Debt Consolidation | Insurance | Financial Planning

Let’s leave the politics of healthcare reform to one side and focus on a proposal to change the law to allow free market competition between insurers in different states. A policy consistently mentioned by the Republican party is to break the state monopolies in the insurance market. Since the 1800’s, the individual states have claimed the sole right to regulate the sale of insurance within their own borders. Each state has asserted the right to license insurance companies and to set the terms on which they can conduct business. This has led to a patchwork of different sets of regulations with each state creating unique laws. In turn, this forces an insurance company to set up separate subsidiaries to trade in each state. No licensed company can sell a policy to someone who has a residence in another state. There was a brief moment in 1944 when a decision of the Supreme Court allowed the possibility of federal supervision. But the lawmakers in Washington immediately changed the law to retain state control. Why is this a bad thing? The national insurance companies have divided up the states between them and choose not to compete against each other. This keeps the number of insurance companies in each state artificially low and, because there is no real competition, premium rates are higher than they should be for weak policy terms.

You are reading this article on the internet. When online, you can buy more or less any product or service across state or national boundaries. Although there are some restrictions, e.g. some states limit your right to import drugs from foreign countries, there is an almost free market where you can search for the cheapest price and buy whatever you need. There is no possible economic justification for retaining this historical privilege for insurance companies. All it does is preserve their ability to maximize their profits at your expense. For example, in Minnesota three insurance companies dominate 80% of the market for health plans. There is no doubt that, if more companies entered the market, the premium rates would fall. During his run for President, Senator John McCain was in favor of free markets for health plans. President Obama supports it and the proposal is in both versions of the healthcare reform bills currently stalled in Washington. But because the Republican party’s only policy is to oppose everything the Democrats propose, it seems even this simple change in the law may be lost. What will the result be? The anticompetitive behavior of the insurance industry will continue and you, the consumer, will suffer.

Could the law change tomorrow and allow everyone access to cheap health insurance wherever it can be found? The problem is that the states have different sets of regulations and compliance leads to different costs. The playing fields are not level. So, premiums are significantly lower in those states which have the fewest consumer protections. It would not be fair competition if people living in Minnesota, which has strong consumer protections, could all get health insurance quotes from states with little or no consumer protections. The only way in which there could be a free market is to have a single set of federal regulations for the sale of health insurance plans. Sadly, the political parties do not want to talk about this even though we would all benefit. In the US, the political elite’s interests do not match the needs of the ordinary citizens.

The advice given by this site is perfectly sound. It really does save you money to shop around and, by using the internet search engine provided here, you can get multiple quotes. Checking through them gives you the best chance of finding the best deal for you and your family. But this site would fail you if it did not take you on to the next question. After you have the policy in place, does it still pay you to shop around? Ah ha! We hear a chorus of, “Huhs”. Well, let’s spell it out. Everything here encourages you to comparison shop, i.e. to get the current prices and pick the one that’s going to give you the best value-for-money solution to your problem. One of the standard ways in which people aim to save money is to take on ever bigger deductibles. Many of the cheaper policies also load you with copayments. So having a policy is only part of the solution if you have the misfortune to fall ill. It’s no longer enough to smile complacently, safe in the knowledge your policy will cover the costs of treatment. You have agreed to self-insure the amount represented by the deductible and/or copayments and out-of-pocket expenses. When you are picking up a percentage of the total cost, it’s in your interest to get the best value. And, guess what? That means shopping around for doctors and hospitals in exactly the same way you found your policy.

By a curious irony, both the insured and the uninsured now often face the same problem: to find prices on the internet for the treatment needed. In the same way you might shop around for an HD TV to replace your old set, you start asking, “How much does this operation cost?” followed closely by, “Where can I find a better price?” A number of doctors and healthcare facilities have begun to cater more directly to the uninsured market and now post their prices online. More importantly, some will negotiate on these prices. The fact you have a policy does not prevent you from taking advantage of this opportunity. But you need to move with care (as always). There is never just one price for any procedure or operation. So many different factors affect price starting with where you live and who the local providers are. The prices will differ depending on whether you ask a hospital, clinic or individual doctor to quote. The root of the problem is often the insurance industry. The companies offer many types of policy and, depending on the volume of business directed to doctors, clinics and hospitals, negotiate different prices for each treatment option. It’s not unusual for there to be ten and more prices for the same treatment depending on who is paying.

So you cut through this arbitrary pricing structure and find the real prices. If you have a health insurance policy, ask your insurer for the provider prices for the networked doctors. The better companies help you find the lowest price treatments. On the internet, there are search engines giving you lists of doctors in your area with the best prices for the treatment you need. Did you know thirty-three states require hospitals publish their prices? Shopping around really can save you money on your health insurance!

One of the more annoying features of modern life is this alphabet soup. You are expected to know what all these letters stand for, iykwim. Even those who are into texting and SMSing can get caught out when it comes to insurance jargon. So here is a simple explanation of the differences between a Health Maintenance Organization (HMO) and a Preferred Provider Organization (PPO) with guidelines to suggest which to buy. Both employers and the private health insurers offer this choice. An HMO is a network of healthcare providers that enters into a contract with insurance companies to provide medical services at a fixed price. This network will include hospitals, clinics and a range of professionals. Usually they are grouped together in a particular part of a city or rural area, offering a spread of coverage across the major medical specialties to all the people living within that area. Because the insurers can bring a guaranteed volume of business to the network, they are able to negotiate quite good prices for the different services. These savings are passed on to you as lower premiums. Even more importantly, service within the network can be free or with only low copayments. But the majority of plans have quite restrictive terms. When you sign up, you have to choose one doctor to be your primary care physician. This person must be an existing member of the network. If your current doctor is not a member, you will have to change. This physician acts as the gatekeeper and he or she must refer you on to specialists within the network. Because the insurers pay bottom dollar, the gatekeepers tend not to refer on unless the problem is really serious. Further, because the network is for-profit, it must see more patients in a day to earn a reasonable profit. You may therefore expect little opportunity to discuss your treatment or explore options. You have only a few minutes and must make the most of that limited opportunity.

PPOs also negotiate contracts with the insurers but the organization of the network tends to be loose. Unlike an HMO, the PPO does not limit you to a single physician. You can see anyone within the network at the standard price. If you go outside the network for specialty advice, you will have to make out-of-pocket payments. So, this gives you more control over the medical care you buy but, as a result, costs more.

So the choice comes down to two key factors. How much can you afford? You will save money if you opt for an HMO. There are fewer copayments and out-of-pocket expenses to cover, but you have less control over your treatment. Secondly, how well do you get on with your current doctor? If you have a good relationship, but he or she is not a member of the relevant HMO, do you want to loose this trusted physician? If not, go with a PPO. Obviously, as a private buyer, you need to get health insurance quotes from as many insurers as possible. Only then can you see which represents the best value for money. But do not forget that health insurance quotes are just ballpark numbers. You will need to read the small print on the plans offered before you can make the overall decision.

Washington likes acronyms when it comes to lawmaking and this new law is no exception. This is the Genetic Information Nondiscrimination Act (GINA) and this November sees it finally come into force. Because it affects both employers and the insurance industry, this has been a hard-fought change and was only signed into law last year. Now it should prevent you from obvious discrimination. Sadly, it does not rule out discrimination by backdoor means. If an employer overhears you talking at the water cooler or routinely surveys local news including the obituaries, it is legal to use this information. But, overall, you should find some improvement. It covers two different situations with the same type of result. Firstly, it prohibits employers from asking you to go through a genetic test or making genetic information the basis of deciding whether to hire, promote or fire you. Secondly, it prohibits insurers from testing or demanding genetic information about you or your family in deciding whether to offer you coverage, in setting the premium rate and level of the deductible, or continue the cover.

Let’s be completely clear. The law does not care who is asking for the information If it is going to be used for either purpose, the asking is unlawful. If this happens to you in an interview, it may pose a dilemma. If you cite the law and refuse to answer, the interviewer may think you a troublemaker with something to hide and not hire you. That you can complain to the local Department of Labor and take satisfaction in seeing a civil penalty imposed, this does not replace the offer of employment in these difficult economic times. The temptation to answer will be strong. But when it comes to insurance companies, you must stand up and assert your rights. If the insurer persists, report to your state’s Department of Insurance. This will put the insurers at risk of losing their license to sell policies in your state. This is a big stick to wave in defense of your rights. More importantly, the Department can order the insurers to offer you insurance on regular terms which protects you. Once employed, it’s just as important to stay alert. The operators of group health plans are known to offer incentives like lower premiums to employees who answer a questionnaire including questions about their family medical history. Obviously, insurers want to know if there is a risk of serious diseases like cancer. You might be more at risk if there is a history of cancer in your family. Everyone should refuse to answer.

The reason for the law is important. Genetic tests are increasingly important in diagnosis and deciding on the best treatment for medical problems. Too many patients were refusing these tests because they feared discrimination should their employers or health insurance companies learn of the results. The medical profession strongly supported this change in employment and insurance law. Doctors want to be able to make an accurate diagnosis which means using the best available tests. With this law in place, your rights should be protected. If you are considering a change in insurer, remember you cannot be discriminated against when the companies give you health insurance quotes. They must always be able to prove their quotes are close to the average for people of your age, gender and general social background. If you think you are being victimized, complain.

If nobody is willing to take you on the insurance plan or you can’t get any type of coverage due to your health condition such as heart attacks, strokes, epilepsy or other serious illnesses don’t give up to early. Don’t think this is the end and please do not feel left alone or useless. There is just some other variant waiting for you. But, as a matter of fact, before you get used to some other idea of “insurance” substitution you should know that if you stay for 63 days without any type of insurance it will be very problematic to get one afterwards. Here are some plans that you may use but please read carefully through them.

Plans with discounts: Insurances can hit your wallet with a wooden stick if you are not careful about them. That is why these so-called plans with discounts started to appear. You can get info on the plans with discounts of insurance company’s websites as they are known to satisfy needs of every client they have. Anybody will find something suitable for himself there. Get your consultation daily on internet’s best websites dedicated to insurance and health. But let us introduce you to what is named: plan with discounts. This plan will never pay for hospital – so don’t even count on it. But you will receive your discount – from 20 to 60% off the original payment you are supposed to make for it. Some plans will even offer you a discount as big as 80% so that definitely helps. But don’t get happy before you find out more precisely about these discounts and how you can receive them. It is important to talk to your doctor about this plan. Healthcare institutions always have their own staff that is willing to help you with any of your questions so do not hesitate to ask anything you like. These insurance plans are not your regular insurance but they can substitute it good though won’t work together with a real insurance.

Indemnity plans: These plans are to be paid at the event of an accident or some misfortune that happened to you. It doesn’t have to be something serious but regular illness and hospitalization may count as well. What one has to know about this insurance “substitution” is that there is a premium that you have to pay that will surely cover all of the members of your family. If you suffered some case of sickness, you can file a claim and the company will compensate you, giving you the money back. Let’s view such an example – you were taken to hospital and it costs quite a lot. Let’s say it is 600 dollars per day but that is the treatment you need to receive. Most companies will do the following – they will show you the most they will pay for your treatment, giving you a chance to add to the sum from your own pocket. This is not good but that is the most they can do for you.

Health insurance plans are always the best option but for those who cannot obtain such a plan there is always an alternative. What you must know is that it is easy to trip and fall into some trap with anything – whether it is health insurance, discount plan or indemnity plan. For you not to suffer a case like this please use resources or health insurance quotes to find out more. We wish you to stay healthy!

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