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Health Care Reform Updates for 2011.  January 1st we have some changes in the non-grandfathered plans, some companies are letting you know about the added benefits with a premium increase letter.  These increases in premium are happening to support the increased benefits provided by the health care reform.  The changes will allow you to have wellness exams (annual physicals) included with your plans.  This will include any tests that are needed to be run in conjunction with your annual exam.  This includes mammograms, pap, colonoscopy and other items that we would usually have some out of pocket expense for.    This is a good thing keeping healthy, the down side is your monthly premiums may be going up.  It is always good to check to make sure that you are at a competitive rates.  You will need to stay with your current company if you have any issues currently in progress – unfinished tests, diagnosis and still under a doctors care.  If you have an older plan – grandfathered plan, you may be better off staying with that plan instead of changing to a newer plan, as you may see premiums higher than what you currently have.  We are happy to show you what your current options are.

There is never any added costs for working with an insurance broker, and they are a valuable resource to help you get the best policy for your specific situation.  Let us assist you with your finding the best plan.

I totally understand the challenge to find health coverage for you and your family. I have had the similar problems when I have been between jobs. I have tried to get advice on what to do for my family. One time I had asked my property and casualty agent what I should do, he did not provide me any guidance. He told me to pick something from Unicare, oh, and please input my agent number when you do. I really felt bad about the lack of help that I could find. This is one of the reasons I though I could help where I had trouble finding assistance.

I know many people have been asking me how is this new health care bill going to affect my health insurance?  I do not think we have a full picture of all the effect of this bill on health insurance.  The first big milestone is the allowing all children to obtain medical coverage without any preexisting conditions starting in September this year.  To prepare for this we have some early warning that most health insurance companies are preparing for rate increases scheduled for July, these are to be 25% plus, some even at 50% plus to the premiums we are at today. They are planning to remove all rate guarantee protection at that time as well.  What this means to you, is that health insurance costs will go up and they can fluctuate as they need to support the claims vs premiums.  If you have not locked in your rate protection before July you are in for a tough ride with a company that will honor rate guarantees prior to July 1st.  This would be something to get from your company to know if you are protected.  I know of only one company that will honor the rate protection for up to 36-months and they have it in writing.

I would recommend that everyone who is wondering if they should have a review of their current coverage, now is the time to take a look at that and ensure that we get a plan in place to control your costs through the next three years.  I believe we will see things get much worse before they stabilize.  If you just let it ride with the hopes of your premium staying controlled, then you may find your new premium unaffordable.  Talk to us to get your rate controlled with a 36-month lock that they will honor through all the changes.  Do it sooner rather than later to not miss locking in your rate. Be prepared and control your premiums, before you find things out of control.  Talk to us soon.

I wanted to share an Article I wrote on EzineArticles about an affordable health insurance approach that I currently use with my customers to help them keep their premiums low.  This method I currently use on my family.  I am not sure how many agents are doing this, I know if you buy on the internet without an agents help, it is hard to figure out this approach alone.

http://ezinearticles.com/?Health-Insurance—An-Affordable-Approach&id=3494485

In today’s busy world people love to use the internet to shop for almost everything. We buy groceries to cars using the internet to find the best prices and research the products. Many people today use the internet to purchase health insurance. There are a few things to know about health insurance prices, they are regulated and they same policy from the internet and from an Insurance broker will be the same price. This is good news for the consumer this makes is easy to compare plans and premium costs via the internet. This can be a great way to go if you are healthy and you know what you want, but it can be a large problem for someone who has some medical issues to find the best plan and company for their particular situation.

The Insurance Agent/Broker can offer you the personalized advice and guidance you need to navigate through obtaining health insurance. To get this personalized service there is no effect in the premium cost, so why would you shop on the internet alone for insurance. The personalized service you will get will save you a lot of time when you need to ask a question or need help. They will know who you are when you call. You will have a person who you know to call if you have a question. If you call an 800 number of one of those internet services to buy insurance, you will be talking to a different agent every time you call. You may even need to call the insurance company and have no one on your side to help you work an issue.

The great advantage of working with an Insurance Broker/Agent is growing a relationship together. They know you and you know them so it will save you time if you need help. The insurance agent has support people in the particular insurance company to help them if your issue has not been resolved through the normal channels.

The Insurance Agent/Broker has something you do not have when you are applying for insurance online is access to the underwriter guide and to underwriters to do a pre-screen before you apply to see if the insurance company can accept you and what your rate up may be. The insurance company has the final word on your premiums, but you will be able to get an estimate with the help of an Agent. Using an insurance agent can save you some frustration and guidance that can help lead you to an approach to saving you on your premiums.

I would suggest you build a relationship with your insurance agent to help you through any personal insurance needs. They will be a good contact for you in the event of any issues and can help you through finding the best solution for your needs. Do not go it alone, find an agent you trust to help you. The best complement for any insurance agent is a referral, so ask around to find one of your friends if they know if an agent. We are always able to help you if you need a trustworthy agent. Call us today.

Help your neighbor not a big company; use an insurance broker/agent.

Some of my most recent customers have been caught up in this question; Do I stick with Cobra or Individual insurance? It is not an easy answer, but if you have a medical condition, you may not have an option to move away from Cobra until it is exhausted. This would be if you have had a heart attack, cancer, diabetes or even if you are over the height and weight requirements to get insurance. If you have one of the un-insurable conditions, then you will need to complete your Cobra to be eligible for the Texas Risk Pool. Your agent will be able to help you determine based on your particular situation.

If you and your family are healthy with no major medical conditions, then you can choose. This week with President Obama signed an extending the federal subsidy for Cobra for an additional six months relieving the financial issues surrounding Cobra. I guess that seeing that Cobra is similar to a short term policy with a known period, I would suggest to my clients to move to an individual policy as soon as possible. There are very few situations in which I would recommend putting a client on a short term policy.

The risk with any of these policies is that they coverage does come to an end. This would mean in today’s health insurance industry, they would not be able to continue treatment on anything that the previous insurance company did not complete and the patient recover fully from. In the future this may not be an issue with the health care reform. This can be a very expensive mistake by the customer to keep Cobra, and find himself in this situation where there was no coverage available to complete his recovery. In Texas we are fortunate to have the Texas Risk Pool, but this is much more expensive than an individual policy.

I had a customer today withdraw his application for individual insurance coverage for his family to continue with Cobra benefits. I tried to make him aware of the exposure with staying with Cobra, but he told me so it is no different than being on a group policy. Well, it is a close comparison to this, with a group you have additional features from your employer that can allow you to stay employed and continue your health coverage with short and long term disability. On Cobra once it is done, you are done.

I still believe that moving away from Cobra as soon as you can is the best move to protect you for the long haul. This can be because you have become self employed or if you have not found another company to work for with group health insurance benefits. Something that is permanent as long as you pay the premiums offers you the best protection. The government incenting Cobra on the American people can leave some uninsured and un-insurable when Cobra is exhausted.

I have run into a customer recently that had a heart attack on Cobra. She was healthy individual with good build and never thought that they may have a heart condition. They ended up on Cobra needing two stents put in, and she had contacted me when her Cobra benefits were almost over – 18-months. I had to tell them that they will not be able to get individual insurance and the only major medical option available to them is the Texas Risk Pool. The customer said to me if they had known that they may be in a situation where they would be forced to the Texas Risk Pool, they would have got off Cobra as soon as they could. They felt that because the government was discounting the rates this was the way to go. There is as well a corporate knowledge that you always sign up for Cobra if you lose your job. For this customer the Texas Risk Pool was in the $500+ a month for a $7,500 deductible plan. The customer said they could not afford it and I now believe they are living without any coverage. It seems very wrong, but this is the way it is.

As a licensed insurance broker I would always recommend replacing Cobra a soon as you can if you are able. I am even starting to believe that group plans are not the best way to go if we leave our health care system be able to deny insurance to customers. Maybe this will change in the future, but today I would move away from Cobra as soon as you can.

I bet you are wondering how much this costs for this HMO dental plan. They do ask that you keep the plan in force for only 6 months. The monthly premiums are below:

• Individual: $39.95/month**
• Plus One: $57.95/month**
• Family : $79.95/month**

**Plus a onetime application/group membership fee of $55.00

**Only a 6-month commitment required

If you are interested in learning more about the plan you can contact us about it at (512) 807-9594. We will be happy to email you a copy of the complete list of dental codes and copays for the plan. I know this has helped many Texans get their mouth feeling better. We look forward to helping you smile again.

Individual Health Insurance and Pregnancy:How can you find a way to get insurance coverage to help pay the costs to having a baby? Careful planning is necessary to help limit your financial exposure for this joyous event. If you can plan this event, this would be the best way to go to maximize your coverage. I would recommend consulting with your insurance agent about your options. I will share how we work with our clients when they are ready to start a family.

The customers I talk with come to me for help in one of the three situations:

1.Preparing to have a baby – looking for ways to minimize cost

2.Pregnant now with Individual Health Insurance that does not cover maternity

3.Pregnant with No health coverage – What do I do?

I will share my approach to the customers in this situation.

Preparing of Pregnancy – Review Your Current Health Coverage

The best way is to ensure you have an individual insurance policy in place before you become pregnant. This may not cover costs associated with pregnancy, but will give you protection for a complication with pregnancy. If you take time to discuss with us we will suggest plans in your area that can offer enhanced coverage for pregnancy. We have a few products that will cover pregnancy and some that will offer the prenegotiated rates for the insurance company and a maternity deductible. This approach will have some cost savings for the client.

I am Pregnant Now with Individual Health Insurance that does not cover maternity

If you are prepared and do have health insurance in place and do find out that you are expecting, then we have some suggestions to help reduce your out of pocket expense. We typically recommend in the first trimester to prepay/negotiate the costs with the doctor and hospital. We have seen prepaying can offer substantial savings. When you are pregnant, you cannot change health insurance companies as you not have an un-insurable condition. This mean you and your spouse will be denied when applying for health insurance due to the fact that you expecting a baby. Maybe President Obama will fix this problem with the health insurance changes. You will need to keep you existing policy to cover you for any complications with the pregnancy.

If you are in this situation where you do not have maternity coverage, you could be looking at a medical bill $8,000 to $17,000 depending on geographic location. This can be negotiated some and prepaying helps as well. I usually recommend a guarantee issue product along with your current health insurance plan that is an indemnity plan that will pay a set dollar amount for an event. This plan I have been recommending has no preexisting condition waiting period, so you can add this plan when you will need it. The highest end plan has a couple of benefits that will help offset some of your expenses. It will pay a $1,000 on hospital admission, and $1,000 a day for hospital confinement benefit. If you stayed in the hospital for 3 days, they would pay you $4,000 benefit. This would help pay a good portion of the costs. You can view the benefits of this plan from Homeland HealthCare. Call us with any questions.

I am Pregnant with No Health Insurance

I talk to customer in this situation every day. They just found out they are pregnant and do not have any health coverage and they are looking for help. I listen to their situation and try to offer suggestions to them. If they are in a place in life where they are not earning much money, they could be eligible for Medicaid to help them with their pregnancy. This may be a good option for some to get the coverage they need and make this very affordable for them, and let them focus on have a healthy baby.

For others, they are earning too much and they are trying to decide how to handle this from a financial perspective. I would still recommend the guarantee issue product for them to help offset the costs. The plan does have some benefit for doctors visits, 5 per year and they will pay $75 for each visit and the above mentioned benefits. This may provide some relief to those that have been surprised by pregnancy. This plan will even pay some benefit for newborns in the first 30 days. You can see the benefits of the Homeland HealthCare Product. Call us with any questions.

Final Thought

Your Pregnant and need advice, talk with us or your insurance agent about your options. This should provide you some advice to help you relax and focus on being healthy. Sometimes your insurance agent does not have the answer you want to hear, but they should be a trusted source for you to help you navigate health insurance options through your pregnancy.We are here to help you.

Your medical history plays the role in determining your insurability. All insurance companies today have a list of deniable conditions that automatically will result in a decline of coverage from them. You can as well be declined for a combination of conditions that can make you fall into the same category of declinable by the insurance company. Deniable conditions for example are build (height/weight), diabetes, cancer, heart attacks, heart issues, bi-polar, and sleep apnea just to name a few.

This is a common issue of people that have some medical history or a few medical issues concurrently find out individual health insurance is different than group plans. While the individual was on a group plan they never would know that their previous diagnosis could be problematic for them in the future. You can avoid this issue of being denied coverage by working close with your personal health insurance agent. The difference between the Group Plan and Individual Plan is that the Group Plan needs to accept all the employees even with medical conditions, the individual plan does not. This is one thing that President Obama is trying to address.

Why do people move from group to individual coverage? This change occurs when changing jobs, or losing ones job for example. Some employers do not offer group health insurance and would require the individual to obtain their own health coverage. Before you apply, consult with you agent and you can have them do a underwriting prescreen for you. It is always best to approach it this way to prevent the insurance company issuing a denial.

What Can You Do if You have Been Denied Coverage?

I would recommend you talk to your health insurance agent if you have not already talked with them. They will be able to listen to your particular situation and recommend the best options for you. The best option would be to obtain coverage from your State High Risk Pool. If that is not an option for you there are limited benefit plans available, but beware these are not health insurance. Careful consideration should be taken before you purchase a limited benefit plan and ensure you understand what you are purchasing.

In Texas, we have the Texas Health Insurance Risk Pool (TRP) if you are not living in Texas check to see if your state has a Health Insurance Risk Pool available that will offer coverage to anyone who has been denied coverage by an individual insurance company. This is major medical coverage that can be obtained by individuals once they have exhausted all COBRA benefits offered. This is required before you apply for your Texas Risk Pool coverage. The Texas Risk Pool premiums are determined by your age, location (zip code), and tobacco use. These are current Texas Health Insurance Risk Pool Rates.

Limited Benefit plans offer an indemnity plan (set amount per situation) to help you with medical expenses, and they are NOT HEALTH INSURANCE protection. The major medical plan provides protection to a lifetime Max of $2,000,000, the limited benefit plan is limited coverage. This option may be a good solution if you were not able to afford the Risk Pool costs and you are looking at going without any protection. Please be sure you understand what you are buying and what limitations the policy has. There may be a pre-existing condition waiting period for 12 month. Be sure that you look carefully. We have found a guarantee issue plan that has no preexisting conditions clause. This allows for this guaranteed issue product to offer coverage to everyone without a waiting period to get things covered. If you are interested in this product you can check out the Homeland Health Care link and the AWA NPX 1-4 products. Before you purchase please consult with us or your agent to ensure this is the best option for you.

Bottom Line

Your personal health insurance agent will offer you the best solutions for your particular situation. Do not go it alone without your agent’s advice and guidance to help you through this stressful time of having to find individual health insurance for you and your family. The strength you will get with working with an experienced insurance agent has the knowledge to help you navigate through the health insurance system. They will provide a level of personalized service you cannot get through purchasing through a web site link. They will know your situation when you call and you will be able to talk to the same person anytime you have a question or need help.