give you greater flexibility and value. However, it’s very much worth the slight price increase to move up to the PPO 2500 and cut your liability in half.

Aetna Coverage Option Seven: Managed Choice Open Access & PPO Value 2000

This Aetna coverage option has the word “Value” in the name, which loyal readers of Georgia Insurance Options will know is code for “watch out – limited benefits ahead.” However, Aetna breaks the mold a bit by offering a robust coverage option and only limiting unnecessary benefits.

Here, you’ll have a $2000 deductible. Once you meet that, you’ll pay 30% of your bills until an additional $2000 comes out of your pocket. At that point, your Aetna coverage will pay 100%. 

You’ve got six office visits per year covered by a copay ($40, or $50 for specialists). Specialist and non-specialists share those six visits under this Aetna coverage option, so budget those visits wisely.

Generic prescriptions are again a $15 copay, and the deductible is waived. Other prescriptions, however, are subject to a $200 prescription deductible with this Aetna coverage option. After that’s met, you’ll pay a $25 copay for preferred drugs and a $40 copay for non-preferred drugs. 

The Verdict: Extremely affordable with low liability means this Aetna coverage option is a great choice for just about anyone. The only people I wouldn’t recommend this plan to are parents with very young children – those six visits will dry up quickly with them.

Aetna Coverage Option Eight: Managed Choice Open Access & PPO Value 5000

Not to sound like a broken record, but this Aetna coverage option is the same as the previous plan with the following modifications:

• You’ll have a $5000 deductible, then 30% coinsurance to an additional $5000 out-of-pocket.
• The prescription deductible is $500, not $200. 

Aside from that, this Aetna coverage option is identical to the previous plan.

The Verdict: This Aetna coverage option is decent if you’re on a budget, but the Value 2000 is far superior and the prices aren’t that far apart. I suggest looking at the Value 2000 Aetna coverage option more closely if you’re considering the Value 5000 plan.

Aetna Coverage Option Nine: Managed Choice Open Access & Value 10000

This Aetna coverage option is flat-out bad. 

First, you’ve got a $10,000 deductible. Once you meet that, you’ll pay 30% of your bills until you pay an additional $2500 out of pocket for a total liability of $12,500.

You’ve got two office visits per year covered by a $30 copay. After that, under this Aetna coverage option your office visits begin falling to your deductible.

Generic drugs under this Aetna coverage option cost $20, no deductible. After a $500 deductible you can get preferred drugs for $40, but non-preferred drugs aren’t covered. On top of that, there is a maximum prescription benefit of $5000 per year for prescription drugs – meaning if you’re on $8,000 a round outpatient cancer treatment drugs, you’ll be out of pocket for everything after the first round.

As a final straw, this Aetna coverage option has a $1,000,000 lifetime maximum benefit. Seems like a lot until you realize that the standard is usually $5,000,000 and some plans in Georgia go up as high as $25,000,000

The Verdict: This Aetna coverage option is bad, bad, bad. However, admittedly, it’s the cheapest health insurance plan in the state of Georgia. If you absolutely, positively cannot afford anything else, then this Aetna coverage option is technically better than nothing.

Aetna Coverage Option Ten: Managed Choice And Open Access Preventative and Hospital Care 1250

This one’s no good either.

First, you’ll have a $1250 deductible with this Aetna coverage option. After you meet that, you’ll pay 20% until an additional $3000 comes out of pocket. At that point, you’ll be covered at 100%.

Office visits are not covered expenses, meaning that with this Aetna coverage option you’ll not only pay for the entire bill for your doctor’s visits, but that amount won’t apply to your deductible and you won’t get network repricing. Horrible!

Labs and X-Rays aren’t covered either. Neither is physical therapy or durable medical equipment (like wheelchairs, crutches, etc.). Again, “not covered” means you’ll not only pay for them, but the cost won’t apply to your deductible with this Aetna coverage.

Preventative care under this Aetna coverage is handled well, giving you unlimited visits at $25 a pop – but who goes for preventative checks more than once or twice a year?

Finally, you’ll get your generic drugs at $15 each, but brand-name drugs are not covered. That’s the final nail in the coffin of this Aetna coverage.

The Verdict: I sat here for ten minutes trying to think of a reason why you should buy this Aetna coverage, and I didn’t come up with a single one. A resounding “NO.”

Aetna Coverage Option Eleven: Managed Choice Open Access and PPO Preventative & Hospital Care 3000

Somehow, worse than the 1250 Aetna coverage.

This Aetna coverage is probably the single most offensively awful thing I’ve ever come across. You’ve got a $3000 deductible, 20% coinsurance, and then another $2000 out of pocket. Then your Aetna coverage kicks in and pays 100% of your bills.

Again, office visits aren’t covered. Labs and X-Rays aren’t covered. Physical therapy isn’t covered. Durable medical equipment isn’t covered.

Under this Aetna coverage, you don’t even get the $15 generics – there is simply zero prescription drug coverage.

The Verdict: I wouldn’t wish this one on my worst enemy. This Aetna coverage option is the absolute, bottom-of-the-barrel worst health insurance plan offered by any major insurance company in Georgia. It is absolutely, positively unthinkable that there would ever be a situation in which this Aetna coverage option was the right choice for you.

Aetna Coverage Option Twelve: Managed Choice Open Access & PPO High Deductible 3000 (HSA Compatible)

The last two Aetna coverage options are very good and very simple. This Aetna coverage has a $3000 deductible – costs before it come out of pocket, costs after are paid 100% by Aetna. That’s it – doctor’s visits, hospitalizations, prescription drugs, everything. Once you’ve paid $3000, you’re done for the year and your Aetna coverage will pick up the rest. This is an extremely simple HSA style plan with very few moving parts and an integrated prescription deductible.

The Verdict: While this Aetna coverage option is great, it doesn’t offer any advantages over the Humana Autograph Total Rx series of plans. These two often run neck-and-neck as far as pricing goes, so comparison shop. However, as we’ll see in a moment, even if the Humana plan comes out to be $30 a month more expensive I’d probably recommend it over the comparable Aetna coverage.

Aetna Coverage Option Thirteen: Managed Choice Open Access & PPO High Deductible 5000 (HSA Compatible)

This plan is functionally identical to the previous plan – the only difference is that the deductible is $5000 instead of $3000. This, of course, makes the plan slightly more affordable while trading off some of the risk. 

The Verdict: My feelings about this Aetna coverage are the same as they are about its $3000 sister. Compare closely against Humana to see which one works better for you.

Special Considerations

There are a couple of things to consider when you’re looking at an Aetna coverage option. Although the plans are some of the most affordable in the state, Aetna has a reputation for being somewhat difficult to deal with on the billing side. Aetna coverage comes with Aetna bureaucracy, which means increased headaches when it comes to getting bills paid and rates negotiated.

Aetna also has a nasty habit of raising their rates multiple times in the second year of coverage, turning a very affordable Aetna coverage plan into an overpriced bank-drainer. In contrast, Humana and Golden Rule will raise their rates once a year at most, and Assurant will allow you to lock in your rate for up to three years on some plans.

There’s also no option to add maternity to your Aetna coverage, so if you’re planning a family then this isn’t the company for you.

On the positive side, Aetna’s dental coverage is widely regarded as some of the best in the business. It’s accepted across a large range of practitioners and geographic areas and is a very affordable form of dental coverage, too. 

The final verdict on Aetna coverage in general: The plans are affordable (for the first year), but you’ve got to be very careful which one you pick. You could either get awesome Aetna coverage, or be stuck with one of the worst plans in the state – there’s very little middle ground when it comes to Aetna coverage. The company also has a slightly spotted reputation, but it’s still a first-tier carrier and that means it’s miles above no-names like Imerica and World.

In short, Aetna coverage is a good budget option, but probably shouldn’t ever be your first choice. Always compare these plans closely with offerings from Humana and Golden Rule before making your final decision.

Now that you’ve learned more about Aetna coverage than you probably ever wanted to know, it’s time to find out how much it costs! Head on over to our free Georgia insurance quote page to get your instant, personalized proposal now!

Which Aetna Coverage is Right for Me? is a post from: Georgia Insurance Options

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Assurant insurance (you may be more familiar with their old name, Time or Fortis) is a major player in the Georgia insurance scene. Assurant insurance plans are uniquely customizable, ultra-flexible, and offer some of the most individually tuned coverage options available in the private insurance market today. If you’re looking for health insurance, then Assurant insurance is an excellent choice.

Please note: Georgia Insurance Options has access to the “Assurant Insurance Elite Product” line – a group of Assurant insurance plans that few brokers in the state of Georgia are able to offer. For that reason, some of what you’ll read here will hold true only at Georgia Insurance Options. The short version of the difference between an Elite Assurant Insurance Broker and a Standard Assurant Insurance Broker is this: the elite lines have more coverage at the same cost.

Now, let’s compare each and every Assurant insurance plan one-by-one to see which ones shine and which don’t.

Assurant Insurance Plan Number One: MaxPlan

The first Assurant insurance plan is called MaxPlan, and it offers the most comprehensive coverage you can get in an Assurant insurance plan. You can elect an office visit copay of $35 (with unlimited visits), generic drugs are covered by a $15 copay, and brand name drugs are covered with a $25 copay plus 20% of the drug cost after a $500 deductible. That extra 20% can mean drug costs can add up quickly with this Assurant insurance plan.

You can select a deductible ranging from $500 to $25,000, a coinsurance level of 100% to 50%, and a maximum out-of-pocket past the deductible of $0 to $7500. The huge range of mix-and-match options means that this Assurant insurance plan is incredibly customizable to your specific needs.

The Verdict: Unfortunately, this Assurant insurance plan is generally overpriced, and the prescription drug benefit is lacking. If you really love this plan, then I recommend getting very similar benefits at a fraction of the cost with Humana’s Portrait Unlimited Plan.

Assurant Insurance Plan Number Two: CoreMed

Our second Assurant insurance plan is far more reasonably priced. Like Assurant insurance plan number one (MaxPlan), you can elect a $35 office visit copay with this plan. This time, however, this Assurant insurance plan will only cover four office visits per person per year – visit five and up are subject to the deductible and coinsurance.

With this Assurant insurance plan you can again select a deductible anywhere from $500 to $25,000 and a post-deductible out-of-pocket maximum of $0 - $7500. The coinsurance level ranges from 100% to 50% just like with our first Assurant insurance plan, MaxPlan.

Unfortunately, prescription drugs are handled in a similar way to the first Assurant insurance plan: $15 copay for generics, $500 deductible then a $25 copay plus 50% coinsurance. That can get astronomical quickly, and honestly should disqualify this Assurant insurance plan from consideration. When you consider the cost of brand-name cancer treatment drugs alone, this Assurant insurance plan simply doesn’t have the coverage anyone needs.

The Verdict: Assurant insurance almost hit a home run with CoreMed, but the weak prescription drug coverage kills it. Again, if you like the idea of having an office visit copay but saving a little money by having a set number of office visit copays available per year, ditch Assurant insurance and the CoreMed plan and check out Humana’s Autograph Share 80.

Assurant Insurance Plan Three: RightStart

At this point, you may be wondering if Assurant insurance has anything worth buying. They do, but it’s not RightStart.

This Assurant insurance plan is unacceptable. Deductibles range from $500 to $3000, and coinsurance levels go from 75% to 60%. Office visits are covered by a $25 copay and are limited to two per person per year. So far, so good.

However, outpatient benefits are capped at $2500 per year (a single ER visit will usually exceed that – with this Assurant insurance plan, you can buy that up to $5000, but it’s still awful). Annual benefits are capped at $50,000 per year, so this plan will not cover claims above that number in any year (Assurant insurance will let you buy that up to $100,000, which is still unacceptable). 

Prescription drugs under the RightStart Assurant insurance plan are handled in exactly the same way as with the CoreMed Assurant insurance plan, but the RightStart Assurant insurance plan won’t pay more than $2,000 per year in benefits. This, again, is an absolutely unacceptable limitation.

The Verdict: Under no circumstances should you ever consider buying this Assurant insurance plan. There’s a reason that it’s jokingly referred to as “WrongStart” by insurance agents.

Assurant Insurance Plan Four: SaveRight

Here’s a general tip: anytime you see a health insurance plan with the word “value,” “save,” or “budget” in the name, be very careful. The SaveRight Assurant insurance plan is significantly better than RightStart, but it still falls short.

Deductible levels with this Assurant insurance plan range from $2300 to $5100, and coinsurance levels run from 100% to 0%. Maximum post-deductible out-of-pocket levels range from $0 to $3000, and no office visit copay option is available with this Assurant insurance plan.

Prescription drugs don’t have a copay – instead, you pay for drugs out-of-pocket until you hit your deductible, at which point they’re covered at 100%. However, be very careful – with SaveRight, your prescription drug benefits are either capped at $2000 or not subject to an annual maximum. It only costs about nine dollars with this Assurant insurance plan to get full prescription coverage, but many agents fail to include that benefit.

The thing that cripples SaveRight is that outpatient services are capped at a maximum of $25,000 per year. A hole in coverage this huge just isn’t acceptable for true major medical insurance. When you consider that this plan also only covers outpatient physical medicine up to $50 per visit for just two visits, a simple broken arm or leg can completely max out the plan benefits.

The Verdict: The inclusion of an outpatient cap opens you up to too much risk. You can get full benefit plans for the same cost as this Assurant insurance plan, so I don’t recommend it.

Assurant Insurance Plan Five: OneDeductible PPO

This is where Assurant insurance truly shines. The OneDeductible PPO is an excellent plan I’d happily recommend to anyone. With this Assurant insurance plan, you select a deductible of $1200 to $5000 ($2400 to $10000 family). You can set this Assurant insurance plan to pay 100% after the deductible is met, or set an 80% or 20% coinsurance level to a maximum post-deductible out-of-pocket limit of $2000.

There is no office visit copay, so doctor’s office visits come out-of-pocket. Prescription drugs do the same – under this Assurant insurance plan, drugs go towards your deductible and are covered at the level you’ve chosen once you meet it. 

All in all, it’s a simple plan – you’ve got a deductible. Once you meet it, you’re covered at 100% (or at 80% or 50% to a maximum out-of-pocket of $2000, if you chose to save a little on your Assurant insurance premiums).

The Verdict: This Assurant insurance plan is extremely reasonably priced, offers totally comprehensive coverage, and is competitive with products from other carriers. It’s also the best product Assurant insurance offers, so if you’ve got your heart set on Assurant insurance, then this is the plan for you.

Assurant Insurance: The Add-Ons and Optional Benefits

Assurant insurance has a ton of optional benefits that you can add. Let’s go through each Assurant insurance optional benefit one-by-one.

Health Savings Accounts

We’ve talked about HSA’s elsewhere, so instead of rehashing that here we’ll just note that SaveRight and OneDeductible PPO are both HSA eligible plans.

RightStart Cancer Benefit

If you, for some unknown reason, simply must go with RightStart Assurant insurance, then you can increase the annual outpatient maximum of $5,000 by $25,000, but only for cancer treatments.

Preventative Care Benefit

If you chose the OneDeductible Assurant insurance plan, you can get $500 of first-dollar coverage for preventative care by adding on this benefit. This means that well-care visits, physicals, mammograms, etc. are covered up to $500 per person per year (total) before you have to pay a dime. You must have this Assurant insurance plan with this add-on for one year before using this benefit, though.

Maternity Benefit

We’ve discussed the Assurant insurance maternity benefit in depth already, so we won’t go through it all again here. One thing to keep in mind is that Assurant insurance has the shortest waiting period of all Georgia insurance carriers for maternity benefits: there’s only a ninety-day waiting period. 

Dental-Vision Discount Plan

Adding on the dental-vision discount plan to any Assurant insurance plan provides discounts on services from dental and eyewear providers. Savings range from 15% – 50% on dental services and 10% to 60% on eyewear. This is a discount plan rather than true insurance, but it’s a nice add-on to an Assurant insurance plan.

Dental Insurance

You can add dental insurance to the health part of any Assurant insurance plan. However, the dental insurance add-on to Assurant insurance plans is less attractive than the full dental coverage discussed in our earlier article on the subject because of the fee-for-service nature of the program. Basically, instead of being guaranteed coverage, you have to compare your procedures to a checklist and determine what the coverage level is with this add-on benefit. 

Accidental Medical Expense Benefit

With Assurant insurance, you can add a first-dollar benefit of $500, $1000, or $2500 that will cover any accidental injuries you might have. No matter what your deductible or how close you are to meeting it, Assurant insurance will pay your selected amount off the top of your bill before you ever pay a penny.

SuiteSolution – SecureSolution Level

SuiteSolutions is a “benefit package” you can add on to any Assurant insurance plan that will provide you with some extra optional benefits to reduce your risk. The first level available to you is the SecureSolution level. You get an Accident Medical Expense Benefit like the one described above, but with two modifications: the benefit level can be $2500, $5000, or $10000 and there’s a $250 deductible per insured, per accident. Secondly, you get an accidental death and dismemberment benefit of up to $10000 for the primary insured and up to $1000 for the spouse and each child (essentially, this is a life insurance policy that pays in the event of accidental death, or pays a reduced benefit in the event of severe dismemberment or deformation). Lastly, adding SecureSolutions to your Assurant insurance will pay 70% of your weekly salary to a maximum of $250 per week for the primary insured if the primary insured is forced out of work due to an accidental injury.

SuiteSolution – SelectSolution Level

With the SelectSolution add-on to any Assurant insurance plan, you get all the SecureSolution benefits plus a critical illness expense benefit. Adding this to any Assurant insurance plan will provide $2500, $5000, or $10000 (your choice) in the event of life-threatening cancer, heart attack, stroke, renal failure, coma, organ transplant, loss of sight, loss of hearing, loss of speech, or paralysis. A critical illness add-on to any Assurant insurance plan can really help you out in a time of sudden need.

OneDecreasingDeductible

With the OneDeductible Assurant insurance plan, your deductible will gradually decrease over time if you don’t have any claims on your policy. You have to elect a higher deductible, and there’s a waiting period before your deductible will begin decreasing but a full outline of just how the OneDecreasingDeductible works would take another five pages and is beyond the scope of this article. Note that you must elect to make this plan HSA eligible for your deductible to gradually decrease.

We’ve gone over a ton of options relating to Assurant insurance in this article, and it’s probably a little overwhelming. Assurant insurance offers more options to its clients than any other insurance company in Georgia, and for that reason it’s exceptionally important that you work with an agent to get your Assurant insurance plan.

Now that you know how the plans work, get a free, instant Assurant insurance quote on our Georgia insurance quote page! There’s no obligation, no cost, and the quotes are instant. And remember, if you ever have any questions about Assurant insurance, or any other insurance, Georgia Insurance Options is here to help!

Which Assurant Insurance Plan is Right For Me? is a post from: Georgia Insurance Options

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United Healthcare is one of the biggest and best known insurers in the USA today. Their individual division, Golden Rule, is responsible for insuring individuals and families who don’t have insurance through a group plan. For ease of reference throughout this article, please note that when we say UHC insurance, we mean United Healthcare insurance, and that their individual division goes by the name Golden Rule.

There are a variety of UHC insurance plans you can choose from when you’re getting private health insurance. Let’s go through each UHC insurance plan one-by-one and look at the benefits of each.

UHC Insurance Plan One: Copay Select

The first UHC insurance plan we’ll look at is the robust Copay Select. This is a plan structure you’re probably very familiar with by now: you select a deductible of $500, $1000, $1500, or $2500. Once you meet that deductible, this UHC insurance plan will pay 80% of your bills until an additional $2000 comes out of your pocket. At that point, this UHC insurance plan will begin to pay 100% of your bills.

Doctor’s office visits are handled by a $25 copay with this UHC insurance plan. Well child care and immunizations (for children 6-18) are covered with that same $25 copay, but labs and x-rays performed outside of the doctor’s office are subject to the deductible (which means you’ll pay for that service out-of-pocket under this UHC insurance plan until you’ve met your deductible). With this UHC insurance you’ll pay $15 for generic prescriptions, and (after a $100 prescription deductible) $30 for preferred and $60 for non-preferred medications.

The verdict: This UHC insurance plan is for the people who want the best of the best and don’t care about cost. The $500 deductible plus a few optional benefits (discussed later) make this UHC insurance plan one of the strongest available on the private market – but it comes with a strong price tag, too.

UHC Insurance Plan Two: Copay Saver

UHC insurance plans are all like this: a great plan, and then a more stripped down “saver” version of the same plan. The Copay Saver UHC insurance plan is identical to the Copay Select with the following changes:

• There’s a $3000 out-of-pocket after the deductible instead of a $2000 out-of-pocket
• You can only select a deductible level of $2500
• Outpatient x-rays and labs are only covered if performed within 14 days of surgery or medical confinement – a gap that severely weakens this UHC insurance plan
• $35 copay instead of $25, and each person on the plan only has two visits per year
• If you go to the ER with this UHC insurance plan but aren’t admitted, you’ll have a $500 copay to contend with
• There are no preventative care benefits with the Copay Saver UHC Insurance plan, but you can add them on again later.
• Several outpatient procedures aren’t covered – listing them all is beyond the scope of this article, but they’re outlined in the policy brochure available for download at the free health insurance quote page.
• There is no name-brand prescription drug coverage, only $15 generics

The verdict: I strongly recommend against this plan. The gaps in coverage are too great to justify the savings on monthly premiums. If you really want a more affordable copay plan, then instead of this UHC insurance plan check out the Autograph Share 80 Humana Plan.

UHC Insurance Plan Three: HSA 100

HSA 100 is the number two most-loved UHC Insurance plan according to client satisfaction surveys. With it, you’ve got your choice of deductible ($1150, $1900, $2900, $3500, or $5000 for individuals; $2300, $3850, $5800, $7500, or $10000 for families). Under this UHC Insurance plan, once you meet that deductible the rest of your expenses for the remainder of the year will be paid at 100%. Prescription drug costs also apply to the deductible, and this UHC insurance plan is HSA eligible. The preventative benefits aren’t great unless you add the preventative care package, which is cheap and very robust.

The Verdict: the second best UHC insurance plan you can get, and a great price tag, too. If you’re in love with the HSA concept then this UHC insurance plan is the one for you – otherwise, hold out for Plan 100.

UHC Insurance Plan Four: HSA Saver

It’s set up again with a standard UHC insurance plan and then a stripped-down saver version. Again, the coverage for this UHC insurance plan is identical to HSA 100 with the following exceptions:

• Outpatient x-rays and labs aren’t covered unless they’re within 14 days of surgery or confinement under this UHC insurance plan.
• Doctor’s office visits aren’t a covered expense, a huge gap in this UHC insurance plan.
• Emergency room fees are covered normally if you’re admitted to the hospital, but with this UHC insurance plan if you’re not admitted then you’re limited to $250 per person per year in benefits.
• Outpatient prescription drugs, adult preventative care, and childhood immunizations are all not covered under this UHC insurance plan.

The Verdict: I don’t recommend this plan – the gaps in coverage are just too great.

UHC Insurance Plan Five: Plan 100

When it comes to UHC insurance, Plan 100 is where it’s at. This is the most popular UHC insurance plan by far and enjoys the highest customer satisfaction rating of all UHC insurance plans.

Plan 100 has a choice of a $2500, $3500, or $5000 deductible. These are individual deductibles, and the family deductible is always twice the chosen individual deductible. That means that even if you have twenty children, if you have the $2500 deductible level then your entire family’s medical bills for the rest of the year will be paid at 100% once the family’s medical costs reach $5000. Everything applies to the deductible – doctor’s visits, prescription drugs, hospitalizations, everything. Well care for the kids up to age five is covered at 100% before the deductible (in other words, under this UHC insurance plan it’s free). 

The Verdict: This plan is not HSA eligible, so if you love the HSA concept then you’ll like HSA 100 better. Personally, I prefer Plan 100 for the more competitive price and the fact that this UHC insurance plan has more optional benefits (discussed later) available.

UHC Insurance Plan Six: HSA 80

This UHC insurance plan is identical in every way to HSA 100 in terms of what’s covered. The deductible levels are the same, the coverage is the same, everything is the same – the only difference is that this UHC insurance plan pays 80% once you meet the deductible instead of the 100% that HSA 100 pays. Once $3000 comes out of your pocket after the deductible is met, then this UHC insurance plan will pay 100% of your medical costs. 

The Verdict: This is the only “budget” UHC insurance plan I’m comfortable recommending to any of my clients. There aren’t any gaps in coverage – it’s just a little cheaper and your benefits are a little slower to kick in. If you’re on a budget and don’t like the Monogram Humana Plan, then this is what you should have.

UHC Insurance Plan Seven: Saver 80

The cheapest UHC insurance plan is, of course, the one with the fewest benefits. Saver 80 has deductible levels of $500, $1000, $1500, $2500, $3500, and $5000. Once you meet your deductible, this UHC insurance plan will pay 80% of your medical costs until another $3000 comes out of your pocket. Then, this UHC insurance plan will pay 100%. 

This plan has some pretty hefty gaps in coverage, though:

• Doctor’s office visits aren’t covered
• Outpatient x-rays and labs are only covered if performed within 14 days of surgery or confinement
• Outpatient prescription drugs aren’t covered (this alone makes this UHC insurance plan not worth having)

The Verdict: Plan 80 is only a few dollars more, so if you’re really on a budget then that’s where you should be looking. I would shy away from Saver 80

UHC Insurance: Optional Benefits

There are a number of optional benefits available for add-on to some UHC insurance plans. Let’s look at them one-by-one:

UHC Insurance Preventative Care Package:

Note: this benefit isn’t available with the Copay Select plan. 

The preventative care add-on gets you free well-child visits up to age 18, free childhood immunizations, free mammograms, free pap smears, and free PSA tests (all one per year). Also, after a twelve-month wait, adults can get preventative care for just a $35 copay. This is a no-brainer, a great add-on to any UHC insurance plan.

UHC Maternity Insurance:

We go over this one in pretty great detail at How Maternity Insurance Works, so we won’t re-hash it here. Just keep in mind that this benefit isn’t available with either HSA 100 or HSA 80 – most people like to add this to their Plan 100.

UHC Prescription Drug Card Benefit:

This one is available with Plan 100 and Plan 80 and it allows you to get any generic prescription for only $20. Name brand drugs can be had for a $50 copay, but you’ve got to meed at $250 per year, per person deductible first.

UHC Supplemental Accident Benefit:

This one isn’t available with the HSA plans, but if you add it on to any other UHC insurance plan you’ll get first-dollar coverage up to $500 for the treatment of an injury resulting from an accident. This is an awesome add-on to any UHC insurance plan, it’s super cheap, and can save you a bundle when you need it.

UHC HSA Hospital Indemnity Rider

With the two HSA plans, you can add on a hospital indemnity rider to help protect you against major hospitalization expenses before you’ve built up cash in your HSA. Basically, on the third day of hospital confinement, this UHC insurance add-on will pay you a lump sum of cash to help offset the hospital costs. There’s a one-time additional premium payment of $40 ($150 family), and the benefit will pay $1500 ($3200 family) if the hospitalization occurs in the first month of coverage. The benefit then slowly decreases until finally it disappears at month sixteen. This is a great add-on to a HSA eligible UHC insurance plan because it provides significant, early-on protection and buys you time to build up your HSA.

Now that you’ve learned more than you ever wanted to know about how UHC insurance plans work, you’re probably dying to know how much they cost. Well, Georgia Insurance Options has you covered there, too. Head up to our free, instant Georgia health insurance quote page where you’ll receive an instant, personalized proposal telling you just how much you can save and how you can get protection for your family today!

Which UHC Insurance Plan Is Right For Me? is a post from: Georgia Insurance Options

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When it comes to individual insurance in Georgia, Humana is one of the best choices you can make. Each and every Humana plan offers excellent coverage, and there’s really no such thing as an unaffordable Humana plan. Let’s go over each Humana plan one by one and see what each one has to offer.

Humana Plan One: Autograph Total HSA

The first Humana plan is called the Autograph Total HSA, and this particular Humana plan comes in two flavors (integrated and non-integrated prescription deductible). The Autograph Total HSA Humana plan has a set deductible for the individual (for single person coverage) or for the family ranging from $1500 – $5000 ($3000 – $10000 for a family). Once that deductible is met, then this Humana plan will pay 100% of your medical costs for the rest of the year. 

With the integrated prescription deductible, any prescription drugs you buy will chip away at that total deductible. With the non-integrated prescription deductible, all of your prescriptions are handled with a discount card, meaning a percentage of your prescription costs are knocked off. The Autograph Total Humana Plan with the discount card also has a slightly different deductible structure ($2000-$5200 individual, $4000-$10400 family). Of these two, I strongly recommend getting the full prescription benefit offered by the Autograph Total Humana plan with an integrated prescription deductible.

Also, it’s worth noting that once the Autograph Total Humana plan has been effective for 90 days, everyone on the plan can get a routine annual physical, mammogram, pap smear, colorectal cancer screen, chlamydia screen, and transvaginal ultrasound totally free of charge. Child wellness visits up to age five are also free, and immunizations from age six to eighteen are free as well under this Humana plan.

Finally, as the name implies, this Humana plan is HSA (health savings account) eligible. 

The verdict: this Humana plan (with the integrated prescription deductible) provides the best combination of comprehensive coverage and affordable premiums on the market today. I like this plan for anyone ready to ditch the office visit copay.

Humana Plan Two: Portrait Unlimited 80

The second Humana plan is the one that probably looks a bit more like what you’re used to. With this Humana plan, you’ve got a $35 office visit copay ($50 for specialists), and then your medical deductible of either $1000 or $2500. Once you meet your medical deductible with this Humana plan, Humana will pay 80% of your bills until an additional $2000 comes out of your pocket. At that point, this Humana plan will start to pay 100% of your bills.

When it comes to prescriptions, this Humana plan divides things into four tiers. Tier one prescriptions are your basic generics (you can often get these at Wal-Mart for $4) and cost $15 if you can’t find them cheaper elsewhere. Tiers two through four are subject to a prescription deductible of $500 (you can buy this deductible down to $0, but it’s not really worth it). Once you’ve met the $500 prescription deductible under this Humana plan, tier two drugs (high-cost generics and brand-name drugs) have a $35 copay, tier three drugs (higher-cost brand name drugs) have a $55 copay, and tier four drugs (biotechnology drugs, self-administered injectables) have a 25% copay up to a maximum out-of-pocket of $2500 (then, this Humana plan will pay 100%). 

This Humana plan is the sort of health insurance that most people have at work and are most comfortable with. However, the vast majority of people will never take advantage of the unlimited office visit copays offered by this Humana plan – and that means that they’re paying for a benefit that they’re not using. 

The verdict: Get this Humana plan if you’re not ready to ditch the office visit copays yet, but be aware that you’re going to pay slightly more than you would for other any other Humana plan.

Humana Plan Three: Autograph Share 80

This Humana plan is the budget-conscious version of the Portrait Unlimited Humana plan. Here, you’ve got the $35 doctor visit copays ($50 for specialists), but under this Humana plan each family member only has six copays per year. The seventh visit onward will be billed to your medical deductible (either $5000 or $6000). Once you meet your deductible, this Humana plan will again pay 80% of your bills until you have another $2000 come out of your pocket – then, this Humana plan will pay 100%.

Prescription drugs are handled just like the Portrait Unlimited Humana plan, but the prescription deductible choices are $500 and $1000 instead of $0 and $500.

The verdict: This Humana plan is right for someone who really wants that office visit copay, but is on a tighter budget. However, if you’re looking at this Humana plan, then you’re almost certainly going to be better off with the Autograph Total Humana plan.

Humana Plan Four: Monogram

The fourth and final Humana plan is the Monogram. This is the lowest-cost Humana plan available, making it very attractive for the most budget-conscious shoppers. With the Monogram Humana plan, you have a $7500 medical deductible. Once that deductible is met, this Humana plan will pay 100% of your costs. Additionally, you’ve got a $1000 prescription deductible. Tier one drugs still cost $15 and aren’t subject to that deductible, but under this Humana plan tier two drugs are $40 and tier three drugs are $65 after the prescription deductible is met. Tier four drugs are still a 25% copay to a maximum out-of-pocket of $2500.

Child wellness services up to age five, routine annual physicals, routine immunizations from age six to eighteen, routine pap smears, routine mamograms, routine colorectal cancer screens, routine transvaginal ultrasounds, and chlamydia screening tests are all paid at 100% before the deductible with this Humana plan, meaning that they’re totally free. The only catch is that you must wait ninety days to take advantage of these benefits.

The verdict: The lowest-cost Humana plan still has comprehensive benefits, but they won’t kick in until quite a bit of medical expenses have already been incurred. This is a great plan if you don’t have room in your budget for the Autograph Total.

Optional Beneifts: Make Your Humana Plan Shine

You can add a few optional benefits to your Humana plan to really beef it up. First, consider adding a Supplemental Accident Benefit (SAB) to your Humana plan to protect you more completely against accidental injury. With this benefit added (for about $8-$12 per month extra), you can have the first $500 or $1000 of your medical bills resulting from the emergency treatment of an accident paid in full, regardless of what your deductible is. So if you trip and break your wrist, and you’ve added a SAB to your Humana plan, the first $500 or $1000 worth of care will be paid in full at no additional cost to you.

You can also add dental insurance to any Humana plan. We talk about the dental available with any Humana plan in great length over at our full dental coverage article.

Lastly, getting life insurance bundled with your Humana plan is as easy as can be. There are no additional questions, no physical exams required, nothing – if you’re approved to get a Humana plan discussed above, then you’re approved to get term life insurance through Humana as well. However, I recommend against this for two reasons: one, since this is a “non-med term” policy, it’s slightly overpriced. And two, tying your life and health insurance plans together isn’t a great idea – rate increases are much more common in the health insurance world, and you’re not going to keep your individual health insurance when you enter the Medicare years. Because of that, I recommend getting your life insurance through a company that makes life insurance their primary focus. Don’t worry, as an agent, I’m able to help you with that, too!

Now that you’ve seen how each and every Humana plan works and you’ve got a good idea of which one you think you want, head over to our free, instant Georgia insurance quote page and find out just how affordable these plans really are!

Which Humana Plan Is Right For Me? is a post from: Georgia Insurance Options

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“Is health care the same as health insurance?”

This question is making health care the hot-button issue these days, and it’s also making health care the most misunderstood thing around. There’s a major difference between the two, and we’re going to take a short look at what makes health care the target of so much attention in Washington today.

The short answer: health insurance is what pays for heath care. Health insurance, held by individuals or groups, is a system into which the policy holder pays so that when a medical problem arises there’s someone to pay the comparably larger bill, making health care the recipient of health insurance dollars and provider of medical care.

Now, a lot of people lately are mixing up universal health care and universal health insurance – but these are two vastly different things. Universal health insurance refers to a system in which absolutely everyone would be able to get health insurance on a guaranteed-issue basis, regardless of pre-existing conditions. The result of this is that costs would rise for insurance companies (because those insurance will have to pay the medical bills of less healthy people, and with health care the prices for treatment are obviously higher for the more critically ill) and that premiums would rise across the board for insured persons.

Universal health care refers to extending health care coverage to everyone, making health care the step-brother of health insurance in a way. Universal health care is related to universal health insurance, but that doesn’t make health care the same as health insurance by any stretch.

Here at Georgia Insurance Options, we strive to bring impartial views on industry trends and to correct misconceptions such as this without bias. While I publicly neither support nor decry universal health insurance or universal health care, I realize that our current political climate has made health care the issue on everyone’s mind. I hope that this short article has made this issue somewhat more understandable and has answered the question that we set out to address: “Is health care the same as health insurance?” While they’re related, and are becoming more and more intertwined at the governmental level, for now we still have a private system, making health care the realm of the doctors  and insurance the realm of the agents and insurers.

If you have any questions or concerns about this article, or you just want some help making health care the topic of your next talk with your agent, please feel free to contact me. And, since you’re here already, why not make saving on health insurance a priority like you’ve made learning about health care the focus of the past few minutes? You can get a free, personalized insurance quote right here at Georgia Insurance Options – we’re still in a private health insurance system, why not save a little money?

Health Insurance and Health Care – The Difference is a post from: Georgia Insurance Options

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The easiest way to get (and save on) full dental coverage is by bundling it with a new health insurance policy. The vast majority of people in the individual market are overpaying for their health insurance, so it’s a great idea to get your agent to do a little extra shopping and save on both products. 

If you’re looking to bundle your full dental coverage with your Georgia health insurance plan, you’re in luck: the best, and lowest priced, health insurance company in Georgia also offers very affordable full dental coverage. Humana One is an excellent insurance company in Georgia (and very reliable – I’ve personally written Humana One policies for my fiancee and her sister, so you know I must believe in them), and their full dental coverage option is very nice. Let’s take a closer look at it:

Preventative services (oral exams, routine cleanings, x-rays, sealants, and topical fluoride treatment) are paid at 100% before the deductible – in other words, they’re free. You have no out-of-pocket cost for these services – now that’s full coverage dental!

Basic services (emergency exams, pain relief, thumb sucking appliances, space maintainers, composite fillings, oral surgery, routine extractions, non-cast stainless steel crowns, and denture repairs/adjustments) and major services (root canals, periodontics, crowns, inlays, onlays, getting dentures, denture relines, and removable or fixed bridgework) are paid at 50% after the deductible. That deductible is $50 for an individual or $150 for a family. So, for example, if you have a root canal you’ll pay $50 then half of the remaining bill. In the world of full dental coverage, this is an excellent deal!

You’ll also get a 20% discount on all your orthodontist work so long as you visit a participating dentist, and most dentists are in this network. Lastly, this full coverage dental plan will pay for 50% of your teeth whitening services after your deductible and up to a $200 lifetime maximum.

Now, this is a full dental coverage plan, but there is an annual maximum benefit of $1000. This means that Humana will pay according to the guidelines above, but they’ll only pay $1000 of benefits per year. On the face, this doesn’t sound great, but full dental coverage in the private market always has caps like this. It’s about in line with what you’ll find anywhere else.

Now, you should have your agent check up on your health insurance plan once in a while to make sure that you’re still getting the best coverage at the best rates. The market shifts constantly, and there’s no harm and no cost to have your agent make sure that you’re still ahead of the game. If you’ve recently had your agent do this and you’re happy with your health insurance, but still want full dental coverage, then you might want to look into standalone full dental coverage.

If this is the route you want to go, then I recommend going with one of AHCP’s full dental coverage options. Option one is the AHCP Saver Dental, which has a $1000/year maximum, a $25 deductible, covers 80% of preventative work, 40% of basic work, and 20% of major work. As you can see, the loss of coverage when compared to the Humana plan is huge, especially when you consider that the two plans are almost the same price.

Option two is the AHCP Comprehensive Dental, which is more of a full dental coverage plan. Here, we have a $1500/year maximum, a $50 deductible, coverage at 100% for preventative services, 80% for basic services, and 50% for major services. This is a much more comprehensive full dental coverage option, and is only very slightly more expensive than the Humana full dental coverage.

The one thing that really pushes the AHCP Comprehensive Dental plan above and beyond is the fact that, so long as you had prior dental coverage, there’s no waiting period for any services. The Humana full coverage dental plan has a six month waiting period for basic services and a twelve month wait for major services. The AHCP Saver Dental has a flat twelve-month waiting period for all services. But, if you’ve just left a job with full dental coverage and have proof of that coverage, then the AHCP Comprehensive Dental plan will kick in immediately with no waiting periods whatsoever.

That, in a nutshell, is what full dental coverage looks like in the private market. As with any insurance plan, I strongly recommend that you talk to your personal insurance agent to help figure out what plan is best for you. Now that you know what the market looks like for individual full dental coverage, why not get a free full dental coverage quote and see how much you could be saving on your insurance?

Full Dental Coverage in Georgia is a post from: Georgia Insurance Options

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1. Should you buy health insurance from an agent, or directly from the company?

This one’s easy: use an independent health insurance agent. The rates are the same since they’re set by law, and agents don’t charge any sort of “broker’s fees” or anything to use their service. Agents tend to know a lot more about your options than your average call center employee, and they’ll work with you for the life of your policy.

2. What are the top five health insurance companies in Georgia?

Based on my personal experiences (level of client service, ease of application, claims payment record, etc.), I’d say that the top five individual health insurance companies in Georgia are:

1. Golden Rule (the individual division of United Health Care)
2. Humana
3. Assurant
4. Aetna
5. Kaiser Permanente

Each company has its quirks, of course – Golden Rule is great if you’re in perfect health, but they love to issue riders. Assurant is more expensive, but they are more lenient in their underwriting. Aetna will decline anyone with three prescriptions. Humana doesn’t offer maternity benefits, and Kaiser requires you to stay within Kaiser facilities with most of their plans. Every company is different.

3. Can I still get COBRA if I was fired?

In most cases, yes. There is a provision in the COBRA law that says you are ineligible for COBRA if you were “terminated for gross misconduct,” but that has never been tested in court. Generally, if you leave a company (either voluntarily or involuntarily) and that company stays in business and keeps the group plan that you were on in force, you can get COBRA.

4. Is there such a thing as emergency maternity coverage?

No. If you’re already pregnant, no major medical insurer will issue a policy to you. Now, there are some guaranteed issue policies that will cover you, but you must be extremely careful with those – oftentimes, you’ll either end up paying more for the policy than you would for the pregnancy, or you’ll get stuck with a bill that the insurer will weasel out of. Never purchase a policy like that without consulting with an agent, preferably an independent agent who can compare it with true major medical plans.

5. How do I get my pre-existing conditions covered with an individual health insurance policy?

Depending on the condition, it’s possible that you can just apply for coverage and have it covered. Things like high blood pressure, cholesterol, and most allergies aren’t generally excluded from coverage under individual health insurance policies (however, the rates to cover these conditions may be higher). If you have a more serious condition, like diabetes or Crohn’s Disease, your options are more limited. In Georgia, there’s no state risk pool, so if you’re above the income level for Medicaid then you’re not eligible for state assistance. Your best bet is to find employment with benefits, or, if you’re self employed, talk with an agent about going on a small group plan. That’s a tricky option, but it can be done. There are some guaranteed issue plans in Georgia that will cover pre-existing conditions, but like with question four, you must be extremely careful with those. You can wind up losing a lot of money if you’re not. 

6. What does maternity insurance cover?

Maternity insurance covers the costs associated with a normal pregnancy. Depending on how your specific maternity benefits are structured, you may either have a set amount of money to apply to maternity costs or your maternity costs may apply to a separate deductible. It’s worth noting that true emergency c-sections are covered by your normal health insurance plan.

7. What do I do when my COBRA runs out?

When your COBRA eligibility runs out, you can do one of two things. You can either purchase an individual policy, or you can elect to use a HIPAA conversion option. With HIPAA conversion, the health insurance company that administered your COBRA plan will switch you over to an individual plan, and you can’t be turned down for coverage. HIPAA conversions aren’t available until you have used up your entire COBRA eligibility period.

8. How does my deductible work?

Your deductible is the amount of money in medical costs you’ll be responsible for before your insurance company starts picking up part of the bill. If you have a copay plan, your copays generally will not apply to the deductible. Once you meet your deductible, then (depending on your plan) your insurance company will either pay 100% of the rest of your bills, or you’ll pay a small percentage until you reach your out-of-pocket limit. That small percentage is usually 20%, but some plans do increase that amount.

9. How did the new stimulus package change COBRA?

Previously, if you wanted to go on COBRA then you had to pay 102% of your health insurance premiums. That came as a shock to many people who went on COBRA, because they were used to paying only a portion of the full premium while their employer picked up the rest of the tab. Now, for the first nine months of COBRA eligibility, you’ll only pay 35% of your premiums and your former employer will pick up the other 65% (they’ll be reimbursed in the form of a payroll tax credit). At the end of those nine months, things go back to the way they used to be and you’ll start paying 102%.

10. What’s the best life insurance option for me?

Most people are best served with simple term life insurance. Get a policy that’s guaranteed renewable so that you never have to worry about being uninsurable, a face value that will provide for your loved ones (don’t forget to pay off debt and account for lost income when you’re figuring out how much you should get), and discuss the various riders available with your agent. In my humble opinion, variable life, universal life, and whole life are just not worth it for the vast majority of people. Term is simple, term is easy, and term is what you need. There are a ton of life insurance options out there, and with all the riders available you can really customize your term life insurance to fit your needs.

Bonus!

11. What does “no-stone-unturned” quote mean, anyway?

I get asked this one a lot, so I thought I’d toss it in there. I’m an independent agent, so when you come to me with a health or life insurance question I work with a bunch of different companies to make sure you’re getting the best deal on the market. Instead of just sticking you with an easy-to-issue policy, I leave no stone unturned to make sure that when I run a quote and write an application with you that I’m doing what’s in your best interest. 

Did I miss any burning questions? Anything you’re absolutely dying to know? Then feel free to comment on this post, use the contact link at the top of the page to email me, or just call me up at 404-660-1020 and I’ll be happy to answer any questions you might have. Who knows, your question might make it into the next edition of this article! Or if this cleared up all of your questions and you’re ready to see how much you could be saving on your insurance, then head to our free insurance quote page and get a no-obligation, personalized quote!

Reader’s Choice: Top Ten Health and Life Insurance Questions is a post from: Georgia Insurance Options

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This economy is rough, no doubt about it. Lots of people are suddenly finding themselves laid off, unemployed, and without the group health insurance benefits they had come to rely on. The transition out of the active job market can be rough, and the last thing most people want to think about is finding new private health insurance (not to mention private health insurance that is also affordable health insurance)! Unfortunately, that’s one of the first and most important things you’ll have to worry about.

The first thing to do is to figure out if COBRA health insurance is right for you. Since we’ve discussed how to do that at length in another article, there’s no need to repeat the entire topic here. If you’ve read that article and determined that you need to look for affordable health insurance on your own, then read on.

You’re probably used to group health insurance, but now you’re looking for private health insurance – and those are two very different animals. There are a few key differences between the two types of insurance that you’re going to want to be aware of:

• A private health insurance policy with the same benefits as a group policy will be more expensive than that group coverage. This is unfortunate, but it is a reality of private health insurance. This isn’t to say that private health insurance can’t be affordable, but you should be ready to either pay a little more for the same coverage or investigate a somewhat higher deductible.
• Group insurance is, by law, required to provide certain maternity benefits. Private health insurance is not bound by that same requirement, so maternity benefits aren’t automatically included. Check out our article on how maternity benefits work in the private market for more details.
• If you have any pre-existing medical conditions (you’ve had cancer or open heart surgery in the past, currently have Crohn’s disease, currently have diabetes, etc.), your options for private health insurance are going to be severely limited. In this case, COBRA is probably your best option.

If COBRA isn’t right for you, then your next step is to think about how long you’re likely to be unemployed. If your prospects for employment look good and you think you might be back in the workforce in six months or so, then a short-term health insurance policy might be right for you.

However, if you think it’s going to take more than six months to get back into the workforce, or if you are considering taking advantage of your newfound unemployment to explore the possibility of becoming self-employed, then a normal full-term private health insurance policy will be your better option.

The sudden loss of income that comes with unemployment means that finding an affordable health insurance plan is important to your budget. However, it’s very, very important to remember the following: an affordable health insurance plan can still provide comprehensive benefits. There are cheap health plans that offer limited benefits, leaving gaping holes in your coverage – avoid these at all costs! Remember, that plan that seems too good to be true probably is – the ten bucks a month you can save on your premiums by buying a limited benefit plan will quickly be wiped out when you find out you need surgery or major medical treatment that your limited benefit plan won’t cover.

Now, you’ve learned about the difference between private health insurance and group health insurance, you’ve seen how to determine if COBRA, short-term medical, or full-term health insurance is the best choice for you, and you know that you need to make sure to buy a comprehensive health insurance plan instead of a limited-benefit policy. There’s only one more thing you need to know before you start looking for your new private health insurance plan:

DON’T HESITATE!

When you find yourself suddenly unemployed, you’re working against the clock. If you immediately purchase private health insurance, so long as you don’t have any pre-existing conditions, your new insurance company will see that you just got off of a group plan and won’t have any trouble issuing you a policy. That’s because they know that if one insurance company had you as a client, then you’re probably okay to be a client of theirs, too. However, if you wait too long (about three weeks) to purchase a private health insurance policy, you’ll have what’s known as a “gap in coverage.” When you go that long without health insurance and then go to buy a new private policy, your new insurance company will generally make you pick a policy effective date 30-45 days from the date of your application. That way, they’ll have time to review your medical records and make sure that you’re an “acceptable risk” – a process that can be avoided entirely by not having a gap in coverage in the first place.

Now that you know the most important points about moving from a group to a private health insurance policy, the last step is to contact an independent insurance agent and work with them to find the best policy for your needs. Let that agent know that you’re newly unemployed and that finding an affordable health insurance policy is important to you, but that you don’t want a limited benefit policy. Since independent agents represent many health insurance companies, you’ll have a lot of options open to you. Your agent will know the best ways to narrow them down and help you find the policy that’s right for you!

I know that finding private health insurance when you’re unemployed is a hard thing to think about. It’s easy to feel like everything is piling up on top of you, and it can get a little overwhelming. However, I’m really glad that you’ve taken the time to read this post and learn more about how to protect your family’s health no matter what. The last step is to get your free health insurance quote so that you can find a plan that will protect you, your family, and your bank account. Don’t worry – I’ve been in your situation before, too, and I’ve already learned from my mistakes. But you can protect your family, even when the economy is down – and I can help!

Finding Private Health Insurance When You’re Unemployed is a post from: Georgia Insurance Options

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1. What’s the deductible?

This should be the first question you ask about any policy. The deductible is the amount of money that must come out of your pocket before your health insurance company will begin paying benefits. So, if you have a $500 deductible, and you get a $750 hospital bill, then your benefits will kick in on the last $250. That first $500 will be applied to your deductible.

Your deductible will have a massive impact on your health insurance premiums. Having a higher deductible will lower your premiums, and having a lower deductible will raise them.

Take care to note, however, that that doesn’t mean you’ll only have to pay $500 dollars and consider that $250 handled. Many health insurance plans have a coinsurance amount linked to an out-of-pocket limit. In fact…

2. What’s my coinsurance and out-of-pocket?

Depending on the company, the “out-of-pocket” limit may also be called a “stop-loss” or “break point,” but these things are all the same. Your out-of-pocket limit is the amount of money beyond your deductible that you’ll be responsible for before your plan pays 100% of your remaining medical costs. The out-of-pocket limit is always paired with a coinsurance amount, which defines what percentage of costs beyond your deductible you’ll be responsible for on any given bill. So for instance, if you’ve satisfied your deductible but have a $1000 out-of-pocket limit with an 80% coinsurance, and you get a bill for $100 dollars:

• The insurance company will pay $80 of this bill
• You’ll be responsible for $20 of this bill
• And that $20 will be applied to your out-of-pocket limit, reducing the balance down to $980.

So, even though the bill was $100 dollars, you were only responsible for $20 because you had met your deductible. With these numbers, if you had medical bills (after your deductible) totalling $5000, you would be responsible for $1000 and the insurance company would pay the remaining $4000. Paying that $1000 would also cause you to reach your out-of-pocket limit, so any additional covered medical bills within your beneift period would be covered at 100%. Out-of-pocket limits are generally locked into various policies, so even if your agent can adjust the deductible it’s common that the out-of-pocket can’t be changed.

One important thing to note is that if you have a high deductible health plan, or HDHP, you usually won’t have an out-of-pocket limit. Once you meet your deductible, your costs will generally be covered at 100%.

3. Is the deductible per-incident, per-confinement, or per-year?

This one is huge. One of the sneakiest ways health insurance companies reduce their risk, and therefore lower their costs and raise their profits, is by defining their deductibles by confinement or incident instead of the standard per-year definition. With most health insurance policies, once you meet your deductible, you’ve met it for the year. Any further medical bills will be applied to your out-of-pocket limit, and then covered at 100% once that is satisfied. This means that if you have more than one incident in a year that causes you to incur significant medical costs, you’ll be covered.

However, if you have per-confinement or per-incident deductibles, things are very, very different.

With per-confinement or per-incident deductibles, every time you have a situation where you require medical attention is subjected to its own deductible. So if you have a $1000 per confinement deductible then have food poisoning in January, a broken arm in March, strep throat in June, a routine OBGYN visit in August, a case of the sniffles in October, and you cut your hand open carving the Thanksgiving turkey, then each one of these incidents is subjected to its own $1000 deductible!! In other words, say the total medical bills related to your food poisoning come out to $800, your broken arm is $750, the two doctor’s office visits together come out to $350, and then the ER visit for the Thanksgiving mishap comes out to $500. That totals up to $2400 in medical bills for the year, which means that $1000 should apply to the deductible and $1400 to the out-of-pocket limit, right? Nope — you’ve got per-incident deductibles, and not a single one of those visits cost more than $1000. That means that with each new medical incident your deductible reset back to $1000, and you never once met it. Every last dollar of those medical bills comes out of your pocket, because the deductible was per-incident, not per-year.

Long story short, deductibles should be per year, not per incident or per confinement, especially if you have more than one person on the policy. MEGA Life and Health is infamous for defining its deductibles by incident instead of by year. Golden Rule’s short-term medical plans also use per-incident deductibles, which is why they’re one of the cheapest short-term medical policies on the market.

4. Do I have an office visit copay?

When you go to the doctor, some insurance plans hold you responsible for the entire sum of the bill (subject to your deductible and coinsurance, of course) while others employ a copay. Basically, when you have a copay, you’re responsible only for a nominal fee to go see your doctor instead of the full bill. That fee usually hovers around $15-$35 for a primary care physician (a family doctor) and $25-$55 for a specialist (an orthopaedic doctor, dermatologist, OBGYN, or other, specialized doctor).

On the face of things, a copay sounds fantastic. Instead of being responsible for the entire cost of a doctor’s office visit, a copay reduces the cost to a predictable amount that is essentially always lower than the full bill. However, adding a copay to your insurance plan is the number two biggest thing you can do to increase your monthly premiums (number one is lowering your deductible). Think about this: how many times a year do you go to the doctor? Most people will say anywhere from one to three visits is average for them. The additional cost you would pay upfront for those one to three visits a year is almost always offset by the amount of money you’ll save off of your monthly premiums by switching to a plan that doesn’t offer an office visit copay. Let’s run the numbers:

• The average cost of a primary care visit is $60; a specialist visit averages about $175
• The average primary care copay is about $35; for a specialist, that’s about $50

So in a year that you went to your primary care doctor twice and a specialist once, you’d pay $120 on a copay plan or $295 for a plan that doesn’t offer copays. The difference there is $175, or a little under $15 a month. In this scenario, it makes sense that if you can save over $15 a month by eliminating copays from your plan, then it’s smarter to be without copays than to include them. I can say with a great deal of confidence that if two plans are identical in every way except that one offers a copay and one doesn’t, then the plan without a copay will always offer savings greater than $15/month in premiums.

If you’re really, really tied to having a copay, then consider asking your agent about a plan with a limited number of office visits covered by copays a year. Most limited-copay plans give you six or so office visits a year covered by a copay, and you’ll be responsible for the full bill after those visits until you meet your deductible. These plans give you a compromise by lowering your premiums but still giving you the comfort of the copay.

5. Do I have a limited period to get diagnostic tests?

After the per-confinement deductible, this is the worst trick an insurance company can pull. With most plans, diagnostic tests can be done at any time so long as they’re medically necessary. This means that if you think you’ve broken your hand, you go to the doctor, have an x-ray, and then find out that you’ve just bruised it, well, no big deal. That x-ray was deemed medically necessary by your doctor, and therefore it was a covered expense.

This changes, however, with some types of health insurance plans. Certain plans allow diagnostics only in a certain time period before and after a surgical procedure or inpatient confinement. For instance, some MEGA Life and Health plans allow diagnostics only fourteen days before and/or fourteen days after a surgery or inpatient confinement. This means that, in our example above, the x-ray would not have been a covered expense because no surgery resulted from it.

That limited window for diagnostics can be a minor pain when dealing with things like hand x-rays, but it can be absolutely devastating when dealing with monitoring a long-term condition like leukemia, or monitoring recovery after major surgery. You have health insurance to cover medical costs, so why would you accept a plan with such a fundamental limitation?

These five questions will give you a great deal of information about your plan by covering the basics (copay, out-of-pocket, and deductible) and will make sure you catch it if the policy includes one of the two most common sneaky limitations (per-confinement deductibles and diagnostic windows) that insurance companies use to limit your benefits. When I sit down with a client, these are always the first five things we go over, because I know that these five points are the most important things they could ask me to make sure they’re getting the level of coverage that they need.

There’s one question that’s not on the list, because it’s the one everyone already knows to ask: what’s the cost? Well, the easiest and safest way to figure that out is to head up to our free Georgia insurance quote page and get a free, no-obligation, no-stone-unturned insurance quote. You’ll be amazed at how easy insurance can be when you work with an independent agent, and shocked at how affordable insurance can be when you have an expert in your corner!

Top Five Questions For Your Health Insurance Agent is a post from: Georgia Insurance Options

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For some reason, people are often reluctant to talk about life insurance. Maybe they think that discussing it means admitting their own mortality. Maybe they think that talking about it makes the possibility of death into a certainty. Or maybe it’s because they’re afraid to admit that the money they’ve made from working hard their whole life won’t be enough to cover their final costs. Whatever the reason, life insurance isn’t often thought of as a fun topic of conversation. And because of that, people push it to the back of their minds, try not to think about it, and hope that their savings account and three bedroom two bathroom house in the city will provide all the assets their loved ones need after they’re gone.

In the early 2000’s, my mother and father lived in a four bedroom two bathroom house on the Satilla River in Woodbine, Georgia and the real estate market was good. My parents were out eating dinner one night and happened to mention, just in passing during a conversation they were having between themselves, how fair their house was from the river. Their house wasn’t on the market, but they got two offers to purchase it on the spot – without marketing it or even listing it! Even though at the time my father was in his late sixties and my mother had just crossed fifty years old, they didn’t worry about final expenses or their debt. If things got too bad, no trouble. The real estate market was good, so if worse came to worst they could just sell the house and cover their expenses by downgrading to a smaller home. In 2005, the real estate market began slipping.

By mid-2006, the real estate market in southeast Georgia had crashed.

Around Thanksgiving 2006, my father started feeling ill.

By Christmas 2006, he started stumbling over words and forgetting things he normally wouldn’t. He didn’t want to worry about it, so he didn’t talk about it. He just pretended nothing was wrong. I guess it wasn’t a fun topic of conversation.

On May 9^th, 2007, my father was diagnosed with cancer of the brain, bone, lungs, blood, and colon. That day was my parents’ 32^nd wedding anniversary, and I still have the journal that my dad wrote in that afternoon.

On July 29^th, 2007, at 12:40 in the morning, my father died. It would take a little while, but before too long we realized that we were in trouble. There was more debt than we had realized, and there were medical bills coming in that his health insurance was doing nothing to cover (which leads me to plead with you again – even if you don’t use me, please use a local independent agent for your health insurance needs, someone you can build trust with and someone who has your best interests at heart). We did everything we could, but things quickly got out of control. My father didn’t have life insurance, and his estate was unmanageable.

This story doesn’t have as sad an ending as it could. That house on the river sold about a month before we would have run out of money and provided my mother with enough capital to stabilize herself and move back to Alabama, where she grew up. But it was a very, very close call, and there’s a lesson to be learned from it. If you expect your savings account to cover your final expenses, then you need to realize that that’s going to mean that those savings are going to be wiped out. If you expect your loved ones to carry the burden, then you have to be prepared for the responsibility of placing that heavy, heavy load upon their shoulders – and you have to realize, like it or not, that no matter how hard they try to feel otherwise they almost certainly won’t be able to help a few feelings of resentment. And if you’re hoping that your non-liquid assets like your real estate, your classic car, or your antique coin collection will provide a source of cash, then you have to consider that those things all take time to sell, that those you leave behind will be likely be too preoccupied to negotiate a fair price, and that it’s truly difficult for your loved ones to sell off all of your possessions when they’re desperately trying to cling to everything that reminds them of you.

Furthermore, while the assets you leave behind may be enough to pay for the cost of your burial, your car payment, and your mortgage, will it be enough to replace the income that your loved ones suddenly find themselves without? And finally, to the folks in their twenties and thirties, don’t think life insurance is only for people in their sixties and seventies. For just a few bucks a month, you could have coverage right now that protects your loved ones in the event of your death, meaning that you can worry about building your career and your life without running the risk of having it all fall apart should a tragedy befall you. Be honest – if you’re twenty-five and newlywed, do you have enough set aside to cover your financial responsibilities and provide for your spouse if something were to happen to you? The answer is probably “no,” and that’s okay. You’re just starting out in life! But that means it’s all the more important for you to protect the integrity of what you’ve accomplished, and the best way to do that is with life insurance.

So, once you’ve realized that you do need life insurance, what next? Well, there are a few major different types of life insurance: term life, whole life, and universal life.

Term life insurance is the simplest, most straightforward type of life insurance. Term life is also the least expensive type of life insurance. Basically, you buy a policy that is in force for a set period of time – a set “term.”If the insured person were to die during that period of time, the policy would pay the entire face value. So, for example, if you purchased a ten year term policy to insure your life and you passed away three years later, the policy would pay the full death benefit to the beneficiary.

When most people think of life insurance, they think of whole life. Whole life provides permanent protection while building a cash value. Premiums are generally fixed along the life of the policy. The cash value of the policy means that, should you need to at any point, you can withdraw money from your policy or even take loans against it, providing you with a small source of emergency funds. All of this is, of course, in addition to the normal death benefit of the policy.

Universal life is the most flexible form of life insurance. Over the life of the policy, you can adjust the premium amounts and payment schedule to better suit your needs at any given time. Universal life policies also accrue a cash value, just like whole life. That cash value allows you to earn a small rate of return based on market rates as well, so you can think of whole and universal life insurance as a low-risk source of very small returns.

So which one is best? Well, that depends on your needs, and a true needs analysis is beyond the scope of this article. The very, very broad brush answer, however is this: if you need life insurance to cover the risk associated with limited time propositions (for example, you want to make sure that if you pass away your kids have enough money to finish college) then term life is probably for you. If, on the other hand, you’re looking for permanent protection that will last for the rest of your life and provide an inheritance for your loved ones, then you need to look at whole or universal life.

To get started with your personalized needs analysis, head up to our term life insurance quote page and let me know a little more about yourself. I believe very strongly in the need for life insurance because of my personal history, and I know that I can help you get the protection that my family should have had. I’m ready to help you whenever you are.

Life Insurance – Why and How is a post from: Georgia Insurance Options

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Insurance might seem like a strange thing to have a passion for, but it’s where my heart lies. Before you put the responsibility for your health and life insurance into my hands, I’d like you to know a little bit about who I am, where I came from, and why I’m dedicated to doing the best job for you that I possibly can.

I’m a graduate of the University of Georgia (go Dawgs!) and proudly hold a Bachelor’s Degree of the Arts in Sociology. At first glance, it may not seem like a sociology degree from the University of Georgia is the most impressive qualification for an independent insurance agent. Perhaps finance, business, or economics would seem more appropriate – but I’d argue that you’d be wrong. The focus of my degree was on quantitative demographic analysis, which means I have spent years crunching numbers to track trends in all sorts of areas. Applying that knowledge to the insurance industry means I not only watch trends as they develop, but I anticipate what will happen in the future. We’ve all heard horror stories about people signing up with a health insurance carrier at a great rate only to see their premiums skyrocket midway through the year. Wouldn’t you want an agent who knows how to track and anticipate that sort of thing? Remember the article on this very website about why you should use an independent agent: you can shop for your own insurance, you can buy direct from the insurance companies, and you can pay a monthly premium. Or, you can use an independent agent, pay the same premiums and no additional fees, and have an expert working for you to select the best policy for your needs. In other words, you can use an independent agent and, at no extra cost, get someone to research all of your options for you and present you with the best ones. Now, doesn’t it make sense that an agent with a college degree in research and analysis is a smart choice?

I’ve worked with insurance ever since graduating from college. As a benefits specialist for a major medical group in the Atlanta, Georgia area, I analyzed and applied the benefits of anywhere from twenty (on a slow day) to one hundred fifty patients every day. In an average week, I would review the health insurance policies of at least four hundred patients. When I say I’m a health insurance expert, it’s not me artificially inflating my credentials: if there’s a policy sold in the state of Georgia, chances are I’ve seen it, I’ve worked with it, and I know just what to expect from it. And I know, from real-world experience, what types of policies work best in what situations. I know what carriers and what networks work best in what geographic areas of our state. And believe me, I know what the consequences of having the wrong coverage can be.

In fact, it’s that last point that led me to leave my position as a benefits specialist for a career in independent health insurance sales, education, and consultation. I lost track within three weeks of starting that job how many people I watched go bankrupt because they either didn’t have the coverage they thought they had or because they thought they could save money by not carrying health insurance. That plan never works – we all get sick, we all have accidents, and we will all incur medical bills. But I wasn’t allowed to say that to our patients, because our golden rule was “We identify benefits, not advise on them.”

Well, privacy laws and personal ethics prevent me from discussing the straw that broke this camel’s back, but suffice to say I saw one too many people walk out of our doors completely broke because they had health insurance that didn’t serve their needs. It wasn’t the fault of our clinic – we followed standard billing guidelines and I never personally saw a charge posted that I didn’t think was fair. It wasn’t the fault of our patients – in almost every case, they had coverage that they thought was more comprehensive than it truly was, and if that wasn’t the case then they honestly believed that they couldn’t afford health insurance. And it wasn’t the fault of the big bad insurance companies – their policies were written and selected by the patients, and claims were paid as promised (most of the time). Health insurance is complicated, and policy contracts are difficult to read. If you’ve never been exposed to them before, they can be completely incomprehensible.

But somewhere along the line, someone forgot to explain to these patients just what was going to be covered and what wasn’t. Someone forgot that you sell a health insurance policy to a living, breathing person with a spouse and a family and a business to run, not a faceless name in a ledger. And so, I took the experience I gathered from reviewing literally thousands upon thousands of policies, left that medical group, and began applying my experience and expertise to filling that gap. And now, I don’t work for the doctors, and I don’t work for the insurance company: I work for you, my client.

If you have any questions about my professional qualifications or affiliations, please use the contact form located on this website to get in touch with me. I’m always excited to speak with new people. A lot of insurance agents like to say that they’re self-employed, but I like to say that I work for my clients. It might seem like a strange decision to trade my one boss for hundreds, but I can’t imagine a more fulfilling profession. So, if you’d like to hire me, I’m always open to an interview! If you want to see how much money I can save you, then head over to my free Georgia insurance quote page and get your personalized insurance quote today!

Know Your Georgia Insurance Agent: Nick Perry’s Biography is a post from: Georgia Insurance Options

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We all know that health insurance is important – without it, we’re open to an unacceptable level of risk from unforeseeable, unavoidable health problems. But we know too that sometimes it can be tough to fit health insurance into our budgets. Trust me, I know – long ago, my family thought that we were spending a little too much money each month and thought it might be a good idea to save by cancelling our family health insurance policy. Well, after a while, my parents realized that perhaps this wasn’t the best idea – my mother hasn’t ever been the gambling sort, and she was worrying constantly about what might happen if one of us got sick without coverage. So my parents sat back down and decided that we’d just skip eating out a few times a month, maybe give up some of the premium channels in our cable package, and perhaps I didn’t really need to be taken to Toys R Us quite so often (I realize now that they made the right decision, but there’s no way you could have convinced me of that then!).

That was probably about fifteen or sixteen years ago. Since then, my parents’ combined medical bills have totaled in the millions of dollars. A fourteen year battle with Ménière’s Disease for my mother and a failed struggle with cancer for my father meant the bills rolled in fast and hard – and we didn’t see the onset of either one coming. Looking back now, I almost have to laugh. The amount we’ve paid in premiums is negligible compared to what the cost of her streptomycin injections and brain surgery would have been out-of-pocket. Paying for health insurance instead of HBO doesn’t seem like such a sacrifice when I realize it bought me a few extra weeks with my dad. The point is, I know it can be tough to find room in the monthly budget for health insurance coverage – but it can frequently be absolutely impossible to find room for those medical bills once they hit you.

We’ve used this example in another article, but it’s a good one that bears repeating. What do you use your car insurance for: to cover your expenses in the event of a wreck, or to cover the expenses associated with oil changes, new windshield wipers, fresh air filters, and a wash and wax every weekend? Of course, your car insurance is there to cover the big things – not the little tiny things like the ones we just listed. But if your car insurance did cover those little things, can you imagine how expensive your premiums would be?

Health insurance works the same way! If you want your health insurance to cover every bump and scrape, then your premiums are going to be higher. If, however, you are willing to take responsibility for some of the minor costs of your medical care, then your premiums are going to be much, much lower. There’s a way to do this, and it’s called a High Deductible Health Plan. Remember the story I told you at the beginning of this article about my own life experiences with the health care industry from the consumer’s perspective? Those bills didn’t come from check-ins with our pediatrician, or from a case of the sniffles. They came from surgeries, tests, and esoteric procedures – and those are the crucial risks you can’t afford to not be protected from.

A High Deductible Health Plan, or HDHP, is defined as any health insurance plan with a single-person deductible of $1100 or more (or a family deductible of $2200 or more) and a maximum out-of-pocket limit of $5600 or more (or a family out-of-pocket maximum of $11200). Usually, however, a HDHP is set up with a straight deductible around $2500 to $5000. You are responsible for your medical costs up to that point – after that, you’re covered at 100% of allowable charges.

What does this mean? Well, first off, it means your premiums are lower. Since you’re assuming more responsibility for the little costs of your personal healthcare, the insurance company doesn’t need to take as much money in the form of premiums to cover that risk.

Secondly, it means that your insurance is covering the things you truly need. If you have a cold, sure, you’re going to have to pay for that visit to the doctor out of your own pocket. The average visit to a primary care physician costs about $60, not including any labs or diagnostics that might need to be done. Think about it though, how many times in the past year have you gone to the doctor? Say you went three times, and each visit cost you that $60 – that’s $180 in doctor’s office charges for the year. So for the year, you’ve spent the same as $15 every month ($15 a month X 12 months = $180). But if you’ve saved $30 a month by switching to a high deductible health plan, then you’re still ahead of the game! Not only that, but you’ve still got quality insurance to protect your assets in the event something happened.

Now, keep in mind, we’re not talking about limited benefit plans. A high deductible health plan isn’t a plan that has a ton of limitations, riders, exclusions, and confusing clauses. The premiums for a HDHP aren’t lower because the plan doesn’t cover cancer, or won’t pay on claims related to high blood pressure – if it’s a covered expense under one of the $1000 a month policies, then it’s a covered expense under a HDHP. The only difference is that you have to meet a higher deductible before your benefits kick in and, usually, that you won’t have a copay for your smaller health care concerns.

There’s one more thing about high deductible health plans that makes them an excellent solution for your health insurance needs: HDHP’s are the only type of plan qualified for health savings accounts.

A health savings account is a tax-advantaged medical savings account. Any money you place into your health savings account is not subject to federal income tax and can be used for qualified medical expenses at any time without federal tax liability. In other words, if you put money into a health savings account and then pay for a qualified medical expense with funds from that health savings account, then that money is never subjected to federal income tax. You can put up to $3000 a year (for an individual policy, or $5950 a year for a family policy) into your health savings account, and those funds roll over year after year after year. So long as you have a HDHP, you can keep depositing money into your health savings account up to the annual contribution limit. If you cancel your HDHP and move to a plan that doesn’t qualify for a health savings account, you don’t lose your money – you can keep taking it out until the account is depleted, but you can’t put any more in. Furthermore, you can take the money in your health savings account at any time even for non-medical expenses, but the funds you withdraw become subject to income taxation and you incur a 10% penalty.

So basically, with a high deductible health plan, you get the same coverage, a lower premium, qualify for a tax-advantaged health savings account, and have more control over your health care dollars. Sound like a good deal?

High deductible health plans are the hottest product in health insurance these days, and it couldn’t be easier to start saving money with one each and every month. Head over to our free Georgia insurance quote page and find out just how much you’re overpaying now and how to put that money in your pocket, not an insurance company’s!

High Deductible Health Plans is a post from: Georgia Insurance Options

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