Affordable Health Insurance

If you left your job voluntarily or I ejected out for the economy, maintain health insurance coverage for you and your family should be one of your top concerns. Even if you are green, can not afford to go without health coverage. All it will take a bad flu season or a serious accident to make a bad situation even worse. Choosing the best type of insurance for your family is as important as deciding to keep it. It’s best to join the Cobra or should go ahead and buy individual health insurance ?

COBRA employers to help you stay healthy for their coverage up to 18 months after he stopped working for them. For most families, this cover acts as a safety net covering them until they are able to sign for different coverage. Individual health insurance, on the other hand, is private insurance that is purchased directly from the insurance company. Until continue paying the premiums will always be covered if you are employed or not.

It’s hard to say whether the individual health insurance is better than COBRA, because the situation of each person is unique and two types of insurance have advantages and disadvantages. With COBRA is sufficient to maintain the same coverage you had with your previous employer. The difference is that now you are responsible for the entire cost of insurance while before your employer in 50-100% of the premium. This can be quite expensive and you will be able to change the insurance plan to something cheaper. Moreover, the coverage is only available for a limited time.

Often you can customize your personal health insurance policy to get what you need can result in lower premiums would be Than COBRA. And, as mentioned before, as long as you continue paying the premiums paid for the rest of your life. The disadvantage of this option is that you may not be able to provide insurance if you have an underlying condition. This, of course, depends on the pre-existing condition you have, but it is quite possible that it would ultimately be rejected outright or pay more for your insurance than you would with a COBRA policy. The best way to understand the best insurance options for you is to talk with an experienced health insurance agent can help you find the policy that suits your needs.

If you’re like most consumers you probably on a glide path to start contemplating the purchase of health insurance when you’re much older then your current age. In fact, studies show that many people don’t even consider health insurance until after they are married or have children. Although it may seem unnecessary, the best time to start thinking about health insurance is while you are young and still relatively healthy. The fact is, the longer you wait to obtain health insurance the higher probability that you will end up paying a higher insurance rate or premium assuming you are still healthy enough to qualify for health insurance.

Research shows that when compared side by side a person in their twenties or thirties will be able to obtain a larger health insurance policy at a cheaper rate then a person who is fifty or older. Good health and habits also play a large role in determining your health insurance coverage and overall associated costs. Someone who is healthy, doesn’t smoke and avoids excessive use of alcohol and stays away from drugs will also enjoy the same benefits of a larger policy value with a lower cost when compared to someone who is out of shape, in bad health and with lifestyle habits that are truly bad for their body, mind and health.

Sadly, some consumers are under the misconception that they can get by without telling their potential health insurance provider negative aspects dealing with their health in order to qualify for better rates and coverage amounts. Unfortunately what those same folks fail to realize is that normally most health insurance companies and providers require a medical pre-screening or physical before they actually provide health insurance coverage. Typically, this medical screening combined with a thorough look over a person’s previous medical records identifies any current health ailments that exist with the potential insurance client and as a result the health insurance coverage amounts and rates are adjusted accordingly.

If you exam the economics side of health insurance you will see that the health insurance companies want to insure you while you are in your best possible health. For this it means more money taken in from the premiums you pay and less money paid out based on your lack of needing to receive regular medical care outside of routine appointments, checkups and of course, medical emergencies. Health insurance companies have gotten so good at this that they have three different types of coverage rates or premiums they classify consumers into based on their health. Those categories are standard, preferred and preferred plus. The preferred plus premium is for folks that are non-smokers and in excellent health continuing on down to the standard premium for consumers with minor health issues and who may have previously smoked but are no longer active in that habit.

Health insurance companies consider smoking a big deal so always make sure to tell the truth when filling out your health insurance application and receiving your medical exam and physical. In fact, some companies actually test a urine sample in order to determine if you are an active smoker. The bottom line up front is in order to enjoy lower rates for your health insurance you really should abstain from smoking. Drinking alcohol is also considered harmful to your health and viewed by many insurance companies in a negative light. You will need to check each individual insurance provider’s policy in terms of alcohol consumption. Some have no issue with consuming alcoholic beverages as long as there is no prior evidence of abuse or previous treatments/rehabilitation that were required and yet others will drastically increase your insurance rates based on the health problems and mortality rate from drinking.

If you’re still reasonably healthy then age can be the least discriminating factor when it comes to purchasing affordable health insurance. Generally speaking many consumers under the age of sixty can still enjoy reasonable health insurance rates and adequate coverage so long as there are no major health problems or illnesses to contend with.

Author: Sharlene Raven
Article Source: EzineArticles.com
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Most Americans who have health insurance are covered through an employer’s plan. However, some employers do not offer health insurance coverage. If you work for one of these companies, you will need to purchase private individual health insurance.
There are certain advantages to purchasing health coverage in the private market. Instead of choosing from plans pre-selected by an employer, you decide which plan features you want, and pick a plan accordingly. For example, by choosing a plan with a higher deductible, or one that doesn’t cover certain services, you may realize a substantial premium savings each month.
Instead of having your coverage tied to a place of employment, coverage through a private health plan is yours to keep no matter where you work. A health insurer can’t drop you as long as you pay your premiums on time.
But along with these advantages come some potential disadvantages—

• Employer plans provide considerably more coverage than individual plans, even when you are paying the same premium rate. That’s because with an individual policy, a larger percentage of the premium goes to pay for such operational costs as marketing and paying claims.
• A group plan generally must insure all employees and family members, while individual plans can reject applicants who aren’t in perfect health. They can also offer plans that exclude coverage for certain pre-existing conditions.
• In most states, private health insurance plan premiums increase as you age. Initially, you can avoid these rate increases by periodically changing plans, because new rates tend to be lower than renewals. However, as you get older, it will become more difficult to find a company to insure you and individual policies will get more expensive.
If you do need to shop in the private health insurance market, you first need to find a competent insurance agent.  Determining what kind of insurance you need and how much coverage to buy are complex issues. A good agent will help you assess your situation, and work with you to find the right coverage for your specific needs. The key to a successful working relationship with aninsurance agent is trust. You should be able to trust your agent’s knowledge, experience and professional judgment, and you should always feel secure that your agent is acting in your best interest. But keep in mind that trust is a two-way street: Your agent also needs to trust you to provide information that is truthful and complete.
If you are comparing several plans, you need to know what to look for before making a decision. When choosing a health plan ask your health insurance agent the following questions:

·   Will the plan cover me for the specific doctor or hospital I would like to use?
·   How does the referral system work?
·   What pre-existing conditions would affect coverage?
·   How will the plan handle care if I (or a family member) am away from home?
·   What is the plan’s monthly premium, and what deductible and coinsurance am I required to pay?
·   Are there other fees, such as copayments and any additional charges if I use providers that are out-of-network?
·   Is there a maximum amount the plan will pay over a year or a lifetime?
·   What types of benefits are specific to this plan?
The purchase of individual health insurance in the private market can seem confusing. Approach its purchase like you would that of any important item—research your options and compare prices, and get the best advice and assistance you can, in this case, the services of a qualifiedinsurance agent.

Now that you realize how important it is to get a California individual health insurance, your next step is to shop around for one. There are a wide number of options for individual health insurance in CA; finding the right coverage for you is a big task. However, you should invest time and effort on making the right choice if you want to get the best value out of the investment you will spend for health insurance. What are some factors to considering when deciding on individual health insurance?

First, before you start thinking about how much a California individual health insurance coverage will cost you, evaluate your needs first. Take note of your existing health conditions, evaluate your lifestyle, ask around for medical family history, and so on. Based on the information you collect, find out what type of insurance coverage you need. Predict what kind of medical attention you would most probably need in the future. Bear in mind though that the more expensive the medical bills needed for the medical coverage you want, the more expensive your premiums will be.

Having said that, remember that when you get a California individual health insurance, you will pay premiums, usually on a monthly basis. This cost associated to getting a health insurance in CA is something you need to be ready for. The cost you pay to enjoy medical benefits will depend on your coverage. The more you are covered, the more you will pay. Some insurance policies require you to pay some additional costs for getting medical treatment. You may be responsible for a portion of the total cost, or for paying a fixed amount for your hospital visit. These terms vary greatly depending on your policy, the medical problem, whether or not the medical service provider is covered by the insurance network, among others. It is very important that your insurance quote provides information on these.

A good way to lessen the financial burden in getting a California individual health insurance coverage is to specify a deductible cost. This is a fixed amount you pay before the benefit payments kick off. Closely related is the out of the pocket cost, wherein the insurance does not cover the entire claim so you have to pay minimal amount straight from your pocket. You need to decide how much deductible and out of the pocket costs you can take. Setting these two to a higher value will go a long way to lessening your monthly or annual payments.

Moreover, another important point about health insurance in CA is the network of medical practitioners. You will make the most out of your health insurance if you see a doctor that is covered by the company you chose. If you are choosy with doctors, try to find a health plan that includes the doctor you want to keep seeing. Finally, choosing the right Californiaindividual health insurance is all about proper self evaluation and thorough research. Some effort and time will save you a fortune when a medical emergency happens. If you follow this guideline, you’re on your way to the health insurance plan that will work best for you.

Many people today think that getting Florida individual health insurance to cover their insurance needs if they do not get this from their employer is out of the question due to cost. There are a great many people who feel that health insurance is too costly for them to afford and go without it. This can not only be detrimental to the health of any individual, but can also end up costing someone their life savings or their home if they wind up in the hospital and face a mountain of medical bills. For this reason, it is important to have health insurance as well as compare health insurance coverage.  

When you compare health insurance coverage, you can see the difference in the coverage that different companies will offer you as well as the rate for the coverage. When you are looking for Florida individual health insurance, it pays to make sure that you compare health insurance by way of coverage that is allowed and the amount of the monthly premiums for the coverage. The more comparisons you do when you are looking for Florida individual health insurance, the more you will see that having health insurance is affordable and usually a lot more affordable than you think.  

You want to compare health insurance coverage by way of what they will allow you. Some companies have a network of doctors from which you can choose when you are getting Florida individual health insurance. Other companies allow you to choose your own doctor. The type of coverage that you pick depends upon your own personal preference. There is also a difference between co payments for some companies as well as deductibles. The higher the deductibles, the lower the health insurance quotes, so this is something that an individual might want to take a look at if they are looking for a way to save on monthly premiums. It is much more affordable to have high deductibles when it comes to health insurance than low deductibles as you are basically getting Florida individual health insurance in this way to make sure that you are covered for a hospitalization.  

It is important for everyone who lives in the State of Florida to have Florida individual health insurance as this can help them not only prevent massive medical bills in case they have to go to the hospital but will also induce them to seek out medical care if they should need it. Many medical problems can be avoided by seeing the doctor before they become a problem that requires surgery or hospitalization. The more someone sees the doctor for regular checkups, the more they can enjoy good health. Those who are looking for Florida individual health insurance should make sure they compare health insurance that not only allows them to be covered in case of a major illness or accident, but also allows them to a see a doctor for preventative medical care. Both aspects of health insurance should be reviewed by anyone who is seeking to compare health insurance quotes.

Illness for non-work related injuries can be financially devastating. Insurance keeps you protected against disastrous health care expenses and lost wages. There are enormous health insurance plans available day-to-day, the insurance cost and its benefits vary from one plans to another. Before enrolling for a policy, an individual should consult with the insurance agencies, read the policy to get the complete information about the benefits and costs and also the way the plan works.

Today, there are many more kinds of health insurance to choose from than were available just a few years ago. Traditional differences between and among plans do not longer any more. Also, there is been an increased emphasis on the role of consumers in managing their own health care and health care finances. There is a focus on providing information on the cost of care and health care quality-at the level of the physician, physician group, and hospital-to help consumers and employers choose among the many options available to them. The things have changed a lot, when most people in the United States had health insurance has indemnity insurance (also called as fee-for-service or traditional insurance). This type of insurance coverage assumed that the medical provider i.e. doctor or physicians will be paid a fee for each service provided to the patient.

When we talk about health insurance, we usually mean the kind of insurance that pays medical bills, hospital bills, and typically, prescription drug costs. Nowadays, the insurance also covers Medicare and Mediaid that provides health insurance coverage for certain people, senior citizens, people with disabilities and also an individual and families with low income. Today, the online information helps an individual to compare two best insurance policies and choose best among it. The insurance help an individual for financial planning and accordingly choose the best suitable for the family. The policy helps to avoid the burden of expensive medical bills and ensure the penny paid in health plan is paid for your care. It protects you and your family financially in the event of an unexpected serious illness or injury that could be very expensive.

In spite of available health insurance help online, unfortunately many Americans are still uninsured or underinsured. Some may be eligible for private or government but may have difficulty in finding the maze of complex rules and insurance jargons. Many more may not even have chosen the plans due to non-affordability coverage or may not be eligible for any. To help you choose right plan, we give you an overview of programs and strategies for seeking free or reduced-cost health care and managing medical debts.

Why does an individual require health insurance?

As the science and medical care advances, the ways of treatment are also increasing simultaneously. The main purpose of health insurance is to help in paying for care. It protects you and your family members in an unexpected serious illness and injury that may be high in cost. Additionally, you are more likely to get regular and routine checkups, if you have an insurance policy. Every individual requires insurance policy because you cannot predict your illness, injury and your high paying medical bills. One must seriously consider the need for health insurance for own and family. We also know that there is interlinking between having health insurance and getting protective health care. The research states that people having health insurance are more likely to have a regular doctor and get care when it is needed.

How should one get health insurance?

Most of the people get health insurance through their employers or company which they belong to. This is formerly known as group insurance. Some individuals don’t have access to group insurance. In this case, one may choose to purchase their own individual health insurance directly from public or privately owned insurance company. Most of the Americans in North America get health insurance through government programs that operate at National, State & Local Levels. Insurance- whether provided by your employer or purchased by you – can be both expensive and complex. To understand better option, you must take health insurance help from the experts and advisors.

Group Insurance:
Group Insurance is basically offered by the employers or else by an organization of which you are a member of union, professional association wherein you may get group coverage. The employee has to choose between several plans been offered by an employer’s including both indemnity insurance and managed care. Some employer may only offer one single plan. Some group plans may also include dental care with the health and medical benefits. Hence, it is a very important decision to be taken by and employee before choosing any insurance benefits offered by employer or an organization. It is also essential to compare plans to find the one that offers the benefits as per your need. Once you choose an insurance plan, you usually cannot switch over to another plan until next open season, usually set once a year.

In group health insurance, employer usually pays portion or all of the premiums. This means your costs for health insurance premiums will be lower than they would be if you paid the entire premium alone.

If you are a member of group insurance offered by an organization, you are benefited from being a member of a large group. You will have to pay lesser premium than an individual would be paying. However, the organization often does not pay a share of premium, meaning you are responsible to pay complete premium by yourself.

Individual Insurance:
In an individual Insurance, you get the coverage directly from the Insurance Company. You don’t have any access to the group insurance offered by an employer or an organization. When you buy you own insurance, you have to pay entire premium rather than sharing with an employer according to Group Insurance. In individual insurance, you do not share any cost of premium with your employer. You should analyze and choose an individual insurance plan that fits your needs at a price that you are willing to pay; you should also consult a tax advisor to find out whether you are eligible for any tax deduction as per the insurance plan.

Insurance variably differs from one company to another within an insurance industry, from one plan to another and one product to another. Hence, choosing right company, right product, right plan are the important criteria before choosing any plans.

Which type of health insurance is right for you?

Whether you choose group insurance or an individual insurance plan, you must carefully compare coverage and costs. You should compare the following important aspects like coverage and benefits, premiums, exclusions and limitations, access to hospitals, doctors, and other providers etc…

One must consider what kinds of services are covered by the plan? How are benefits being availed of health insurance plan; do you have to submit a claim? When do you need pre-approval to ensure coverage for care? What steps do you need to get the care of you and your family members need? You must ensure how does your insurance plan works. Don’t wait until you need emergency care to ask questions.

Author: Harshal Shah
Article Source: EzineArticles.com
Provided by: Excise Tax

Without a doubt the Internet has made life much easier for consumers, especially when trying to obtain the best deals when shopping for health insurance online. The ease of use and the ability to quickly compare the offers from competing health insurance providers makes it almost to fast and hassle free to purchase health insurance online. However, there are some important facts, questions and answers you or any consumer searching for an online health insurance provider should research before quickly making a decision that could lock you into a health insurance policy that may not be right for you.

Health insurance like most other insurance products and services contains a variety or jargon and terms that you should become intimately familiar with prior to signing up for a policy or health insurance plan that you may have found online. Most, in fact almost all, health insurance companies will require you to partake in a physical before they consider underwriting you for a policy. Basically, this underwriting process consists of your taking a physical, which the insurance company then verifies against the information you filled out on their application for accuracy. The reason for this full disclosure is so that the health insurance provider can determine the rate or premium they will charge you for your health insurance coverage and it’s also for your protection so that the insurance company cannot refuse you treatment for a condition at a later time. In some minor cases when obtaining health insurance online you may not have your information verified against the actual physical.

As mentioned above, when searching for health insurance online there is a chance that some insurance providers will not do their due diligence in the beginning (comparing your physical to your completed application or questionnaire) and will instead play the odds that you won’t get sick, injured or suffer some other health catastrophe. In the event that you do get ill and need their services they will then scrutinize your records with the hopes of finding a reason not to pay your health insurance related claims. If for some reason they find what they consider a valid discrepancy they may then attempt to not pay your claim or cancel your health insurance completely. Remember, this is not all insurance companies just a extremely small percentage that may do this practice or tactic to strong arm you into not receiving your proper health insurance coverage.

When shopping and comparing health insurance online make sure any application you fill out contains full disclosure and a complete and accurate assessment by you regarding your health otherwise you may find a future health related claim denied. When filling out your health insurance online application always list every illness, broken bone, accident, operation, medication you have taken and any other ailment you may have suffered from during your life. Failure to do so could nullify your insurance policy should you ever need to make a claim against it.

In some cases the health insurance agent for the company or provider you are considering will fill out the health insurance application for you. In the event he or she does this you must make sure and double check it for accuracy. Remember agents get paid based on the business they provide to the insurance company so always make sure no shortcuts were taken to get you initially covered by the health provider. If your future claims get denied due to an error on your initial application it doesn’t really phase the insurance agent hat helped you in the beginning.

Finally, after you’re approved make sure you double check your health insurance online application for any errors that may have occurred during and after the insurance company accepts your paperwork. The difference between a no and yes answer could prove costly in the future should you ever need to file a health related claim against your health insurance provider.

Author: Sharlene Raven
Article Source: EzineArticles.com
Provided by: Gadget reviews

Affordable health insurance, it’s something we all want to take part in but the reality is many consumers don’t know how to properly search for the best online health insurance deal. Fortunately, with the advent of the Internet finding the most affordable health insurance online has never been easier.

One thing you must know before doing any type of online research for health insurance or any other insurance product is that there are many insurance company websites that promise incredibly low rates for their insurance products but actually fail to deliver. Shopping for affordable health insurance isn’t as easy as buying the latest hard cover novel, the newest DVD or the latest Play Station 2 game. When purchasing health insurance online you will be required to divulge information about your current state of health as well as other information that is normally personal in nature. For that very reason always take the time to make sure the website you are considering purchasing your insurance through is truly legit and that they actually have licensed insurance providers that can help with your health insurance needs, wants and desires.

Perhaps the easiest way to find affordable health insurance online is to simply do a cost comparison as well as a benefit comparison between insurance providers or specialists. Don’t be mislead by the numerous ads touting insurance policies for 70% and 80% cheaper then anyone else. Although many of the insurance companies advertising specials like this are doing so to gain your business and may have a very good health benefits package there are a few bad apples that will do nothing more then take your health insurance premiums and provide little in the way of health care coverage. Remember the goal is to get the maximum amount of health insurance coverage at the lowest possible monthly rate.

So to recap the quickest and simplest way to find the best affordable health insurance online is to do the following; Step 1 – Search on the internet for health insurance companies and providers. Step 2 – Obtain their health insurance premium rates and quotes. Step 3 – Accurately (this means read the fine print) compare and contrast the plans and prices you obtained in step 2. Step 4 – Choose the health insurance plan that meets your health coverage needs and stays within your monthly budget and then apply online.

In some cases consumers shopping for affordable health insurance get confused or lost by the variety or options available to choose from. One way to seek resolution on this minor problem is to actively utilize the insurance company’s licensed health insurance agent by requesting guidance and information on their company’s respective plans, coverage amounts and monthly premiums.

Finding affordable health insurance doesn’t have to be a hassle or pain in the neck procedure. In fact by following our quick and easy tips you will find that locating the most affordable health care insurance online doesn’t have to be frustrating at all.

Author: Sharlene Raven
Article Source: EzineArticles.com
Provided by: Duty tariff

For those who don’t know, health insurance is simply the coverage of medical claims of an individual, against the medical costs. Like many others you may not be able to afford an expensive insurance policy – but you can eliminate all the frills you don’t need and get the low cost health insurance you want and still be adequately covered. Health insurance, as with any kind of insurance today, whether individual, personal, business or family health insurance, is always a gamble. You’re gambling that you’ll take out more than you are paying in and your health insurance company is gambling they will pay out less.

You want to know what to look for in any type of good insurance. If you have always had a health insurance benefit where you’ve worked and especially if you were a state or federal employee and now find you have to buy your own, you may not be able to afford the level of coverage you used to have. Finding good low cost health insurance today is easier than most people think.

To start, shopping for free health insurance quotes online is the easiest and best way to find low cost health insurance coverage. If you have any permanent health problems, such as diabetes, or have had cancer at any time in your family history, your monthly cost could easily be more than your house and car payment combined, but there are many different good insurance plans available today in the US.

The cold hard facts are the older you get the more important your health insurance policy becomes; this isn’t to say that you should not be concerned about your insurance when you’re younger. In case your doctor decides that something is an absolute medical necessity and it’s not covered under your current policy, the insurance company may exercise its discretion in paying for it, but don’t hold your breath. Many report they were eventually covered yet many more people get turned down.

One of the best ways to find low cost insurance is to get free health insurance quotes online. You can generally get very fast quotes and you want to compare several companies, as they will all have different criteria. This will be the fastest way to find low cost insurance.

Most importantly, you want a health insurance provider or company that has a good track record for paying without fighting you on every little detail. Your local agents may only be able to offer what they have currently available and not be able to offer you what’s best for both your pocketbook and your health.

The death rate in any given year for someone without insurance is twenty-five per cent higher than for someone with insurance so you want to make sure you get the best coverage you can get at the lowest cost as soon as possible. Heart-attack victims who don’t have insurance are less likely to be able to get angioplasty, which is often the treatment of choice. People who have pneumonia who don’t have insurance are less likely to receive initial or follow-up x-rays or necessary consultations.

In general because people who are uninsured are sicker than the rest of us because they can’t afford proper medical care, they can’t get better jobs, and because they can’t get better jobs they can’t afford insurance, and because they can’t afford insurance they get even sicker.

Although it does increase your risk, one way to lower your insurance costs is to set a higher deductible; if you’re in good health you’ll like come out ahead, barring an unforeseen event such as an accident, etc. Keeping yourself in better health will help you with less health insurance claims. All the insurance companies have to be very competitive because it’s so quick and easy to compare them with the other competing companies online.

Children without any insurance are less likely to receive proper medical attention for serious injuries, for recurrent ear infections, or for asthma for example and you want to avoid having to face a $100,000 open heart surgery without having any insurance.

So taking out insurance with higher deductibles and spending a little time online comparing at least five or more companies will make it more likely that you’ll find the best low cost insurance. There are many different health plans so make sure you get an understanding of all the low cost health insurance policies that are available from each company. Cheap or low cost insurance does mean a lower price and in some cases lower quality, but the price may be more important to some than the quality of the health plan. You don’t want to pay for more than you need but you want to consider any possible future health events you might encounter too.

Finding good, hopefully cheap, low cost insurance without giving up quality does not simply mean looking for the lowest premium but it means fully understanding all of the costs that will be involved in your policy. And finding the best health insurance is easy to do online, whether you’re shopping for long-term or short term health insurance from California, Texas or Florida.

With the rise of medical insurance costs today, most people look for low cost health insurance premiums that will ensure quality medical attention at the time of need, but at a price they can simply afford. Make sure to keep in mind that with low cost insurance options, you’ll need to compromise somewhat on the variety of services covered. Proceed surely but carefully.

Author: Helen Hecker
Article Source: EzineArticles.com
Provided by: Digital Camera Times

In today’s fast paced world, business owners don’t often have the time to thoroughly check out the companies they rely on to provide goods and services. In many cases, a determination of product/service quality can be made at the time goods are delivered or services are rendered. If goods or services do not meet expectations, there is often an immediate remedy available. For example, poor quality goods can be shipped back to the supplier and/or payment for services can be withheld until services are satisfactorily rendered.

Unfortunately, business owners do not always purchase items that are tangible items, in the sense that they can immediately determine the quality of the goods and/or services at the time of purchase. One example of such a purchase is health insurance. Since health insurance is not usually used immediately after purchase, the quality of care or the legitimacy of the policy may not even come into play until the business owner, or a family member, actually needs to have medical treatment. This is one of the primary reasons that many companies, often appearing legitimate, can get away with selling bogus health insurance coverage to unsuspecting business owners.

In most cases, fraudulent health insurance policies are sold to business owners by telemarketers or “agents” through bogus Associations and Unions. In that, the buyer must join a professional and/or trade association or become a union member to qualify for health insurance. In fact, in a study published by the U.S. General Accountability Office (GAO) in 2004, the GAO found that association schemes ranked at the top of the marketing methods followed by bogus health insurers. According to the report, “Employers and Individuals Are Vulnerable to Unauthorized or Bogus Entities Selling Coverage, between 2000 and 2002, the U.S. Department of Labor and state insurance regulators identified 144 unauthorized entities selling health insurance unlawfully. These entities defrauded 15,000 employers and more than 200,000 policyholders out of $252 million.”

However, it is important to mention that many individual and group health insurance products are endorsed by reputable Associations, such as the ARRP and the American Bar Association and, many reputable Unions, such as the AFLCIO and the Teamsters. These organizations have long been recognized for bringing a common class of professionals or citizens together for other purposes that have very little to do with health insurance. Membership commonly includes a wide range of other benefits in addition to discounted health insurance. Typically, the organizations have a governing organization, a constitution and bylaws, a set of officers, voting rights, regular membership meetings and a professional code of conduct.

Unfortunately, most individuals do not find out that they were making hefty monthly payments or premiums to fraudulent Associations or Unions until they have a severe condition that requires medical treatment. Usually, it isn’t until after they receive treatment that they receive notice from their medical provider that the claim that was submitted to the insurance company was denied and that all the medical charges that were incurred are now their responsibility.

Often, the scheme starts when business owners are contacted by telephone or approached by someone who claims to represent a certain, official sounding, Association or Union. The business owner is then informed that if s/he becomes a member of the Association or joins the Union, s/he could qualify for a low cost group or individual health insurance plan. Typically the Association or Union is promoted to represent self-employed individuals and small business owners. The low cost health insurance is usually presented as one of the many “perks” that the business owner can qualify for, in addition to many other “member” benefits, like discounts on other services, such as dental, eyeglasses, office supplies, hotels, rental cars, etc.

In many instances, these bogus companies involve licensed health insurance agents to sell their fraudulent health insurance products. Sometimes the “agents” know the products are fraudulent, other times, the “agent” also falls prey to the scheme. Often, the schemes prey upon consumers who have been previously declined insurance coverage or suffer from a pre-existing condition. Since these consumers have very limited options to purchase private health insurance coverage, the benefits of an Association or Union membership that offers health insurance coverage for a “membership fee” or “union due” is enticing. To the unsuspecting consumer that has a pre-existing medical condition or is paying high premiums for coverage, the “membership fee” or “union due” is a small price to pay for what they believe will be a quality health plan that provides “guaranteed” coverage with no “pre-existing condition exclusions” and no “waiting periods.”

In many circumstances, the print materials that are left with the consumer are very well designed, however, the majority of the time, the language in the “health plan brochure,” if there is one, is very unclear. The literature may name the entity that is authorized to act as the health plan administrator of the plan, but neglect to name the actual insurance company that is providing the health insurance coverage. Unfortunately, it is often difficult for the consumer to separate the illegitimate companies selling official sounding health plans from the legitimate ones. Typically fraudulent health plans have many commonalities.

Here are 10 “Red Flags” that may indicate health insurance fraud:

1. The “agent” is not a licensed insurance agent but an “enrollment” or “membership” coordinator.

2. The term “discount plan” is written in the product literature, but the term health plan, health insurance or policy is frequently used by the plan promoter. Discount plans often provide nothing more than a discount for medical services, such as prescription medications, eyeglasses, dental, etc. These plans are not designed to offer major medical health insurance coverage.

3. The official sounding “Association or Union” is one that you have never heard of before.

4. The plan is referred to as an ERISA plan. The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that allows employers to set up employee benefit plans for employees and their dependents. ERISA plans are not subject to state regulation and are not regulated by the state insurance commissioner. ERISA plans are normally not sold as health insurance, but are instead, established by employers, unions or groups acting on behalf of employers. Therefore, unsuspecting buyers believe these plans actually offer health insurance coverage, when if fact, they do not.

5. The buyer is told that the “membership fee or union dues” includes the health insurance premium, but there is no mention of the word “premium” in any of the plan literature.

6. The plan offers “guaranteed” insurance coverage with no exclusions for “pre-existing conditions” and no “waiting periods.”

7. The plan is significantly cheaper in price than other health insurance plans.

8. The term “reinsured” is used in regards to the plan. Reinsurance is something insurance companies buy to protect themselves against their own risks. It is insurance for insurance companies. Licensed insurers rarely have their agents mention any of their reinsurance arrangements during a sales presentation.

9. If the Association or Union is comprised of members from all walks of life and/or requires its members to state that they belong to a certain trade, class or group of professionals that they have no affiliation with, for example, the Association or Union is said to be comprised of “Food and Beverage” workers, but “Florists” and “Machinists” are allowed to enroll as members.

10. If the Association or Union is said to have a special arrangement with a health insurance company, a plan administrator or another third party that has designed the plan using a legal “loophole” that allows members to purchase health insurance at a discounted rate or to purchase a individual or group health insurance policy.

So how can you protect yourself from falling victim to a fraudulent insurance scam? Make sure you contact your state’s department of Insurance to determine if the health insurance company and the third-party administrator are licensed to do business in your state and make sure that the “agent” selling the plan is a “licensed health insurance agent.” Additionally, make sure that the health insurance company has been approved to sell the particular policy that is being offered. Since it may be difficult to tell if fraud is involved, always put off buying your insurance policy until you have had the opportunity to perform your own due diligence.

2007 Small Business Insurance Services, Inc. http://www.smallbusinessinsuranceservices.com

Author: C. Steven Tucker
Article Source: EzineArticles.com
Provided by: Canada duty