The Diabetic and Health Insurance

What is a diabetic supposed to do for health insurance?

The following is a list of options that a diabetic can follow in their pursuit to find health insurance:

1. Look at your employer. Many group health insurers will take people that cannot find health insurance elsewhere. Why is that? Many group health insurers understand and calculate the potential for having a percentage of the employees in a company who are not able to obtain health insurance on their own. This is the primary reason that most group health insurance policies are costly for employers.

2. Do your homework. Shop around. There are plans out there, but you really need to look. If your employer does not offer health insurance there are additional avenues that you can explore. This leads us to number three.

3. Be upfront when talking to an insurance agent. Many times a good agent will have a program for people that are hard to cover due to health complications. For instance I currently have two carriers that I use to help people get coverage.

Additionally, when you sign a health insurance application for coverage you are attesting that the answers that you gave are true and correct. Please understand that if you intentionally misrepresent yourself on an application you can, in the very least, be denied coverage for falsifying an application. I have even seen insurance companies revoke a policy because someone was untruthful on an application.

4. Realize that there is going to be a pre-existing waiting period. I have yet to find one insurance company that will waive the pre-existing waiting period for a diabetic. Please understand that most health insurance companies treat diabetes as an uninsurable condition, and because of that, most insurance companies will deny coverage to new applicants who have been diagnosed as a diabetic.

Therefore, if you have been diagnosed with diabetes and you have found a health insurance company that will insure diabetics, then please recognize that there will, most likely, be a pre-existing condition clause or rider attached.

5. Understand that insurance will be expensive. In all my years as a health insurance professional, I have found that the people with the lowest premiums are the younger healthier people. The converse is equally true. The premiums that are the highest are paid by the people with pre-existing conditions.

Contact me and let me help you find the coverage that is right for you.

Tim

How to choose the appropriate insurance company

I believe that there are a few factors to keep in mind when choosing an insurance company. I believe that it is necessary for you to do your homework and not just go with the first company to call. With that in mind I want to introduce to you several parameters to consider when choosing your health insurance company.

The first factor to consider is insurability. In a previous article I addressed the utilization of common sense in being insurable and what makes you uninsurable. Depending on your level of insurability will determine the number of carriers that will be willing to insure you.

If you are healthy you might have scores of companies willing to extend insurance to you. The converse is just as valid. If you are sickly you might only have one or two companies willing to take on the risk of providing you with health insurance. Therefore, do your homework and find a company that will insure you.

The second factor to consider is the company’s financial rating. This cannot be overlooked. Too many people that I have counseled with came to me having a previous carrier that is not financially strong enough to pay their claims. Common financial rating companies are A.M. Best and Standard & Poors. Getting a company’s rating from them is akin to checking out a bank before getting your mortgage through them.

Third, consider the companies network. There is no sense in going with a company if your doctors do not accept them. Also, in checking out their network, check out the company’s coverage outside of the network as well. Ask your agent that, “If I were to travel and become ill, will I have the same level of coverage, as I would, if I were home and became ill?” You want the peace of mind to know that you were to go on a vacation and became ill, that you would still have coverage.

Forth, consider the coverage. The coverage must cover what is important to you, the consumer. If preventative care is very important to you, then a policy that does not offer preventative care should not be a consideration. I want to know from a company that if I invest money into an insurance policy, that the benefits provided by that company will meet my needs.

Most people would list the coverage requirement higher in the list, but I do not. The reason for this is that if I have a policy that promises me all these great coverage benefits, but the company won’t insure me, or they will insure me, but cannot pay their share of the bill, or even worse they will insure me, but their network is so small that they have no doctor coverage, then what good is the benefits that the policy gives?

I only purchase an insurance policy for my family if I am positive that the company will provide coverage, pay the bill, give me a large list of doctors to choose from and have great coverage benefits.

Finally, I consider price. The price I pay for an insurance policy must be reflective of the quality of policy I purchase. I would not expect a Mercedes to cost the same as a Yugo. By the same measure I do not expect a quality health plan from a reputable insurance company to be the same cost as a fly by night discount plan. I encourage you to not be afraid to pay for quality. It will cost you less in the long run to have a quality insurance plan versus going with a cheap plan and gambling that you will never be seriously ill.

Consider these five factors when purchasing your next insurance policy and I will tell you that you will sleep better at night knowing you have done your homework and chosen the best policy for your family.

What makes you uninsurable?

If I have said it once, I have said it a thousand times, that health insurance is not rocket science.

Really this should not be all that hard to understand. However, it seems that people think that they can just leave their common sense at home when they are applying for health insurance.

Not a day goes by, that I do not speak with someone that says, “I’m in perfect health. I haven’t been to the doctor in years.” Only to find out that they have had open heart surgery, or a heart attack, or a stroke, and the real reason that they haven’t been to the doctor is that the doctor advised that they have a procedure that they have yet to get. That makes you uninsurable.

Another issue that will flag your application as uninsurable is your weight. Health Insurance companies have a height and weight chart that gives them the guidelines to give people insurance. If you do not fit within those guidelines you are uninsurable. This is not just for the overweight; this also is for the underweight, the very short, and the very tall. Why? Because the actuaries have made calculations to determine that based on height and weight how big a risk a person is to insure. When you couple that with various problems such as high blood pressure, diabetes, smoking, heart issues, etc... That combination is what determines eligibility for insurance.

So, then, what options are available to you if you are deemed to be uninsurable? There are a few. Depending on your individual condition depends on the course of action to explore.

The first thing to remember is that if an insurance company is willing to extend coverage to you, then it will not come with a cheap price tag. If most companies consider you to be uninsurable and you can find a company that will extend to you a health insurance policy I suggest that you take it.

The second thing to remember is that if an insurance company is willing to extend coverage to you, then it may not be the best coverage in the known universe, but it will be coverage. In this instance, something is better than nothing. A card in your pocket will get you into hospitals where before you could not get needed care.

Third, keep it as long as possible. Expect for there to be rate increases. Count on them, but remember that you need this policy. So stick it out as long as you can. I have always told my clientele to always look for other coverage, but to never drop their current coverage until they have a replacement policy in force.

I do not want to see anyone over pay for insurance. I want all my clients to be happy with their premium, but I also understand the consequence for not having an insurance policy.

It breaks my heart to tell someone that there is nothing I can do to help them. I want to see everyone get Health Insurance, but I know the reality of life is that not everyone will qualify.

That is why I personally offer a hospital indemnity policy. This policy is not your typical insurance but it pays something should you have to go to the doctor or go to the hospital. In that case, if I have no other alternative than to offer you that policy, I am in essence saying to you that “something is better than nothing.” That sounds unfair to the writing company of the indemnity, because it is actually a very good plan, but in all truthfulness, if I can place you into an actual health insurance policy then I will do so.

Like I said, Insurance is not rocket science. Use the head that God gave you, and you will be able to find some kind of coverage, regardless of your condition.

It's official. I'm an Expert

I have an announcement:

I received an email last night from an online publication, I have been classified as an expert in Health Insurance.

Click here to see the expert page.

It is a nice accolade to have, and I am glad to have it.

I just wanted to share it with you.

Happy Friday,

Tim

Dealing with Procrastination

Procrastination is a poison to the person looking for health insurance. Over the years I have sat with, spoken to, too many people that have put off buying a health insurance policy only to have a tragic event occur and thus rendering them uninsurable.

Case in point, I remember the time I sat with an older couple and spent over two hours with them discussing the benefits and reasons why they should get the health insurance policy, and in the end, they did buy. Feeling good about the sale I went home. Two days later the wife called me to let me know that her husband was admitted into the hospital for what later was diagnosed as a stroke. If they had waited, if they had turned me away, he at least would be uninsurable.

Let’s discuss the number one reason not to procrastinate when looking for a health insurance policy.

The number one reason is the unknown. There is a problem that plagues us, humans. I call it the Unknown. It is the future. We do not know what tomorrow brings. We don’t even know what the next hour will bring. It is the unknown factors that we guard against. It is the reason we lock our doors at night. It is the reason we prepare our houses for a big storm. It is the reason we buy insurance. Not knowing the future is only a problem if you are not prepared.

The fix, then is to be prepared. When you are shopping for a deadbolt to put on your door, do you pick the cheapest, least effective lock on the market? No, you choose a lock that will withstand anything thrown at it. It is your family that you are protecting, so you buy the best lock on the market.

Likewise, when a major storm is approaching, do you leave all the windows and doors unprotected? Do you leave yard items in the yard to blow around? No, you put the storm shutters on the windows and doors, the yard is picked clean, and everything that can be tied down is.

If you prepare for the storms and the burglars that might come your way, then doesn’t it make sense to prepare for the health storms and burglars that can rob you of your good health and eradicate your bank account? Health Insurance does just that. Health insurance protects you and your family just as much as that lock and the storm shutters protect you and your family.

My suggestion, don’t procrastinate. Get the best policy that you can get to protect your family. I guarantee that you will sleep better at night knowing that you have protected your family against the dangers of the unknown.

The HSA, What is it?

The HSA stands for Health Savings Account. Simply put it is an insurance policy paired with a savings account. Personally, I love them. To me the HSA is a great insurance policy for people of all walks of life.

If you a sickly person the HSA is appropriate, because it reduces your out of pocket costs to your deductible, On the other hand, if you are a healthy person that rarely sees the doctor, it provides a tax break on your health insurance costs, and it allows you to build up a savings account to cover any medical costs up to the deductible amount.

A typical HSA has a deductible that can range from $1100.00 up to $10,000.00 depending on the company that you choose and your personal preference on premiums and deductibles. Typically after you meet the deductible, the HSA then covers your health care costs at 100%. There are exceptions to this, in that, some companies offer the HSA with 80% coverage after the deductible is met.

That is the gist of the HSA. Complicated? No. It is very simple. Now there are additional benefits for the HSA that are not commonly in your traditional 80/20 plans. The additional benefits are in the form of your money.

You contribute in a HSA to a savings account that you set up concurrently. You can choose any approved HSA savings account to invest into, on a monthly basis.

Say for example that you have an HSA that pays 100% after the deductible. Your deductible is $2850 for the year, and you contribute $300 per month into the savings account.

If you are a sickly individual that sees doctors each month, then the deductible will be exhausted rather quickly and then for the remainder of the year your health care is then covered at 100%. You continue to contribute every month into the savings account, and that gives you a leg up on meeting next year’s deductible. What is the benefit to this? There are many; small deductible that is easily achieved and paid for using the savings account, a generous tax break at the end of the year, should something else happen your have 100% coverage, and you are still building the amount in the savings account so that you will have the deductible covered with less out of pocket than the year previous.

If you are healthy and have no medical expenses throughout the year, then you reap the benefit of accumulating $3600.00 into the savings account for use on future claims. This plan is a huge winner on all accounts.

Check IRS publication 501 at irs.gov to find over 40 pages of deductions that use can use your HSA savings account.

The HSA, it can change the way you look at health insurance.

Memorial Day

I'll admit it this holiday is one of my favorites. The reasons are many. Cookouts, family, spending time relaxing, and others that I could name, but the real reason that I enjoy this holiday is because of why it was created in the first place.

Memorial Day, to me, is a day of thanks. I am grateful to the thousands of men and women who have laid down their life, so that, I can live mine freely. I am grateful to the hundreds of thousands of men and women that are now standing in the gap to continue to protect my freedoms and, if necessary, die so that my children will continue to have those freedoms.

On this coming Memorial Day, I encourage you to do as I do. Take a moment and reflect on how blessed we really are to be in this great country, and thank God for the brave men and women who continue to protect us.

Warmest regards,

Tim