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Archive for the ‘Health Insurance’ Category

Insurance is protection against any loss. Several types of Insurances are available in market like Auto insurance, Health insurance. Health insurance policies pay for your all medical expenses. These insurance bodily covers long term nursing or any disabilities. Health insurances are provided by government sectors or by private companies. These health policies are available on basis of group or can be purchased for individuals too. These policies protect you from high and unexpected expenses.

Idea of health insurance was first purposed by Elder Chamberlen in 1694. Firstly it was just for diseases. But at the start 19th century accidental insurance is also added to medical insurance. This insurance adds insurance facility for permanent disabilities. Actually this model started in 20th century. Most of health insurances cover cost of routine checkups, emergencies and most of the drugs. But it’s not always the same case. Different health insurances have their different conditions and terms.

Health insurance plans are designed in such a way that it can suit your expenses and easy to purchase. These insurance plans will protect you from costs as well as provide you wellness without any tension of payment of doctor bills. There are many health insurance plans provided by different hospitals or other organizations to suit your premium and your need.

Two types of health insurance plans are available: -

1. Comprehensive health insurance plans: – These plans will provide you a percentage of your total medical expense. These plans are very costly but they cover nearly total expense.

2. Scheduled health insurance plans: – These plans are not so expensive, so these are common in peoples. But have limited benefits. These plans are not so effective. They don’t give you all medical expenses. They give you maximum fixed amount of medical benefit.

Health insurance companies first checks the previous health record of person and current records too like smoking and drinking habits, weight or does he had any treatment done for any long term diseases. So they give them health insurance packages to choose according to that reports like a person having serious health issues have to buy comprehensive plans. This is called adverse selection. They also give discounts if person leaves smoking and stays healthy for long time. Other factors like lifestyle, high-price technologies, advance medical technology, age, drinking and smoking habits etc. also affect the health insurance cost. Some of the countries have made health insurance plans compulsory for every citizen.

Cheap health insurance has become the issue of the moment in South Carolina and across the country. More small businesses are increasingly unable to provide cheap health insurance plans to their employees because of the rising cost and the lack of federal and state legislation that would allow small businesses to purchase cheap medical insurance in pools. In the meantime South Carolina and other states are looking to cut the costs of the Medicare and Medicaid health insurance programs for the elderly and the poor. However, more affordable forms of health insurance plans are available as some private companies are experimenting with a new variation of cheap health insurance known as health discount plans. In the article that follows we’ll explain the various aspects of cheap health insurance in South Carolina and how to find a plan that works for you.

Health Care Costs due to Managed Health Care

The current health care system in America is inaccessible to approximately 47 million poor and lower middle class people. In order to address the growing health care insurance crisis in the U.S. that resulted in health care cost growth in the 1970s and 1980s, health maintenance organizations (HMOs) sprung up. These were initially as non-profit groups designed to separate unnecessary tests and treatments from those that the patient required in an effort to keep costs down. Managed care organizations began screening requested procedures by physicians to pre-authorize what the HMO would or would not cover. However, the number of people who are the riskiest to insure-diabetics, cancer, etc.-continues to rise. Many South Carolina managed care industry experts say the cost of cheap health insurance is still high because of the existing pool of insured people who use the health care system more than an average amount.

The other battle that is ongoing in South Carolina involves the health insurance companies and hospitals, the latter which cannot turn anyone away from care by law. However, as the number of South Carolinians who cannot afford cheap health insurance increases, hospital emergency rooms are handling the majority of the load. More people have to turn to hospitals as their primary health care givers given a lack of adequate or non-existant health insurance coverage.

Cheap Health Insurance Plans Through the Workplace

Most cheap medical insurance policies in South Carolina are usually written through group coverage offered at work by your employer through a private South Carolina cheap health insurance company. This is usually the more cost effective way to purchase cheap health insurance now available since a large number of employees allows South Carolina companies to reduce their insurance premiums. Similar to buying in bulk, the more health insurance plans a business can purchase for its employees the less expensive the insurance is per employee. In South Carolina, like the rest of the nation, the number of companies that can provide cheap health insurance for their employees is declining.

Personal Health Insurance Plans

Health insurance plans can be purchased by individuals and families from virtually every insurance provider in South Carolina. Trying to purchase health insurance on an individual basis can be more expensive if the person already has a health problem, known as a pre-existing condition. Many companies will not cover people with pre-existing conditions if they have no continuation of coverage-renewing health insurance coverage after only a prescribed short period of time-picked up from an earlier cheap health insurance policy.

South Carolina Health Insurance Pool

The South Carolina Health Insurance Pool is a state health insurance plan designed to provide coverage for those that either do not have or have lost medical coverage at no fault of their own and are uninsurable. The pool was created by the General Assembly to help people who couldn’t get health insurance coverage from any other source, including people with certain disabilities. Blue Cross and Blue Shield of South Carolina currently administers the pool.

Coverage is available to a person who has been a state resident for at least 30 days and meets the following criteria:



They were turned down for private health insurance coverage for health reasons;

They were accepted for private health insurance, but have pre-existing illnesses or conditions excluded from coverage, for a period exceeding 12 months;

They are paying health insurance premiums for comparable coverage which are more than 150 percent of the premium levels charged by the pool;

In certain situations, other individuals whose last health insurance coverage was an employer based group health plan may be eligible for coverage.



No matter what your age, there are also several federally sponsored programs to help you if can’t afford the premiums for individual health insurance, providing you meet their eligibility guidelines.



Medicare, a health insurance program for people age 65 or older, certain younger people with disabilities, and people with end-stage renal disease.

Medicaid, a program for the poorest individuals and low-income families with children.

The Children’s Health Insurance Program (CHIP), a plan that provides health care to children whose parents make too much to qualify for Medicaid, but earn too little to afford individual health insurance.



Types of Cheap Health Insurance Coverage

Cheap health insurance plans generally fall into one of two categories: indemnity plans and managed care plans (HMOs, PPOs or POS plans). An indemnity plan allows you to choose your own doctors and pays for your medical expenses totally, in part, or up to a specified amount. Managed care plans generally provide broader coverage within a specified network of health-care providers.

Although you can purchase cheap health insurance plans that cover specific areas of health care (surgical, hospital, physician expense plans) most plans cover varying degrees of health care in a number of different areas. This health insurance coverage, known as major medical insurance, offers extremely broad coverage with a very high maximum benefit that’s designed to protect you against losses from catastrophic illness or injury.

When comparing cheap medical insurance plans, check to see if they provide additional benefits that you may need, including prescription drugs, preventive care, mental health benefits, maternity care, and vision care. A comparison of various health insurance policies and rates through many South Carolina health insurance companies can be obtained at www.insurances.sc.

Cheap Health Insurance Recipient Costs

With most cheap health insurance policies available in South Carolina, the way to control cost is to cut down on the out-of-pocket expenses. Since most health care insurance policies require you to make a co-payment (the amount you pay a health care provider with every visit), anything involving a lot of time spent in the doctor or dentist’s office can become expensive. Most also require a deductible (costs you must cover out of your pocket for any major expense before your cheap health insurance policy picks up the remaining costs). You may also have coinsurance, the percentage of cheap medical insurance cost you will still have to pay after you reach your deductibles.

Another thing to consider is COBRA health insurance. This law allows employees who leave a job the ability to stay on that South Carolina company’s employee health insurance for up to 18 months although they have to pay the full amount of the coverage. Check the COBRA benefits to see if purchasing a less expensive individual health insurance plan may be in your best interest.

How to Buy Cheap Health Insurance

If you need to purchase individual health insurance, it can be expensive. Unlike group plans, in which the costs and risks associated with
health care are spread among many people; individual health policies are “medically underwritten” to take into account your personal health history. Any “pre-existing” condition such as heart disease, diabetes, and even pregnancy, can nix your chances of acceptance or boost your premiums.

To determine the acceptability of a particular applicant, a health insurance underwriter can require information regarding the following:



The individual’s age: Age determines rates and whether coverage will be issued at all.

The individual’s gender: at younger ages, males have a lower rate of illness and injury than females. That changes by age sixty.

The individual’s health history and physical condition: Someone who has had a previous condition that can contribute to a future illness/injury is not considered an ideal risk. In response to a less than ideal medical history, modified coverage may be offered depending on the individual’s health, higher than normal premiums may be issued, or the person may be denied coverage altogether.

The individual’s occupation and hobbies: Some occupations such as construction workers have higher insurance rates, along with people who enjoy dangerous activities such as skydiving or bungee jumping. At times certain occupations are considered so hazardous that insurance companies will not cover them at all.



Your first step in getting cheap health insurance coverage is to understand exactly what you need. Think carefully about what coverage you must have. Do you need health insurance for your whole family, or just yourself? Do you want to choose your providers? If you’re over 65, do you need insurance to fill the gaps in Medicare? Do you need – and can you afford – long-term disability and/or long term care coverage? Even if you begin by soliciting cheap health insurance quotes you must still know exactly what you want in terms of health insurance coverage so you will be comparing apples to apples when weighing any cheap health insurance premium quote.

After that, contact a South Carolina insurance agent in your area. Ideally, you can start with an independent South Carolina insurance agent who is familiar with the insurance companies that do business in your area. This agent is also not bound to write coverage for any particular health insurance company so he or she can give you an honest appraisal of various health insurance policies.

When you’ve found the right coverage, you’ll give information to your agent to complete the necessary forms. Be honest. It’s important to disclose your medical history thoroughly and accurately. Report all of your health problems to your agent. If any of your health information is misstated or incomplete, the company might refuse to pay your claims and could cancel your policy.

The United States does not have socialized medical care. If you have no health insurance coverage, you have to pay for health care out of your own finances at the time of service. This can run into many thousands of dollars for serious illnesses.

You buy health insurance for the same reason you buy other kinds of insurance: to protect yourself financially. With health insurance, you protect yourself and your family in case you need medical care that could be very expensive.

You cannot predict what your medical bills will be. In a good year, your costs may be low. But if you become ill, your bills could be very high. If you have health insurance, many of your costs are covered by a third-party payer, not by you. A third-party payer can be an insurance company or, in some cases, it can be your employer.

Many people in the United States are enrolled in some sort of managed care health insurance plan. This is an organized way of both providing services and paying for them. Different types of managed care plans work differently and include preferred provider organizations (PPOs), health maintenance organizations (HMOs), point-of-service (POS) plans and fee-for-service plans.

Individuals enrolled in health care plans pay a monthly or quarterly fee as insurance for the time when they will need medical attention. At the time when a service is provided, the health insurance organization pays part or all of the fee, minimizing the amount you have to pay at the time you receive the service.

The information presented here will help you choose a health insurance plan that is right for you. If you are married or single, have children or no children, this information will help you to find out how to choose a health insurance plan that best meets your needs and your financial circumstances. Definitions of the health insurance terms used are included in the section called Understanding Health Insurance Terms.

Understanding Health Insurance Terms

Coinsurance

The amount you are required to pay for medical care in a fee-for-service plan after you have met your deductible. The coinsurance rate is usually expressed as a percentage. For example, if the health insurance company pays 80 percent of the claim, you pay 20 percent.

Coordination of Benefits

A system to eliminate duplication of benefits when you are covered under more than one group plan. Benefits under the two plans usually are limited to no more than 100 percent of the claim.

Co-payment

Another way of sharing medical costs. You pay a flat fee every time you receive a medical service (for example, $5 for every visit to the doctor). The health insurance company pays the rest.

Covered Expenses

Most health insurance plans, whether they are fee-for-service, HMOs, or PPOs, do not pay for all services. Some may not pay for prescription drugs. Others may not pay for mental health care. Covered services are those medical procedures the insurer agrees to pay for. They are listed in the health insurance policy.

Customary Fee

Most health insurance plans will pay only what they call a reasonable and customary fee for a particular service. If your doctor charges $1,000 for a hernia repair while most doctors in your area charge only $600, you will be billed for the $400 difference. This is in addition to the deductible and coinsurance you would be expected to pay. To avoid this additional cost, ask your doctor to accept your health insurance company’s payment as full payment. Or shop around to find a doctor who will. Otherwise you will have to pay the rest yourself.

Deductible

The amount of money you must pay each year to cover your medical care expenses before your health insurance policy starts paying.

Exclusions

Specific conditions or circumstances for which the policy will not provide benefits.

HMO (Health Maintenance Organization)

Prepaid health plans. You pay a monthly premium and the HMO covers your doctors’ visits, hospital stays, emergency care, surgery, checkups, lab tests, x-rays, and therapy. You must use the doctors and hospitals designated by the HMO.

Managed Care

Ways to manage costs, use, and quality of the health care system. All HMOs and PPOs, and many fee-for-service plans, have managed care.

Maximum Out-of-Pocket Expenses

The most money you will be required pay a year for deductibles and coinsurance. It is a stated dollar amount set by the health insurance company, in addition to regular premiums.

Non-cancellable Policy

A policy that guarantees you can receive health insurance, as long as you pay the premium. It is also called a guaranteed renewable policy.

PPO (Preferred Provider Organization)

A combination of traditional fee-for-service and an HMO. When you use the doctors and hospitals that are part of the PPO, you can have a larger part of your medical bills covered. You can use other doctors, but at a higher cost.

Pre-existing Condition

A health problem that existed before the date your health insurance became effective.

Premium

The amount you or your employer pays in exchange for health insurance coverage. Primary Care Doctor

Usually your first contact for health care. This is often a family physician or internist, but some women use their gynecologist. A primary care doctor monitors your health and diagnoses and treats minor health problems, and refers you to specialists if another level of care is needed. In many health insurance plans, care by specialists is only paid for if your are referred by your primary care doctor. An HMO or a POS plan will provide you with a list of doctors from which you will choose your primary care doctor (usually a family physician, internists, obstetrician-gynecologist, or pedicatrician). This could mean you might have to choose a new primary care doctor if your current one does not belong to the plan. PPOs allow members to use primary care doctors outside the PPO network (at a higher cost). Indemnity plans allow any doctor to be used. Provider

Any person (doctor, nurse, dentist) or institution (hospital or clinic) that provides medical care.

Third-Party Payer

Any payer for health care services other than you. This can be an insurance company, an HMO, a PPO, or the Federal Government