Don’t Get Caught Without Health Insurance Know the Facts

When it comes to preparedness, health insurance will always be your best bet. Because one cannot easily determine when he or she will need medical help, having a reliable health insurance plan will be very helpful in covering the costs of treatment and care. There are many factors one must consider before signing up for a health insurance policy. Since there are different types available, one needs to carefully assess his needs and also manage his allotted budget.

What do you need to know about health insurance? How can this help you and your family in times of need? Read on to learn about interesting facts about policies and coverage, so you can make the informed choice when buying health insurance for you and your family.

o In the United States, it has been reported that nearly 45 million Americans have no form of health insurance whatsoever. This accounts for about 15 percent of the total population as of the year 2006. As mentioned by the Centers for Disease Control and Prevention (CDC), among the total population of Hispanics, 32 percent were uninsured. This is compared to 19 percent of all African-Americans, and 10 percent of all whites who do not have health insurance coverage.

o Of all the uninsured persons in the United States, about 7 million were minors, below the age of 18. This accounts for about 10 percent of the below 18 population of the country, as reported by the CDC. According to the new health insurance plan proposed by the administration of President Barack Obama, about $87 billion of government funds will be allotted for the improvement of state insurance programs, as well as the SCHIP, or the State Children’s Health Insurance Program. This will expect to reduce the number of uninsured children in the country by up to 72 percent, giving minors better opportunities for health care.

o More on the uninsured: what percentage of the population ages 19 to 64 (non-elderly) do not have health insurance? The Kaiser Health Foundation reports that approximately 20 percent of adults in this age group are without any form of health insurance, as of the year 2007. Which states have the most number of uninsured adults? The same site reports that New Mexico and Texas top the list, with about 30 percent of people in this age group without health coverage. On the other hand, Massachusetts has the least uninsured adults, which only comprise about 10 percent of the total age group.

o Which states have the highest number of uninsured children, who are from ages 0 to 18 years old? As the Kaiser Health Foundation statistics present, Texas has about 22 percent of children without health insurance, with Florida following with 19 percent. Massachusetts also has the least percentage in this category, with only about 5 percent of children without health coverage.

o According to the Insurance Information Institute (III), about 34 percent of the nation has their own private health insurance plans, while nearly half of the population rely on government funded insurance programs. To be more specific, 19 percent are under MediCare, 15 percent under MedicAid and SCHIP, and another 12 percent from other select public insurance providers.

o The National Association of Insurance Commissioners reported in 2007 the insurance companies who have written the most premiums as of that year. Topping the list were UnitedHealth Group owning 11.7 percent of the market share, and WellPoint Inc. Group, with 9.75 percent of the market share. Kaiser Family Foundation follows in third with 7.7 percent market share in that same year. Among the oldest health insurance providers in the country, Blue Cross, is the ninth on the list, with approximately 1.72 percent of the market share.

o When comparing individual insurance plans and group insurance plans, you can expect to save more if you purchase multiple policies. However, according to some people who choose individual policies, they are able to tailor their plans to be in tune with their specific health needs. You can learn more on the pros and cons of these two types of health insurance when you consult with an insurance agent.

o During the economic recession in the United States, there were millions of people who have become unemployed. However, thanks to the new administration and the initiatives of President Obama, these employees can still reap the benefits of their health insurance plans, as the government intends to allot $25 billion. These will cover for as much as 65 percent of each employee’s health insurance premiums, according to a report by Reuters.

o Speaking of employment, even the insurance industry is responsible for contributing to the number of jobs available for people in the United States. In two of the largest states in the country, hundreds of thousands are able to find work through many opportunities provided by the state. In California, about 300,000 employees are in the insurance sector, while in Texas, the figure has reached above 216,000 as of 2006. Other states included among the top in the list are Florida, New York, Pennsylvania, and Illinois.

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Know More About Types of Health Insurance Plans in Florida

Individual, families, groups, and businesses need customized health insurance plans to ensure that they have to spend minimum out-of-the-pocket money for their healthcare needs. With the implementation of healthcare reforms, the options for buying health insurance are widened.

With the advent of internet technology, the concept of transparency of price is gaining momentum. Insurers in Florida health insurance are facing a compelling need of price transparency when they offer health insurance quotes to their clients. At the same time, application time and waiting time for health insurance has reduced significantly as compared to earlier times.

Types of health insurance plans offered in Florida
Apart from State and Federal governments’ sponsored program including Medicare, Medicaid, etc., there is an option of buying health insurance from private companies. Like many other states, health insurance plans in Florida are offered to the residents in traditional format. These could be classified as:

1. Individual health coverage
2. Family health coverage
3. Group insurance
4. Student health coverage
5. Dental health insurance
6. Low cost insurance
7. Low-income families insurance
8. Short-term insurance
9. Small business insurance

Companies offering health insurance Florida
Below is the list of health insurance companies offering health insurance to the residents of Florida:
• Aetna
• AMS
• Assurant
• Avalon Healthcare
• AvMed Health Plans
• Blue Cross and Blue Shield
• Celtic
• Cigna
• Coventry
• Golden Rule
• Humana One
• IAC
• Solera Dental
• Vista

Types of health plans offered in Florida

A lot of consumer end up having discount coupons, which sometimes are termed as health plans; however, it needs to be understood that these discount coupons are not insurance. To buy affordable health plans in Florida, consumers need to equip themselves with proper knowledge about the same.

Traditional categorization of health coverage in Florida offers indemnity and managed care health plans. Indemnity health plans have the insured file claims for reimbursement. While managed care health plans allow the providers to file claims for the insured person.

Managed care health plans are further categorized as HMO, PPO, and POS.

Impact of the Affordable Care Act on insurance in Florida
• 290,000 small businesses in Florida will be offered tax credits for offering health coverage to their employees.
• Medicare beneficiaries in Florida will be automatically mailed a check of $250 to defray the cost of their prescription drugs.
• Early retirees will be offered reinsurance options.
• Uninsured Floridians with pre-existing condition will have a huge boost with $351 million federal dollars made available to Florida starting July 1 to provide coverage.
• Like many other states, for the first time ever, Florida will have the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status.
• 8.8 million Floridians will no longer have to worry about lifetime limits on the coverage.
• Around 1.1 million individuals will not have to worry about getting dropped from coverage when they get sick.
• Children in Florida will be able to stay with their family insurance policy till the age of 26 years.

Costs involved in a health coverage plan in Florida

It is important to understand types of costs involved in a health coverage plan to make sure that Floridians have assessed everything before they finalize a health plan. We talk about the types of costs involved in a health coverage plan:

Premium-premium is the amount of money to be paid on monthly basis. Premium is the main cost that a health plan constitutes. It could vary from person to person and in plan to plan. It mainly depends on the age, gender, and health status of a consumer applying to get health coverage.

Deductible-deductible is the second major cost involved in a health plan. It is the amount of money that a consumer pays before the insurer actually begins to pay for the coverage. With higher deductibles, premium costs are reduced.

Coinsurance – coinsurance, as the name explains itself, is the amount of money that the consumer agrees to pay in percentage of the total cost of medical service after the deductible has been paid. Generally, it is usually 80/20 of the total value where 80% of the cost is paid by the insurance companies while the 20% is by the consumer.

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Why You May NOT Want to Use Your Health Insurance for Counseling

Why not use your health insurance for counseling? Isn’t that what it is for?

Perhaps.

But using health insurance for mental health services is a little different than other medical issues. Sometimes mental health issues are not covered by your health insurance. Once you use your health insurance for mental health, you will have a mental health diagnosis on file – a mental health disorder/mental health illness must be on the insurance claim in order for insurance to pay for treatment. This will be in your permanent medical record.

Of course you want to consider using your health insurance for counseling, but there are some good reasons for you to consider why you may not want to use your insurance for counseling services.

Why doesn’t my counselor accept my health insurance?

Many counselors choose not to accept health insurance for very good reasons. They want to focus 100% of their time in treating you. If they accept health insurance, there is a lot of extra work involved in accepting insurance, in addition to agreeing to work for a discounted fee. The counselor may spend hours on the phone getting benefit information, authorizations, or following up on claims payments. The counselor has to wait a month for payment from the insurance company. The counselor has to file progress reports with the insurance company. The counselor is required to submit treatment reports and other details about your medical history with the insurance company.

It’s not that counselors don’t like insurance companies, or don’t want you to use your insurance (we have health insurance too!), but many counselors prefer to focus 100% of their time and energy in helping clients, rather than doing paperwork for insurance companies.

But this isn’t the only reason counselors may not be in network with your health insurance company.

The other reasons are more compelling, and you need to consider them BEFORE you decide to use your health insurance.

Many counselors prefer not to work in network with health insurance companies so that they can better protect your confidentiality. Any information (claims, reports, or treatment plans) filed with health insurance leaves the protection of their office and their locked files and your personal, private, emotional information is outside of your counselor’s office. In order for any insurance company to reimburse or pay for counseling (both in network and out of network), you must be considered “ill”. You must be diagnosed with a mental health illness or disorder. If you are not ill enough to warrant a diagnosis, then insurance will not pay for counseling services. If you do qualify for a mental health diagnosis, your illness will be listed in your permanent medical record. Many counselors don’t like this “medical model” of declaring someone ill, so they choose not to accept insurance because they want to focus on their client’s strengths, and not label them as mentally ill.

Do you want to be considered mentally ill? If you have a mental health diagnosis already, because you have been to counseling or psychiatric appointments in the past, find out what your diagnosis on file is. If you already have a mental health diagnosis, this may not be a concern to you, but if not, you may not want this in your medical record.

Counselors also do not like releasing information to others to protect your confidentiality. Once a claim is submitted to the insurance company, who knows how many people take a look at it and rubber stamp it while it travels through the system? If insurance pays for any counseling sessions (in network or out of network), then the insurance company has the right to audit your complete file. They can request copies of counseling notes, assessments, and other personal emotional information to determine if you really are “sick enough” to warrant their payment. They can deny services to you if they think you aren’t sick enough or if they think your counseling is not “medically necessary”.

Additionally, there are many counseling issues that are not even covered by insurance at all. Stress management and anger management are usually not covered. Marriage counseling is usually not covered. Certain medical conditions/mental health conditions may be excluded (such as attention deficit disorder or adjustment disorder). Even if your illness or disorder is covered by your insurance plan, they may limit the number of visits they will cover (sometimes only 20 per year), and they will set a maximum amount they will pay per calendar year or in your lifetime.

Additionally, counselors prefer not to have someone in the insurance company telling them how to treat their clients. Insurance companies can decide what type of counseling is covered, what diagnoses are allowed, and how many times the client needs to come before they are cured. Many counselors prefer to work directly with clients to serve their needs, without interference from an insurance company.

Using your health insurance for counseling services can also affect your security clearance, life insurance rate, employment, or future health insurance coverage.

For the above reasons, I recommend that you be informed about using health insurance for counseling. You may choose to file anyway, but be an informed consumer.

Be an informed consumer.
Know your mental health diagnosis.
Talk to your counselor about the diagnosis.
Ask your counselor about your treatment reports.
Decide if you have, or want to have, a psychiatric illness.

If you have clinical, severe depression, anxiety, or other issues, then you probably already have a diagnosis.

But if you are stressed, having relationship problems, or trying to figure out your purpose in life, your symptoms may be minor, and you may not want to have a mental health diagnosis in your records.

Once an insurance claim is submitted to your health insurance company, your diagnosis becomes part of your permanent medical record, and can affect future life insurance, preexisting conditions, or the cost of private health insurance.

Jama Thurman is a Licensed Professional Counselor in Manassas, VA. She helps teens and adults who are stressed and anxious find peace and purpose.

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Dos and Don’ts When Completing Individual Health Insurance Application

If you do not have access to a group employer plan then the other option you have is to apply for individual health insurance plan. Individual health insurance application require more information from you then group health insurance plans that you might have had through job. The reason for that is that individual, and that applies to family health plans, are medically underwritten. That means that a person called medical underwriter will go over your medical application and decide if you are a good risk for the insurance company. The main reason for medical underwriting is to keep over all cost for every one low. The more insurance company has to pay out in claims the more they have to charge every one for health insurance to keep the average cost down.

If you have already had a chance to take a look at individual application then you probably know that it can be long. How much of the application you have to fill out depends on your previous medical history. If you are in perfect health then there is not much that you can write on your application other then some basic information. If you are some one who has been to the doctors for lab work, test or takes prescription medication then you would have to include that on your application. Most individual application require you to provide information of your doctor or the last doctor you have been to. If you are not sure of the name of the doctor you can always include the hospital name, clinic name or doctors practice name. When it comes for the dates of your last doctor office visit or any other dates. If you do not remember exact dates, just put down your best estimate.

The most important thing to keep in mind when filling out individual or family application, especially if you do have some medical issues, is to understand this. Until there is a permanent change to health care system and health insurance is not medically underwritten. Insurance company will consider every condition that you have and every medication that you take. The reason for that is that in most states in the US health insurance companies require to cover everything once you are approved. That means that all of your medical conditions and prescription drugs have to be cover by law once you have been approved for coverage. That is if you are approved. I hate to use this analogy because we a talking about human lives, but the simple way to explain health insurance is to compare it to car insurance. For example lets say you get in the minor car accident and you do not have car insurance. Your car is still drivable and it looks like you will need a new bumper and some paint. The next day you go out and purchase car insurance to cover your accident. Well we know it does not work like that. If you could just go out and get car insurance only after you had an accident then no one would pay for car insurance. Why pay if you can just get it after you had an accident. No one would pay for car insurance and car insurance companies would not exist. Then you would be fully responsible for all the damages out of your own pocket. I know I would rather pay that $100 a month just in case something does happen.

Most people do not recognize that health insurance works in the same way. Health insurance companies are not going to approve some one who requires immediate medical assistance. That includes pending follow up visits to the doctor, recent surgery (after a surgery a lot of complications can arise), prescription drugs and anything that is known upfront that could potentially be covered expense. Insurance companies use a “actuarial tables” to underwrite individual applications. If based on what you have put down on the application could potentially cost insurance company money, chances are your application will not be approved.

If health insurance companies automatically approved all the application then it would be the same scenario as with car insurance example, that no one would pay for health insurance. I know I would not, why pay for insurance if I can get it when I get sick. If no one would pay for insurance then there would no insurance companies to cover us for unforeseen large medical expenses. I am certainly not prepared to pay $400,000 or higher for medical emergency.

Getting approved for health insurance could take some preparation. If you are currently taking prescription drugs, find out how to can slowly get off them. I am not a doctor and certainly would never tell anyone to not take drugs that were subscribed by their doctor. I think sometimes great health starts with us, with small daily choice we make. Take care of your body and it will take care of you. When completing application sometimes being too honest can cost you also. That does not mean lying. Going to chiropractor and writing on the application that you have had back pains and you will need to see a specialist. On top of that is that you have not has any health insurance previous is just way to suspicious. It looks like you are trying to get health insurance to get medical care for something that you do not want to pay yourself. Do not make it worse then it is and always phrase everything in the positive. Instead of you writing that you are having back pain, taking Advil and going to chiropractor. Phrase it that you went to chiropractor for maintenance just to realigning your back. I see a lot of people get declined for coverage even though they are in perfect health just because how and what they wrote on the application.

Real people will be looking at your application if you are making it worse then it is or you are volunteering too much information then it is only your fault if you get declined. Your answers should be, everything is fine, just a check up, results were normal. Also before you know that you might be looking for health insurance do not go see your doctor until you do have coverage. If you go to the doctor and they find something “wrong” with you then bye, bye health insurance. Now you are stuck. When at the doctors office, again, be careful what you tell your doctor because it will end up in your medical records. When self diagnosing your self do not volunteer that information to your doctor, it is your doctors job to find if there is an issue. If you have been declined for health insurance there are options available to you so is having or not having health insurance. Having any health insurance plan is infinitely better then not having anything at all. It is a know fact that you will get a better treatment if the hospital knows that you have some way to pay for your medical care and that they are not just working for free taking care of you. The one and the most important thing that you can do is to take care of your health. Eat your broccoli.

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What to Do If You Were Turned Down For Health Insurance

If you’ve been living without health insurance, you’re not alone. 15.9 percent of all Americans are uninsured as reported by the UHF (United Health Foundation). Sadly, sometimes even when people are trying to be financially and socially responsible they’ll find that they’re unable to qualify for a health insurance policy.

According to survey by U.S. Census Bureau, nearly 60 percent of the population gets health insurance in the form of group policies through their employer. There are other people who get covered by government-sponsored health care, such as children, the elderly, and those with low incomes. Until recently, however, those outside of these groups were largely at the mercy of the policies of for-profit insurance companies when it came to whether they could get coverage.

If initially turned down, ask again or apply with another insurance provider

If you find that you’re in this group that has difficulty getting coverage, the first thing you should do is to try to find out what happened. In some cases, you may be rejected due to an error on the part of the company. If the reasons for your rejection were minor, you may also still be able to get individual insurance through another company. However, if you have a major pre-existing condition such as Cancer or Diabetes, it’s unlikely that any insurance company will consider you a good risk and you’ll have to seek out other options.

State high risk health insurance pools as an option

It is for this reason that a national high-risk insurance pool will be created within 90 days following the passage of the March 2010 Health Care Reform Act for people with existing medical conditions. The pool is backed by $5 billion in federal subsidies, and will offer subsidized premiums to people who have been uninsured for at least six months and have medical problems that have resulted in their being rejected from other insurance options. In some cases these risk pools will be run through the state governments. Either way, the law says that these pools will remain available until the new health care reforms have fully taken effect in 2014.

Prior to this legislation, high risk pools were already available in 34 states and covered 183,000 citizens. From the perspective of someone who wants a policy, the important thing to note is that the quality of coverage offered can vary widely depending on the attitude and policies of the state offering them. Some states are just more generous than others in programs like this, and if you believe that you’re likely to need to use your health care policy regularly, it’ll be worth your while to get a sense of the kind of coverage that your state offers. You should also remember that even though you’ll already be paying higher premiums than a typical insurance plan, you’ll still have to make sure you have enough money in reserve to cover deductibles and co-payments or health care will be as unattainable to you as ever.

In extreme cases, if you find your state’s high risk pool to be a completely unacceptable option, you still have choices but none of them are easy. If you’ve been working at running your own business or at a small business, you may be able to get into a group plan if you can find employment at a large company. In an extreme case, if you know that another state offers a high risk pool option that would work for you, and you have the means to do it (such as family in that area), you could even consider relocating.

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Enjoy Your Journey To The Fullest With A Travel Cover

Traveling helps you gain new experiences of life, it displays the tradition and custom across the world. It refreshes you from the everyday hectic schedule. The trip will surely give you a new dimension of life. Obliviously, whether you travel with family or alone, business trip or government job purpose, you want the trip to be fun filled and with ease. What wants to encounter trouble while travelling distant countries, cut off from your familiar surroundings? For a moment there will a panic button pressed in your minds. However, unexpected situations do come up and you have to be prepared for them. Accidents, illness, theft, an emergency situation like flight delays, riots, terrorist attacks at the airport might erupt anytime and so you have to be planned to face such situations. To avoid such as unwanted situation and stay financially equipped to combat it, owning best travel insurance would be the masterstroke.
The article discusses some situation that will make you realize how travel insurance can be handy:
Accident/Illness
While nothing may go wrong, but if something bad were to happen you may suffer an injury else fall critically ill due to bad weather as such and needs to be hospitalized. Imagine the costs that would incur on medical treatment in the foreign country. It will make a huge hole in your pockets. A good travel plan will just help you to take care of such contingency and a major portion of your medical expenses will be covered.
Financial Emergency
In case your hotel room gets burglarized, wherein you get robbed or baggage is stolen, then obviously you cannot travel as your passport important documents were kept inside. The result would be you would have to stay for few extra days. Naturally, it will incur costs to protect you from this unexpected financial hit, your policy will provide assistance for these incidents. Your financial emergency assistance will also help you during a loss of travel funds.

Personal Liability
Many times accident happen unexpectedly, you may not be the victim but could help liable for damage or injury caused, in that situation. The mishap is as such that resulted in injury to someone or damage to someone’s property. At such point of time, your Best travel insurance will come to your rescue. It will take care of third party liability cover and make your free from any form of tension during your journey giving a peaceful and enjoying experience.
These day online sites offer travel insurance policies with varied benefits and features. You can visit the comparison sites and compare them in terms of benefits & features, claim settlement ratio, terms, and conditions, etc. and then go for suitable purchase.
Purchasing Best travel insurance online is all about providing travellers an ideal cover against financial emergencies and uncertainties right from the comfort of your home or offices. However, certain factors which one should look for while zeroing the policy would be:
Covers entire patient hospitalization along with daily allowance
Personal accident covers in case of permanent disability/death
Cover for contingencies related to personal possession
Cover baggage, documentation visa or passport loss
Covers Expenses related to trip delays/ hotel accommodation, trip cancellation
So, buy your Best travel insurance policy today for creating happy memories in while traveling abroad!

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Why You May NOT Want to Use Your Health Insurance for Counseling

Why not use your health insurance for counseling? Isn’t that what it is for?

Perhaps.

But using health insurance for mental health services is a little different than other medical issues. Sometimes mental health issues are not covered by your health insurance. Once you use your health insurance for mental health, you will have a mental health diagnosis on file – a mental health disorder/mental health illness must be on the insurance claim in order for insurance to pay for treatment. This will be in your permanent medical record.

Of course you want to consider using your health insurance for counseling, but there are some good reasons for you to consider why you may not want to use your insurance for counseling services.

Why doesn’t my counselor accept my health insurance?

Many counselors choose not to accept health insurance for very good reasons. They want to focus 100% of their time in treating you. If they accept health insurance, there is a lot of extra work involved in accepting insurance, in addition to agreeing to work for a discounted fee. The counselor may spend hours on the phone getting benefit information, authorizations, or following up on claims payments. The counselor has to wait a month for payment from the insurance company. The counselor has to file progress reports with the insurance company. The counselor is required to submit treatment reports and other details about your medical history with the insurance company.

It’s not that counselors don’t like insurance companies, or don’t want you to use your insurance (we have health insurance too!), but many counselors prefer to focus 100% of their time and energy in helping clients, rather than doing paperwork for insurance companies.

But this isn’t the only reason counselors may not be in network with your health insurance company.

The other reasons are more compelling, and you need to consider them BEFORE you decide to use your health insurance.

Many counselors prefer not to work in network with health insurance companies so that they can better protect your confidentiality. Any information (claims, reports, or treatment plans) filed with health insurance leaves the protection of their office and their locked files and your personal, private, emotional information is outside of your counselor’s office. In order for any insurance company to reimburse or pay for counseling (both in network and out of network), you must be considered “ill”. You must be diagnosed with a mental health illness or disorder. If you are not ill enough to warrant a diagnosis, then insurance will not pay for counseling services. If you do qualify for a mental health diagnosis, your illness will be listed in your permanent medical record. Many counselors don’t like this “medical model” of declaring someone ill, so they choose not to accept insurance because they want to focus on their client’s strengths, and not label them as mentally ill.

Do you want to be considered mentally ill? If you have a mental health diagnosis already, because you have been to counseling or psychiatric appointments in the past, find out what your diagnosis on file is. If you already have a mental health diagnosis, this may not be a concern to you, but if not, you may not want this in your medical record.

Counselors also do not like releasing information to others to protect your confidentiality. Once a claim is submitted to the insurance company, who knows how many people take a look at it and rubber stamp it while it travels through the system? If insurance pays for any counseling sessions (in network or out of network), then the insurance company has the right to audit your complete file. They can request copies of counseling notes, assessments, and other personal emotional information to determine if you really are “sick enough” to warrant their payment. They can deny services to you if they think you aren’t sick enough or if they think your counseling is not “medically necessary”.

Additionally, there are many counseling issues that are not even covered by insurance at all. Stress management and anger management are usually not covered. Marriage counseling is usually not covered. Certain medical conditions/mental health conditions may be excluded (such as attention deficit disorder or adjustment disorder). Even if your illness or disorder is covered by your insurance plan, they may limit the number of visits they will cover (sometimes only 20 per year), and they will set a maximum amount they will pay per calendar year or in your lifetime.

Additionally, counselors prefer not to have someone in the insurance company telling them how to treat their clients. Insurance companies can decide what type of counseling is covered, what diagnoses are allowed, and how many times the client needs to come before they are cured. Many counselors prefer to work directly with clients to serve their needs, without interference from an insurance company.

Using your health insurance for counseling services can also affect your security clearance, life insurance rate, employment, or future health insurance coverage.

For the above reasons, I recommend that you be informed about using health insurance for counseling. You may choose to file anyway, but be an informed consumer.

Be an informed consumer.
Know your mental health diagnosis.
Talk to your counselor about the diagnosis.
Ask your counselor about your treatment reports.
Decide if you have, or want to have, a psychiatric illness.

If you have clinical, severe depression, anxiety, or other issues, then you probably already have a diagnosis.

But if you are stressed, having relationship problems, or trying to figure out your purpose in life, your symptoms may be minor, and you may not want to have a mental health diagnosis in your records.

Once an insurance claim is submitted to your health insurance company, your diagnosis becomes part of your permanent medical record, and can affect future life insurance, preexisting conditions, or the cost of private health insurance.

Jama Thurman is a Licensed Professional Counselor in Manassas, VA. She helps teens and adults who are stressed and anxious find peace and purpose.

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Dos and Don’ts When Completing Individual Health Insurance Application

If you do not have access to a group employer plan then the other option you have is to apply for individual health insurance plan. Individual health insurance application require more information from you then group health insurance plans that you might have had through job. The reason for that is that individual, and that applies to family health plans, are medically underwritten. That means that a person called medical underwriter will go over your medical application and decide if you are a good risk for the insurance company. The main reason for medical underwriting is to keep over all cost for every one low. The more insurance company has to pay out in claims the more they have to charge every one for health insurance to keep the average cost down.

If you have already had a chance to take a look at individual application then you probably know that it can be long. How much of the application you have to fill out depends on your previous medical history. If you are in perfect health then there is not much that you can write on your application other then some basic information. If you are some one who has been to the doctors for lab work, test or takes prescription medication then you would have to include that on your application. Most individual application require you to provide information of your doctor or the last doctor you have been to. If you are not sure of the name of the doctor you can always include the hospital name, clinic name or doctors practice name. When it comes for the dates of your last doctor office visit or any other dates. If you do not remember exact dates, just put down your best estimate.

The most important thing to keep in mind when filling out individual or family application, especially if you do have some medical issues, is to understand this. Until there is a permanent change to health care system and health insurance is not medically underwritten. Insurance company will consider every condition that you have and every medication that you take. The reason for that is that in most states in the US health insurance companies require to cover everything once you are approved. That means that all of your medical conditions and prescription drugs have to be cover by law once you have been approved for coverage. That is if you are approved. I hate to use this analogy because we a talking about human lives, but the simple way to explain health insurance is to compare it to car insurance. For example lets say you get in the minor car accident and you do not have car insurance. Your car is still drivable and it looks like you will need a new bumper and some paint. The next day you go out and purchase car insurance to cover your accident. Well we know it does not work like that. If you could just go out and get car insurance only after you had an accident then no one would pay for car insurance. Why pay if you can just get it after you had an accident. No one would pay for car insurance and car insurance companies would not exist. Then you would be fully responsible for all the damages out of your own pocket. I know I would rather pay that $100 a month just in case something does happen.

Most people do not recognize that health insurance works in the same way. Health insurance companies are not going to approve some one who requires immediate medical assistance. That includes pending follow up visits to the doctor, recent surgery (after a surgery a lot of complications can arise), prescription drugs and anything that is known upfront that could potentially be covered expense. Insurance companies use a “actuarial tables” to underwrite individual applications. If based on what you have put down on the application could potentially cost insurance company money, chances are your application will not be approved.

If health insurance companies automatically approved all the application then it would be the same scenario as with car insurance example, that no one would pay for health insurance. I know I would not, why pay for insurance if I can get it when I get sick. If no one would pay for insurance then there would no insurance companies to cover us for unforeseen large medical expenses. I am certainly not prepared to pay $400,000 or higher for medical emergency.

Getting approved for health insurance could take some preparation. If you are currently taking prescription drugs, find out how to can slowly get off them. I am not a doctor and certainly would never tell anyone to not take drugs that were subscribed by their doctor. I think sometimes great health starts with us, with small daily choice we make. Take care of your body and it will take care of you. When completing application sometimes being too honest can cost you also. That does not mean lying. Going to chiropractor and writing on the application that you have had back pains and you will need to see a specialist. On top of that is that you have not has any health insurance previous is just way to suspicious. It looks like you are trying to get health insurance to get medical care for something that you do not want to pay yourself. Do not make it worse then it is and always phrase everything in the positive. Instead of you writing that you are having back pain, taking Advil and going to chiropractor. Phrase it that you went to chiropractor for maintenance just to realigning your back. I see a lot of people get declined for coverage even though they are in perfect health just because how and what they wrote on the application.

Real people will be looking at your application if you are making it worse then it is or you are volunteering too much information then it is only your fault if you get declined. Your answers should be, everything is fine, just a check up, results were normal. Also before you know that you might be looking for health insurance do not go see your doctor until you do have coverage. If you go to the doctor and they find something “wrong” with you then bye, bye health insurance. Now you are stuck. When at the doctors office, again, be careful what you tell your doctor because it will end up in your medical records. When self diagnosing your self do not volunteer that information to your doctor, it is your doctors job to find if there is an issue. If you have been declined for health insurance there are options available to you so is having or not having health insurance. Having any health insurance plan is infinitely better then not having anything at all. It is a know fact that you will get a better treatment if the hospital knows that you have some way to pay for your medical care and that they are not just working for free taking care of you. The one and the most important thing that you can do is to take care of your health. Eat your broccoli.

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What to Do If You Were Turned Down For Health Insurance

If you’ve been living without health insurance, you’re not alone. 15.9 percent of all Americans are uninsured as reported by the UHF (United Health Foundation). Sadly, sometimes even when people are trying to be financially and socially responsible they’ll find that they’re unable to qualify for a health insurance policy.

According to survey by U.S. Census Bureau, nearly 60 percent of the population gets health insurance in the form of group policies through their employer. There are other people who get covered by government-sponsored health care, such as children, the elderly, and those with low incomes. Until recently, however, those outside of these groups were largely at the mercy of the policies of for-profit insurance companies when it came to whether they could get coverage.

If initially turned down, ask again or apply with another insurance provider

If you find that you’re in this group that has difficulty getting coverage, the first thing you should do is to try to find out what happened. In some cases, you may be rejected due to an error on the part of the company. If the reasons for your rejection were minor, you may also still be able to get individual insurance through another company. However, if you have a major pre-existing condition such as Cancer or Diabetes, it’s unlikely that any insurance company will consider you a good risk and you’ll have to seek out other options.

State high risk health insurance pools as an option

It is for this reason that a national high-risk insurance pool will be created within 90 days following the passage of the March 2010 Health Care Reform Act for people with existing medical conditions. The pool is backed by $5 billion in federal subsidies, and will offer subsidized premiums to people who have been uninsured for at least six months and have medical problems that have resulted in their being rejected from other insurance options. In some cases these risk pools will be run through the state governments. Either way, the law says that these pools will remain available until the new health care reforms have fully taken effect in 2014.

Prior to this legislation, high risk pools were already available in 34 states and covered 183,000 citizens. From the perspective of someone who wants a policy, the important thing to note is that the quality of coverage offered can vary widely depending on the attitude and policies of the state offering them. Some states are just more generous than others in programs like this, and if you believe that you’re likely to need to use your health care policy regularly, it’ll be worth your while to get a sense of the kind of coverage that your state offers. You should also remember that even though you’ll already be paying higher premiums than a typical insurance plan, you’ll still have to make sure you have enough money in reserve to cover deductibles and co-payments or health care will be as unattainable to you as ever.

In extreme cases, if you find your state’s high risk pool to be a completely unacceptable option, you still have choices but none of them are easy. If you’ve been working at running your own business or at a small business, you may be able to get into a group plan if you can find employment at a large company. In an extreme case, if you know that another state offers a high risk pool option that would work for you, and you have the means to do it (such as family in that area), you could even consider relocating.

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Before Choosing Health Insurance, Here is Critical Information You Should Know

Understanding Health Insurance

This article is written to assist consumers sift through multiple options, plans, exclusions and summaries of benefits and understand what Critical questions you should ask when researching health coverage. Finding the most beneficial health insurance plan to meet your unique and individual needs is difficult. This guide will help consumers understand the basics of health insurance and what to look for when comparing plans.

14 Costy Mistakes You’ll Want To Avoid

1-FREE – Do You Have a “30 Day FREE Look Period?” Can you get your $ back if you are not happy?

2- DEDUCTIBLES: How many deductibles do I have per year? Some plans will have more than 1 deductible per person per year!

3- NETWORK RATES: Prior to your deductible being met, will your insurance company extend their discounted network rates to you? Example: Insurance Company A – 5 stitches to finger – Total cost $2000, patient responsibility, $800, or Insurance Company B – 5 stitches to finger – Total cost $2000, patient responsibility, $2000. (no network break).

4- NEGOTIATED RATE: What is the AVERAGE negotiated rate? (Sometimes referred to Network Rate – very very important!)

5- UNCLEAR TERMS Is your $100 “co-pay” for an Emergency Room visit REALLY $100? Some companies the $100 copay is more like a fee AFTER your deductible, and you’ll still pay the co-insurance and the $100.

6- LIMITS on benefits, for example: $500 limit or $250 limit on Emergency Room expenses. $50 limit on Dr. Visits. Once the Limit is reached, YOU pay everything else out of pocket. $500 limit on hospital expenses per day (quick way to bankruptcy!)

7- PREVENTATIVE – Will you have to meet your deductible, or do you have a 1 year waiting period for preventative? Do you want to wait 1 year before you can have your female exam, or a mammogram?

8- TRAVEL – If you are out of state, are you covered for illnesses? If you eat something that doesn’t agree with you and become very sick and need a doctor, will you be covered? (Not just life threatening emergencies.)

9- RATE INCREASES – I am buying a “fixed rate”. Ask yourself if it makes sense to pay extra over the next 2 – 3 years for a fixed rate? Make sure your rate is set for at least 12 months but does it make sense to pay in advance for a fixed rate? Sometimes plans will naturally go down in price, so does it make sense to pay extra to have a fixed rate?

10- SUPPORT – After I buy this plan, MAY I CALL MY AGENT’S DIRECT LINE with billing issues, or plan questions, or technical problems, or claims questions or concerns of any kind?

11- EXCLUSIONS – Read the “Exclusions” in your plan. Are the exclusions available for you to read? Is there an exclusion that you cannot live with? For example: exclude well baby visits. Is this an exclusion that you didn’t catch in the plan details?

12- MAJOR MEDICAL plans are designed to pay for MOST of your medical expenses when you become ill or injured. You’ll want a Major Medical plan from a reputable company that has “Credible Coverage.” Discount plans or Limited Medical Plans are NOT designed to protect your losses like Major Medical plans are. They are marketed as “Insurance,” but you MUST ask, is it a Credible Coverage Major Medical plan?

13 – MATERNITY – Maternity plans. Do your homework. Does your plan have an outrageous deductible for maternity? Do you have a waiting period of 12 months, 24 months, or more? How many doctors do you get to choose from “In Network” that can deliver your baby? Are you happy with the choices of Doctors in the network that will deliver your baby? What if your doctor is not on-call the night you go in for delivery?

14- MEDICATIONS – Is there a limit on how much the insurance company will pay for medications. If you become very ill, this could be a very big problem. Do your research, ask questions. Do you have a deductible on medications?

*Did you know that key information about how coverage works is not always disclosed? *When comparing plans, is the language confusing? Why is the language confusing? *Did you know that many consumers compare prices of health insurance plans, but cannot always tell if they are comparing “apples to apples.”

How to avoid Medical Bankruptcy!

According to a Harvard Law and Harvard Medical School study, they found that ½ of all bankruptcies are caused by illnesses and medical expenses. If you are a breadwinner for yourself, or breadwinner for a family or spouse, and the breadwinner gets sick, you may loose your medical coverage, and a way to pay for your day to day expenses.

When you are shopping for a health plan to protect yourself financially from medical bills and bankruptcy, there are many things to consider. Probably the most important thing is to consider is what “Type” of plan you are getting. There are several types of health plans that are available. If you buy a plan that is not “Underwritten” and is “Guaranteed Issue” you are not buying a Major Medical Plan. Major Medical plans will go through a process called “underwriting.”

Some plans will pay a certain dollar amount for a procedure, or a certain dollar amount per day while in the hospital. IT IS CRITICAL you understand the implications financially if choosing a non Major Medical plan. Your chance for greater personal losses including Bankruptcy exist with non-Major Medical plans. If you are shopping price with health insurance, and you decide on a discount or limited liability plan, YOU HAD BETTER UNDERSTAND WHAT YOUR RISKS ARE if you end up needing to use that “insurance.”

Major medical plans are designed to cover most of your hospital expenses if you become hospitalized.

Do you have a disability plan? This type of plan will pay your day to day expenses if you loose your job due to an injury or illness. This should be a very important consideration when getting health insurance. If the breadwinner loses his/her income while injured or ill, how will the day to day expenses be paid for?

The 6 costly misconceptions about Health Insurance

1 – I don’t need medical insurance, I’m a healthy person, I eat right, exercise and take care of myself. This is risk-taking. You are gambling your financial future.

2- I’m not getting insurance because There is no benefit before my deductible. Some Major Medical Plans will A) extend their network rates to you before the deductible is met, but not all. Another benefit before your deductible is met is B) the copays for Dr. Visits and C) Copays for Prescription coverage. Again, check the individual plan.

3- If I get sick, or now that I’m pregnant I’ll get insurance. Once you are ill or pregnant, depending on the illness, you may or may not be eligible for health insurance. Certainly once pregnant, you will not be eligible for an individual plan. The insurance company will always reserve the right to underwrite your medical condition and elect to take you on as a risk, or not. You wouldn’t expect to run out and get auto insurance after you’ve banged up your car and have them pay for it. For this reason, it is important to not let your Major Medical insurance lapse for more than 63 days.

4 – I will get stuck with a bill that I thought should have been paid for, or the insurance company should have paid. Here again, you must do your homework on the plan you intend to purchase. Look for Limits, deductibles, exclusions, co-pays, and understand these details. Also, if you come into a plan with pre-existing conditions and did not have continuous “credible coverage,’ you can expect to pay for your pre-existing conditions for 1 full year.

5- I want excellent care at a cheap price. If you want Major Medical, shop between the competitors, and get the most for your money, but don’t expect the same benefits in a discount plan as in a Major Medical Plan.

6- I’m waiting for the President to take care of this mess. It is not a good idea to wait to purchase medical insurance ever!

Important to Know:

Many People Feel That Health Insurance Companies are Greedy and Corrupt According to the Wellpoint Institute of Health Care Knowledge:

“Popular theories suggest that health insurance premiums are driven by an aging population, excessive insurer profits or medical malpractice. Objective research, however, clearly indicates that these factors have a minimal impact on the high price of health insurance premiums.

If meaningful health care reform, including health care cost containment, is to occur, emphasis must be placed on the real drivers of increased health care costs and concomitantly, health care premiums. These include the following key factors: such as

* Advances in medical technology and subsequent increases in utilization

* Price inflation for medical services that exceeds inflation in other sectors of the economy

* Cost-shifting from people who are uninsured and those receiving Medicaid to the private sector

* High cost of regulatory compliance

* Patient lifestyles, such as physical inactivity and increases in obesity.”

Other Important Facts

Will they check my credit score. NO

Will they require a physical or blood work? In most cases, NO.

All insurance companies are the same. No they are not.

My Premiums keep going up. You can do very little about increases in health care costs. You may want to change plans or increase your deductible to try and save money. Try and find a company that will guarantee their rates for at least 1 year. No need to pre-pay for future rate increases.

Definitions:

DEDUCTIBLES (Phase 1)- Money that you pay out of your pocket before traditional insurance begins. Ranging traditionally from $0 to $10,000. Usually if you choose a lower deductible, your premiums will cost more, if you have a higher deductible, your premiums will be lower (you are assuming a higher risk in exchange for lower premiums).

CO-INSURANCE – (Phase 2) – After you meet your deductible, you’ll pay a “co-insurance.” “Co” meaning 2, two entities will share the burden of the bill; usually you’ll see “co-insurance” as a 70/30, 80/20, 50/50, 60/40, 90/10. The larger portion of the co-insurance the insurance company will pay, the lesser portion you will pay.

MAXIMUM OUT OF POCKET – (Phase 3) – After you’ve paid your deductible, and then your portion of the co-insurance, you finally reach your maximum out of pocket. From this point on, the insurance company will pay the rest of the bill. (Major Medical Plan.)

CO-PAY – A flat dollar amount to be paid at the Doctors office. Sometimes referred to as a “first dollar benefit” (before deductible). Meaning, you pay a flat $30 or $20 or $40 dollar copay, or whatever the copay is, and the visit is paid in full. WATCH FOR LIMITS! Make certain the copay is a flat dollar amount paid BEFORE your deductible.

HMO is Health Maintenance Organization, usually a limited regional/geographical area, with a certain number of providers in the HMO. You will select 1 Dr to manage your care, and your Dr. will “help you decide” if you need a referral or not. HMO’s usually have very low deductibles and copays.

PPO Insurance is Preferred Provider Organization. You may visit anyone you wish in the network, still you must know the geographical area of your Network, even with a PPO plan. If you are on vacation and become ill, will your plan out of state cover you (in network)?

CREDIBLE COVERAGE In order to cover your pre-existing conditions when moving from one plan to another, you must have a Credible Coverage Major Medical plan. It is a document given to you from your insurance company as proof that you had a Major Medical plan protecting you from a start date to an end date. You must not go further than 63 days from one Major Medical Insurance coverage to the next, if you do go beyond the 63 days, you will have a pre-existing condition clause in your new policy that states you will not be covered for any of your pre-existing conditions for 1 full year (at a minimum.)

If you go beyond 63 days without “Credible Coverage,” the new insurer will look to your previous 6 months (average) health history and condition, and not cover you for any ailment you have (pre-existing.)

Now don’t be mistaken, that when you want to go from one insurer to the next, if you were covered with “credible coverage” that you are automatically guaranteed a plan. This is not true. You will still need to be underwritten, and the new company is not obligated to take you on as an insured if you don’t fit their underwriting guidelines.

Please Note: This Free Consumers Guide is meant to be used as informational only. The author herein will not accept liability for any circumstances in which an outside company may define their features and benefits differently than in this document. Consumers will accept this document as informational only, and not a legal document. Consumers will be held responsible for their own purchases, and not hold the authors in this document liable for any actions taken by any consumer. Consumers must verify the plan in which they purchase, and will not hold the information in this document as a specific reason to take or not to take a certain action. This document is produced by a licensed health agent. The 14 Costly mistakes you should avoid when selecting your health plan.

Shelly Rogers is a Retired Nurse and Licensed Health Insurance Agent In Nevada. Her desire is that those that are seeking for a Health Plan KNOW what questions to ask BEFORE they buy. This article deals with understanding deductibles, what happens before your deductible has been met, and know what important questions you should ask about deductibles.

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