5 Basic Facts About Health Insurance Policies In A Bad Economy

Many health insurance plans have specific exclusions that keep you from getting benefits for anything that could have been covered by Workers' Compensation or similar laws. Now, re-read the last sentence.

COULD HAVE BEEN COVERED!?

That's right. Most people who work for themselves and even some small business owners do not cover themselves with Workers Comp.

If you are not required by law to have Workers Compensation, there are insurance plans that will cover you on and off the job, 24 hours a day.

Independent contractors (1099s), people who run businesses out of their homes, professionals, and others who work for themselves don't usually take advantage of the tax laws that are available to them.

Many people who pay for all of their own costs can deduct their monthly insurance payments from their taxes. Just doing that can lower your net out-of-pocket costs for a good plan by up to 40%. Ask a professional accountant if you qualify, or visit the IRS website for more information.

All real insurance plans have some kind of internal controls that help them decide how much to pay for a certain service or procedure. There are two main ways to do it.

-Scheduled Benefits

Many plans, including some that are aimed at self-employed and independent people, have a clear schedule of how much they will pay per doctor's office visit, hospital stay, or test. People usually think of "Indemnity Plans" when they see this structure. If you are given one of these plans, make sure you get a written list of the benefits. It's important to know about these limits right away because once you reach them, the company won't pay you anything more.

-As usual and as expected

"Usual and Customary" means that the rate of pay for a doctor's office visit, procedure, or hospital stay is based on what most doctors and facilities charge for that service in that area or a similar one. The highest level of coverage on most major medical plans is "usual and customary" charges.

You are probably looking for a health plan if you are reading this. People shop every day for everything from food to a new house. During the shopping process, the buyer usually looks at the value, price, their own needs, and the market as a whole. Considering this, it's very strange that most people never ask how much a test, procedure, or even a visit to the doctor will cost. In a health insurance market that is always changing, it will become more and more important to ask these questions of our doctors. Asking price will help you get the most out of your plan and lower the amount you have to pay out of pocket.

Almost all insurance plans and benefit programmes work with medical networks to get discounted rates. In broad terms, networks are made up of doctors, hospitals, and other medical facilities that agree in a contract to charge less for their services. The network is often one of the most important parts of your programme. Discounts can be anywhere from 10% to 60% or even more. Different medical networks offer different discounts, but if you want to keep your out-of-pocket costs low, you need to look at the list of doctors and hospitals in the network before you join. This is to make sure that your local doctors and hospitals are part of the network and to find out what options you have if you need a specialist.

Ask your agent what network you're a part of, whether it's a local or national network, and then decide if it fits your needs.