Getting Health Insurance
What type of health insurance might I get from my employer?
In today's world, employers offer group plans with HMO benefits or PPO benefits. When I first started in the insurance business, everybody in a company, everybody in a firm, had to be on exactly the same health insurance policy. Today the insurance companies have risen to the occasion, and now they're saying to some people who want HMO plans, that they can have HMO. Other people can have PPO. The employers are sometimes they'll pay a certain amount a month, and if you want any other plan that's more expensive, you pay the difference. Employers are now giving a lot of flexibility to these health insurance programs. They are much better today than they used to be.
What types of health insurance can I get if I am self-employed?
If you're self-employed, you still may have employees working for you. If you have employees working for you, we can put in a group health insurance plan, even for a self-employed person. If you're a one-person show, let's say you're a psychiatrist or an attorney or a real-estate broker, and you're just a one-person show, you don't work for anybody but yourself and you don't have any employees, then you're pretty much going to buying an individual health insurance policy. If you're self-employed, you can purchase a PPO plan, an HMO plan, point-of-service plans. If you have employees, you can put in a small group. Even though you're self-employed, you still may have one or two employees. You have several health insurance choices to go with if you are self-employed.
What are my options if my company doesn't offer health insurance?
If your company doesn't offer you health insurance, one good thing to do is to ask your company to think about putting you in a group plan. Another thing is if your company cannot afford to put you in a group plan at this point, which is happening a lot in America today, you should consider buying your own individual policy. You can buy a PPO plan, an HMO plan, various plans. There is also a new program which we will talk about is what it's called an HSA, a health savings account, it's a great policy. There are several programs that you could go on if you are a self-employed person or if you are working for somebody and they just don't offer health insurance benefits.
What is a "group insurance plan", and how does it differ from an "individual plan"?
A group plan is, in most States, a plan of two or more employees. That could be the boss and one assistant - a full time boss, so a group insurance program usually requires everybody to be full time employees. The nice thing about group insurance is it's usually guaranteed issue. That means that if two people, even, have a group plan, and one person is completely unhealthy, they could still be guaranteed by most insurance companies a group health insurance policy. Many companies have to do this. Small companies, because they can't qualify for an individual policy. An individual policy is individually underwritten. That means you answer all these medical questions and you write down the doctors you've been to and the insurance company underwriter looks at all that medical history and decides whether or not you're insurable or not. Under a group plan, the underwriter and the insurance company says we have to accept you because it's the law. There's a law that says if you have two employees or more that the insurance company has to accept you regardless of your health or potential conditions.
What if I can't afford health insurance?
If you can't afford insurance in today's world, then, in many cities there's county hospitals. County hospitals will take you for free if you have a serious problem. The problem is, if you don't have a serious problem, let's say that you were having the beginnings of diabetes, that's something that doesn't just exacerbate immediately and you don't see it right away. It takes years before it really does damage to your body. If you had a health insurance policy, you might have been able to catch that condition early and live normal life expectancy. What most people have a misconception about is that they don't realize that they can go to a very high deductible policy to cover the big picture. It's not unusual for people to buy a $5,000 deductible health insurance policy so that if they have a catastrophe, they're still covered. Even on high deductible policies, you can go into a doctor's office and you'll get the discounts, because they'll be a PPO provider, for example. If the doctor charges $400 for a procedure, but you're using your $5,000 deductible policy, the doctor will have to reduce his fees to $100 or $150, and that might be something affordable. Most people are scared away by expensive health insurance policies, but a high deductible might only be $100 per month. I have two children who are nineteen and twenty-one. I will pay for their health insurance premiums the rest of their life because I don't want to have a situation where one of my children forgets to pay an insurance premium and I have to come up with a half a million dollars of my retirement income to pay for their medical claim. Sometimes by just talking to the insurance client and finding out a little bit more about them, I can usually figure out a solution to a health insurance problem.
How does getting married or divorced affect my health insurance?
If you get married you'll probably want your spouse to be on your policy or you'll want to be on their policy. If you get divorced, there is no problem because most individual policies allow both partners to separate and continue the same policy, except that they'll now have two separate premiums instead of a joint premium. If you get married and you marry a younger person, like for example if a forty year old man marries an tweny four year old woman most insurance companies go by the younger spouses age and so that would be a major benifit by marrying a younger person.
How does having children affect my health insurance?
If you have children, you want to make sure that you add your children to your policy. When you have a baby, it's very important within 31 days of the child's birth, to notify the insurance company that you have a child. If you don't, then after 31 days the insurance company could say that we want to check your child's insurability. That means if the child has any health problems, they could actually refuse to insure the child. So, it's very important for young people who have children to immediately notify the insurance company that they have kids. It's going to increase your premium, but that's part of life.
