Individual Health Insurance

Health insurance is a type of insurance where the insurer pays for the medical expenses of the insured when the insured becomes sick due to illness or injury. Today, there are several types of health insurance to choose from. Individual health insurance, group health, worker?s compensation, and government health plans such as Medicare and Medicaid are some of the different types of health insurance plans.

Individual health insurance plays a significant role in the health care system of the United States. It is an ideal option for people who do not have access to job-based coverage. Of the different types of health insurance, individual health insurance provides coverage for an individual or to an individual and their family.

Fee-for-service insurance, managed care plans, open enrollment in managed care plans, association-based health insurance, and high-risk pools are some of the different individual health insurance options available in the market. Compared to group health insurance, individual health insurance is highly expensive. Benefits of individual health insurance are fewer than group insurance.

Individual health insurance plans can be obtained directly from insurance companies. The insurance company to whom you apply will ask you to provide personal information, including your medical history. Based on your health status, the company determines whether you qualify for an individual health insurance plan or not. Once you are qualified, a premium is charged based on your age, income, and medical history.

Choosing an individual health insurance plan is an important decision. You must choose a plan that meets your needs as well as budget. Prior to buying individual health insurance coverage it is necessary to consider several options. It is very essential to compare the coverage and cost of insurance plan as it may vary from company to company. Also, make sure that the selected insurance plan provides the kind of coverage that’s right for you.

Finding an affordable individual health insurance is a bit confusing and time consuming. So it is advisable to consult an insurance agent or a broker who will help you to find the individual health insurance that suits you.

Group Health Insurance

Health insurance is a type of insurance policy in which the insurer provides for the cost of any or all of the health care services. Today, there are many types of health insurance such as fee-for-service, managed care, and more. Health insurance is offered to individuals as well as groups. Group health insurance is designed to meet the health care needs of employees of large as well as small companies. Group health insurance policy provides medical expense coverage for many people in a single policy. Under group health insurance, the cost of premium is spread out among the members of the group.

Group health insurance offers health care coverage for student organizations, religious organizations, employers, professional associations, and other groups. Most Americans get group health insurance from their employer. In most cases, employer pays all or part of the health care insurance premium.

Group health insurance benefits both employee as well as employer. Employees covered by group health insurance plan, get medical treatment quickly with little or no cost. Compared to individual health insurance, group health insurance is less expensive. Another advantage is that no medical exam is required to qualify for group health insurance.

A wide range of group health insurance plans are available to choose from. Fully insured employer group, small employer group, large employer group, health maintenance organization (HMO), self-funded ERISA, group managed care, and preferred provider organization are some types of group health insurance.

Getting group health insurance quote through websites is quite easy. In order to qualify for a group health insurance policy, employer must have at least 2 full time employees on the payroll. While purchasing a group health insurance, it is advisable to seek the assistance of group health insurance broker. Golden Rule Insurance Company, UniCare, Aetna Inc., Horizon Blue Cross Blue Shield of New Jersey, Health Net of California, and Time Insurance Company are some of the leading health insurance companies that offer group health insurance.

Georgia Health Insurance

Georgia health insurance offers medical benefits that cover the cost of treatment incurred in a hospital. The coverage provided is comprehensive which includes doctor visits, hospital stays, emergency, prescription, dental care, and mental health care. It serves families, students, kids, employees, workers, self employed, small and large businesses, and retirees.

For the citizens of Georgia, a wide variety of health insurance plans are available to choose from. Each one varies significantly based on the size of deductible and the benefits covered. Individual health insurance, family health insurance, group health insurance, student health insurance, affordable health insurance, health insurance for children only, and temporary health insurance are some of the insurance plans available in Georgia.

In Georgia, health insurance laws and regulations regarding individual health insurance is different from other US states. The law allows insurers to deny the request for individual health insurance based on pre-existing medical condition and current health conditions.

The state of Georgia has moderate insurance regulation which protects both insurance consumers as well as the insurance company. According to “guaranteed renewability provision”, a health insurance policy regulation, an insurance owner is allowed to renew a policy without considering his/her health status.

In Georgia there is no limit on the premiums that the companies can charge for a health plan. Also, the law restricts that an insurer cannot cancel one?s insurance policy based on their health condition or age. In certain states, children of unemployed parents are denied from getting health insurance policy. Through a plan called Peach Care, Georgia State provides opportunity for such children to be insured.

Before purchasing health insurance, it is necessary to compare the different health insurance quotes. An insurance agent or an insurance broker is the right person to help you in finding a health insurance policy that best suits your requirement. Blue Cross Blue Shield of Georgia, Kaiser Permanente, Assurant Health, Celtic Insurance Company, Time Insurance Company, and United Healthcare of Georgia are some of the leading companies that provide excellent health insurance coverage for the citizens of Georgia.

Health Insurance Facts to Know

How can health insurance help you out? Being an investment, it is imperative that people prioritize this expense along with many other financial responsibilities. Health insurance coverage should be there to support you and your family in times when you need immediate health care. Think of it as a nest egg where you can get funds from to pay for the various costs of medical treatment, hospitalization, medication, and more.

There are various types of health insurance plans that you can obtain, and there is an equally innumerable number of firms that offer such services. It can be a little challenging to choose one that is right for your budget, as well as tailor made to suit your health needs. Note that you don’t have to spend a fortune to be able to get insurance coverage. There are ways by which you can earn discounts and save, while at the same time receiving quality and reliable services from your insurance provider. All it takes is the right knowledge to be able to evaluate your health insurance priorities and lock down your choice of provider.

In line with this, this article presents some interesting statistics that you might want to keep in mind regarding health insurance plans in the United States. Knowing these important notes will help you make a wise decision with regards to choosing a plan for you and your family. Mentioned here is also vital news regarding the direction that the health insurance system in the US is headed.

How many people in the United States are without health insurance? Regardless of how important it is to be covered, there is a significant percentage of the population who has no resources to obtain their needed health policies. As the Centers for Disease Control and Prevention (CDC) reports, about 45 million people in the US have no health insurance. And that translates to roughly 15 percent of the population. The Hispanics have the most number of uninsured children and adults, which is about 32 percent of the total Hispanic population. On the other hand, 19 percent of the total African American population does not have health insurance, and around 10 percent of all whites are uninsured as well.

If you are interested to know, there are specific states that contribute the most to the uninsured adult statistics in the country. If nearly 20 percent of Americans aged 19 to 64 have no form of health insurance, which states significantly add to that number? To be more precise, Texas and New Mexico have almost a third of the total aged 19 to 64 population uninsured. On the other end of the spectrum, Massachusetts has the least number of uninsured adults in that age group, with only about 10 percent accounted by the Kaiser Health Foundation statistics.

How many children in the US are without any form of health insurance? This age group is considered as the minor group, comprised of children aged 18 and below. The CDC stated in a 2007 report that about 10 percent of the total minor population does not have health insurance. That means that there are 7 million children out there who may not be able to get afforded medical treatment. Which states have the most number of uninsured children? The Kaiser Health Foundation accounts that Texas ranks at the top of the list, with about 22 percent of the ages 0 to 18 population having no health insurance. Massachusetts is still the state with the least number of uninsured children, with only about 5 percent having no coverage.

In terms of the performance of insurance companies in the country, which are the ones that write the most number of health policies? As of the year 2007, the National Association of Insurance Commissioners reports ten of the largest insurance firms in the US, with respect to their market shares. Topping that list with approximately 12 percent of the market share is the UnitedHealth Group. Second is WellPoint, Inc, having almost 10 percent of the market share. The third largest with 7.7 percent market share is the Kaiser Family Foundation. Blue Cross, which is among the oldest health insurance providers in the country, ranks ninth, with a market share of 1.7 percent.

On a final note, what does the American government intend to do in response to the ever growing health insurance needs of the country? Among the highest priorities of the new Obama administration is to focus on revamping and further developing the health insurance system in the US. About $150 billion is expected to be allotted for provision of more accessible and more affordable health insurance options for the population. In line with the recession which led to the loss of over 7 million jobs, $25 billion will be used to cover for nearly 65 percent of health insurance premiums for these employees.

To be able to answer to the health needs of children, it is expected that 5 million kids will be granted health insurance, as $87 billion will be for funding state health insurance programs, including the SCHIP or State Children’s Health Insurance, which assists minors from low income families as well. The rest of the funding will be for modernization of medical facilities, including access to records, as well as research for diseases such as cancer, Alzheimer’s, diabetes, and heart conditions.

The Pros and Cons of Group Health Insurance

The health insurance marketplace is certainly challenging, but count your lucky stars that at least you have choices. To that end, this article is going to explore the pros and cons of group health insurance.

Group Health Insurance Pros

Group health premiums are subsidized by the employer. Generally, an employer must contribute at least 50% of the “employee only” premium. As such, if you are the employee, you can likely get a richer health plan for less premium than you would pay in the individual health marketplace. However, the cost to add your dependents to the employer’s plan, may be cost prohibitive. In this case, and assuming that your dependents can qualify, then you may want to put them on an individual health plan.
Group health premiums for large families are the same as for small families; whereas in the individual market, you pay a separate premium for every family member. So, if you have a large family, you may be able to get a better deal by adding them to your employer’s plan. As with any insurance change though, don’t make any changes without consulting with an experienced insurance advisor in your state.
Group health insurance in most states is guaranteed issue – meaning that you can’t be turned down because of pre-existing health conditions. This is a real blessing if you or a family member has a medical condition that prevents you from qualifying for a individual plan. But, this is a double-edged sword. While being guaranteed issue is a huge benefit for those with pre-existing medical conditions, it does come at a price. This one feature alone accounts for most of the disparity between group and individual insurance premiums. Yes, that is right – in most states, individual health premiums are almost always less expensive than group health premiums.
Most group plans cover maternity. So, if you are planning on having more children, you should definitely consider hopping on to a group plan. While you can add a “maternity rider” to individual plans, these riders tend to be expensive, restrictive, and otherwise provide less value than the coverage you can get in a group health plan. That being said, if you are considering having more children, we recommend that you contact a health insurance advisor in your state for advice about what is best for your family. The right answer is different for each unique family.
Economies of scale can benefit employees of large employers. It is true that the larger the group, the larger the risk pool is in which to share the risk which CAN result in lower premiums than are available in the individual health market. However, the guaranteed issue “issue” CAN wreak havoc on this type of plan. For example, a large employer with good benefits tends to retain employees for long periods of time. Eventually, the average age of the group starts to creep up and so do premiums. In addition, people with large medical needs (expensive medical conditions) tend to be attracted to large plans because they are guaranteed issue with good coverage. And so, over time, not only is the group’s average age increasing, but the group is also attracting employees with large expected health costs. This is the dilemma that we see with large health plans like the U.S. auto-makers and even government plans. Eventually, those with lots of medical needs begin to outnumber those with little or no needs and so premiums are driven higher and higher.

Group Health Insurance Cons

Group health insurance can be more expensive than individual health insurance. ln fact, if you don’t factor in the employer’s contribution towards premiums, then individual plans are almost always more affordable than group plans. However, as we discussed earlier, not every one can qualify for an individual plan.
What happens if your employment is terminated (by you or your employer)? Yes, you will likely have some benefit continuation rights (through COBRA or state continuation programs), but these benefits can be very expensive and the term limited. So, eventually, you either have to secure another job with benefits, an individual health plan (assuming you are insurable), or possibly join a government health insurance program for the uninsured (if you are not insurable). Let me emphasize, that you should NEVER be without some form of major medical health insurance. Being without this insurance puts you and your family in serious financial jeopardy. In fact, a recent Harvard University study found that 50 percent of all bankruptcy filings were partly the result of medical expenses.¹ To the same point, every 30 seconds in the United States, someone files for bankruptcy in the aftermath of a serious health problem. Don’t let this happen to you.
Group health insurance premiums are rising faster than individual health insurance premiums. Why? Because most group plans are guaranteed issue and since they accept “all comers”, they tend to attract those with high medical costs. On the other hand, most individual health insurance plans are medically underwritten. This means that the insurance company can say “no thanks” to any application that it deems to not be in its interest. Put yourself in their shoes – would sign a contract to provide $30,000 in annual benefits to someone that was only going to pay $3,000 in premiums (for a net loss of $27,000) if you didn’t have to? Hmm…let me me think about that one. The answer is a resounding “NO!”. Because of this underwriting process for individual health insurance, insurance companies can control their risk and more effectively manage their profitability, resulting in more stable prices.

As you can see, there is no clear cut answer as to which type of insurance is the best. The answer depends on a number of factors and is different for every unique situation. The best advice I can give you as you consider your health insurance options — get good advice from an experienced health insurance advisor.

You Have Been Declined for Health Insurance in California, Now What?

If you are reading this then you probably have been declined for health insurance in the recent past. When you get declined for health insurance it probably has something to do with your medical history. Since California is one of the underwritten states health care companies have the right to declined people for health insurance. Who health insurance company might decline and who it might not all depends on risk assessment using actuarial tables. Anytime when you fill out individual application for health coverage and answer yes on one of the medical questions your application might be manually reviews by one of the underwriters. It is a person who is responsible to reviewing application using actuarial tables. Actuarial tables are statistics done by the insurance companies, hospitals, doctors, researchers that predict the cost of insuring some one with a specific medical history.

Some states like New York, New Jersey and Washington require insurance companies to insure everyone. Those three states do not have medical underwriting and everyone is automatically approved for health coverage. In order to insure everyone with medical history insurance companies increase rates to the point where it becomes un-affordable to most people. What keeps the average monthly premiums low is low utilization of health care. If there are more people with high medical insurance utilization with a specific health insurance company they have to raise the rates for everyone in order to keep up with paying medical claims. That also drives people who do not use health insurance that often to drop health insurance all together and yet driving rates even higher. This leaves no choice for insurance carriers but to drive rates even higher. New York, New Jersey and Washington have highest premiums for medical coverage and a lot of families find health care out of reach.

In California if you have been declined for health coverage you have options. If you out of job or currently on low income you can qualify for Medical and if you have kids they can qualify for a program called Healthy Families. Most states including California have high risk pools that are designed for people who have been declined for individual health insurance. In California this program is called MRMIP. Just the quick search on the Internet will guide to a government website. MRMIP is a program that is managed by the state and your big name medical insurance providers participate in it. Chances are you will be able to keep the same health insurance company if you are already use to them. MRMIP program has limits and it might have a waiting period.

One of the best options might be when it comes to getting the most coverage for your money is through a group plan. In the state of California all group plans by law are required to be a guaranteed issue. That means that there is no medical underwriting. This options requires more work from you. Insurance companies are not just going to let you set up a group plan if you have been declined for individual health insurance. Since insurance companies are required to insurance everyone who is part of the group state requires insurance companies to have rules when it comes to setting up a group plan. Some of the basic requirements change from the insurance company to the insurance company.

The best way to find out is talk to insurance broker. The basics that insurance companies are going to be looking for are that you have to have a reason for starting a group plan other then getting medical insurance. It is illegal to start a group plan just to get health insurance. That means that you have to have a business and that could be anything. To have a group plan you obviously have to have more then just yourself It takes at least two people to start a group plan. All the people that are going to be on the group plan are either have to be the owners of the business or have to be on the payroll. Some insurance companies require either a DE-6 form or six weeks of payroll records. If every one if the owner then you will be required to provide proof of the ownership listing everyone that is going to be on a group plan as the owner. This might not be simple but is is certainly doable and it is definitely worth it if you do not have any coverage and cannot get it on your own.

It is always easier to just blame the insurance company that they have declined you for health coverage. If you have been declined and are looking for health insurance you just have to be more proactive in getting your coverage. Once you work with a broker on getting on the requirements on setting up a group plan then it is forever yours and no one can take that coverage away from you unless you stop paying for it.

How and Where To Get Health Insurance for Low Income Individuals

In the US, reading the statistics of Americans without their health insurance is startling. According to Huffington Post, this 2012, almost 50 million Americans are living without health plans. This is different from years ago. And why does this happen? This is because there are lots of Americans today that don’t have jobs or cannot find stable jobs that can let them have the luxury of paying for their health plans. In some families, paying for their home rent is even a problem. So, is it still possible to secure health insurance for low income families and individuals while in the midst of the crisis? Yes, it is still possible according to experts. We only need to know where to find it.

Health insurance for low income people are actually out there. Unfortunately, some of us know only few of them while other people don’t know how to tap them well. But as we have said, these resources are already here. So in this article we have gathered the most possible sources that we can tap to get almost the same benefits that low premium insurance plans can provide.

Below are the best possible options in place of securing health insurance for low income people.

COBRA. This is the Consolidated Omnibus Budget Reconciliation Act. If you are out of job, you can try applying for COBRA and if you will be eligible you can continue your previous companies’ health insurance through this process. This is better than finding a new health insurance plan but there is a possibility that you may pay higher premium for it.

Workers’ compensation. If you are employed and your job is risky, inquire from your employer if you are under the Workers’ Compensation program. You can have injury compensations if you get injured during your work.

Medicaid. Even if you are employed, better apply for Medicaid especially if you belong to the low income bracket. Medicaid can help you pay your health care expenses or some of it if you can’t afford to pay for it. Medicaid exists through federal and state partnership and was designed to help low income families, disabled and old people with their medical expenses. You can also apply your family to Medicaid because this is an opportunity that your state provides to those who can’t afford paying for regular health insurance plans.

Medicare. This is an option that comes from the government and being administered by the Social Security administration. If you are unemployed or don’t have a regular employment and with a family, you can try enrolling yourselves and your family to Medicare especially if you are getting Social Security benefits. For those who are sixty-five years old or even older, they are most eligible to be under the Medicare programs.

State High Risk State Insurance Pools. All of us do have health problems sometimes and unfortunately when we have pre-existing medical conditions we are usually denied coverage by health insurance companies. If you are denied of such privilege and did not qualify for COBRA while getting health insurance for low income individuals can also be a problem, you can rely on high risk state insurance pools. You can inquire from your city administrators or community hospitals where you can apply for this option. You may still pay premium for the plan but at least this can answer your medical cost even you have pre-existing health conditions.

Short Term Health Insurance Coverage. This is an appropriate option for low income individuals who don’t have regular jobs or just starting to work on their new jobs. This is much like individual insurance policies but in this option you will only be under the coverage for short period of time. You only pay low premium with this one and while you are at it you can find time examining the viability of this insurance company if this could be the right choice for your long-term insurance coverage.

Group Health Insurance. If you are a member of an organization and without the health insurance, you can encourage your group to apply for a group insurance. With this type of insurance, you can choose from various insurance options how you want to be covered. The nice thing about being insured as a group is that you pay lower rates because your premium is scattered among your members. You may not get large benefit from it like what individual insurance plans can provide but at least you are also secured and have something to rely on. If you don’t have a group you can also search for organizations online that accept individuals for their group health insurance.

Group Sharing On Health Expenses. Basically, this is not a type of health insurance for low income people but it is a logical option for those who want financial support during medical crisis. This system works in simple process. You form a group and pool your money and deposit this money to the bank so that you are your own insurance health group. When one of you needed the expenses due to health concerns, the money can be used to support the individual’s medical expenses and he pays when he can be able to work. Religious groups usually do this but this can only be viable if there lots of people who will provide contributions.

With all these given options, providing health insurance for low income individuals is always possible. If all of us would realize the things we can get from these options, we don’t need to worry so much anymore. Getting confined in the hospital or treated with serious injuries without the health insurance is simply unimaginable so the only thing that we can do four ourselves is to rely on these options which equate the benefits provided by health insurance for low income people.

All About Affordable Health Insurance Plans

While consumers search for affordable health insurance, they have price in their mind as the top priority. A general conception among the consumers is that cheap health plans should not be costly-the cheapest health plan available in the market is their target. However, this approach is not good. Sometimes, paying for a cheap health insurance plan but still not getting the required level of coverage results only in wastage of money.

With the implementation of the affordable care act, the reach of affordable health plans is set to increase. Or at least, this is what is believed to be the objective of healthcare reforms. However, lots of consumers are still in confusion about how things would work. In this article, we will discuss some detailed options that consumers can try while looking to buy affordable health plans.

To get a hand on affordable health insurance plans, consumers need to take of certain things. First among them is about knowing the options in the particular state of the residence. There are lots of state and federal government-run programs that could be suitable for consumers. Knowing the options is pretty important. Next would be to understand the terms and conditions of all the programs and check the eligibility criteria for each one of them. Further, consumers should know their rights after the implementation of healthcare reforms, and something within a few days, they may qualify for a particular program or could be allowed to avail a particular health insurance plan. If consumers take care of these steps, there is no reason why consumers can’t land on an affordable health plan that could cater to the medical care needs.

Let’s discuss some options related to affordable health insurance plans state-wise:

State-run affordable health insurance programs in California

While considering California, there are three affordable health insurance plans that are run by the state government. Consumers can surely get benefitted by these if they are eligible for the benefits.

• Major Risk Medical Insurance Program (MRMIP)

This program is a very handy one offering limited health benefits to California residents. If consumers are unable to purchase health plans due to a preexisting medical condition, they can see if they qualify for this program and get benefits.

• Healthy Families Program

Healthy Families Program offers Californians with low cost health, dental, and vision coverage. This is mainly geared to children whose parents earn too much to qualify for public assistance. This program is administered by MRMIP.

• Access for Infants and Mothers Program (AIM)

Access for Infants and Mothers Program provides prenatal and preventive care for pregnant women having low income in California. It is administered by a five-person board that has established a comprehensive benefits package that includes both inpatient and outpatient care for program enrollees.

Some facts about affordable health insurance in Florida

While talking about affordable health insurance options in Florida, consumers can think about below mentioned options:

• Floridians who lost employer’s group health insurance may qualify for COBRA continuation coverage in Florida. At the same time, Floridians, who lost group health insurance due to involuntary termination of employment occurring between September 1, 2008 and December 31, 2009 may qualify for a federal tax credit. This credit helps in paying COBRA or state continuation coverage premiums for up to nine months.

• Floridians who had been uninsured for 6 months may be eligible to buy a limited health benefit plan through Cover Florida.

• Florida Medicaid program can be tried by Floridians having low or modest household income. Through this program, pregnant women, families with children, medically needy, elderly, and disabled individuals may get help.

• Florida KidCare program can help the Floridian children under the age of 19 years and not eligible for Medicaid and currently uninsured or underinsured.

• A federal tax credit to help pay for new health coverage to Floridians who lost their health coverage but are receiving benefits from the Trade Adjustment Assistance (TAA) Program. This credit is called the Health Coverage Tax Credit (HCTC). At the same time, Floridians who are retirees and are aged 55-65 and are receiving pension benefits from Pension Benefit Guarantee Corporation (PBGC), may qualify for the HCTC.

Some facts about affordable health insurance in Virginia

While talking about affordable health insurance options in Virginia, consumers need to consider their rights:

• Virginians who lost their employer’s group health insurance may apply for COBRA or state continuation coverage in Virginia.

• Virginians must note that they have the right to buy individual health plans from either Anthem Blue Cross Blue Shield or CareFirst Blue Cross Blue Shield.

• Virginia Medicaid program helps Virginians having low or modest household income may qualify for free or subsidized health coverage. Through this program, pregnant women, families with children, and elderly and disabled individuals are helped.

• Family Access to Medical Insurance Security (FAMIS) helps Virginian children under the age of 18 years having no health insurance.

• In Virginia, the Every Woman’s Life Program offers free breast and cervical cancer screening. Through this program, if women are diagnosed with cancer, they may be eligible for treatment through the Virginia Medicaid Program.

Some facts about affordable health insurance in Texas

While talking about affordable health insurance options in Texas, consumers need to consider their rights:

• Texans who have group insurance in Texas cannot be denied or limited in terms of coverage, nor can be required to pay more, because of the health status. Further, Texans having group health insurance can’t have exclusion of pre-existing conditions.

• In Texas, insurers cannot drop Texans off coverage when they get sick. At the same time, Texans who lost their group health insurance but are HIPAA eligible may apply for COBRA or state continuation coverage in Texas.

• Texas Medicaid program helps Texans having low or modest household income may qualify for free or subsidized health coverage. Through this program, pregnant women, families with children, elderly and disabled individuals are helped. At the same time, if a woman is diagnosed with breast or cervical cancer, she may be eligible for medical care through Medicaid.

• The Texas Children’s Health Insurance Program (CHIP) offers subsidized health coverage for certain uninsured children. Further children in Texas can stay in their parent’s health insurance policy as dependents till the age of 26 years. This clause has been implemented by the healthcare reforms.

• The Texas Breast and Cervical Cancer Control program offers free cancer screening for qualified residents. If a woman is diagnosed with breast or cervical cancer through this program, she may qualify for medical care through Medicaid.

Like this, consumers need to consider state-wise options when they search for affordable health coverage. It goes without saying that shopping around and getting oneself well-equipped with necessary information is pretty much important to make sure consumers have the right kind of health plans.