Some common red flags:

1.  What is the cancellation policy? – All policies have provisions where the insurance company can cancel (rescind) the policy if there is evidence of fraud or an omission of a condition or medication.  They can also cancel a policy for lack of payment.  This is normal.  However, there are also policies that state that the insurance carrier can cancel as long as they give the policyholder 30 days written notice.  This is a scary proposition!  What if you contract an expensive disease that requires months of hospitalization?  A letter cancelling your coverage would not give you any options. 

2.  What are the waiting periods?  – Some policies have no waiting periods on coverage.  Some will state a 30 day waiting period on doctor’s visits.  A 90 day waiting period on elective surgery is normal, but stay away from policies that require a 6 or 12 month waiting period.  

3.  Does the maximum out-of-pocket include the deductible? –  If you have a plan with a $2500 deductible and a $5000 out-of-pocket maximum, it is reasonable to assume that the maximum you will spend is $5000.  But the scary truth is, some plans don’t include the deductible into that equation.  If you are comparing two plans side by side and they seem equal but are vastly different in price, this might be the reason.  It can be easily overlooked.

4.  Is the deductible per year? – This seems like a stupid question at first.  Most deductibles are per year, after you spend your deductible in that year then you may or may not have more to spend before you reach your out-of-pocket maximum.  But there is one company in particular that offers a lower-priced policy with a deductible per incident.  Yikes!  What if you have 3 separate surgeries in the same year?  That could get very expensive very quickly.

5.  Is the out-of-pocket maximum too high?   Some plans will have a reasonable deductible, like $2500, and then put it with an out-of-pocket maximum of $10,000.  That’s pretty high! Sure it looks like a bargain, but in reality may be similar in price another company’s plan with a $5000 out-of-pocket maximum.  Why not get something that will cost you less in the long run, even if it costs a few dollars more now?  I can help.

Most people are confused by insurance quotes or statement of coverage.  Don’t just skim over it.  Figure out what you are buying (or already have bought) or at the very least let me take a look.  I understand it and won’t charge you anything.  I won’t even try to sell you something unless there is a red flag that needs to be corrected or I can get you better coverage for less money.  Give me a call.

What is a Co-Payment? Also called a co-pay, it means the amount of money you are responsible to pay whenever you go to the doctor (your insurance pays the rest).  Co-Pays are generally range $25 to $35, depending on your insurance plan (it could be $50 if the doctor happens to be a specialist).  

What’s a Deductible?  If you have to have a surgery or procedure based on your doctor’s recommendation, you are responsible for the first set of costs, called the deductible.  Common deductibles are $1000, $2500 and $5000.  Generally the lower your deductible, the more expensive your insurance plan will be.  Deductibles run in a yearly cycle and start over in January.  Important Note: If your deductibles are per incident instead of per year, this is a problem!  Let me take a look at it your policy and get it fixed. 

What about Co-insurance? Your co-insurance is the set of costs that you and the insurance company share after the deductible has been met.  For example, if you have an 80/20 plan, it means that your co-insurance is being paid 80% by the insurance company and you are paying 20%. This can be confusing because people often assume incorrectly that the insurance company is paying 80% of the total bill and they will be stuck with the rest.  

Example:
If you have a $2000 procedure and a $1000 deductible insurance plan with an 80/20 co-insurance, you should expect to pay $1200. 

Some plans pay 100% after the deductible, which means no there is no co-insurance. 

What does Out-of-Pocket Maximum mean?  This is the total amount of money you could end up paying in a single year for health costs.  On some plans, once you reach your deductible you have also reached your out-of-pocket maximum.  On other plans you have co-insurance to pay first.  Once you have reached your out-of-pocket maximum for the year, you are done.  YAY!

Here’s an example to incorporate everything we’ve learned today:

Let’s say your co-pay is $35 (but $50 for a specialist) with a $1000 deductible, an 80/20 co-insurance and a maximum out-of-pocket of $3000.   You go to the doctor because your ear is hurting.  You pay $50 (co-pay) for your doctor’s visit because she is a specialist.  Unfortunately though, you find out that it’s more serious than you’d hoped and you have to undergo an ear surgery.   That procedure costs $5000.  So, you would pay the first $1000 (deductible) and 20% of the $4000 balance – which comes out to $800 (in co-insurance).  You should expect to pay $1800.  So in this example you would not reach your maximum-out of pocket.  

Hopefully this helps you understand what these common terms.  Now you can compare two plans that sound similar but are widely different in cost.  Also you now have the information to begin to understand the plan you currently have.  I would be glad to look at your plan and point out any red flags I see.  I never charge for evaluations or advice.  Give me a call at 615-478-7146.

But why, exactly, does procrastination always seem to kick in when it comes to life insurance?  Maybe you don’t really see the point of life insurance or understand how it works.  Maybe it feels too daunting.   Maybe you don’t feel like you have the money to spend on it. Whatever your excuse – it’s time to put them those excuses to rest and get that peace of mind that you and your family crave!

What is the point of life insurance?
The reason to have life insurance is pretty simple: If you have loved ones and you have an income, there are probably bills that need to be paid and people who are being cared for.  It’s likely that they are at least partly supported by your income.  Since 100% of us face death at some point and don’t know exactly when that will occur, it makes sense to get a plan in order now.   In addition to burial costs, you need to consider how your dependents will account for the loss of your income.

How does it work? 
If something happens that results in your death, your life insurance company pays a pre-determined amount of money to your loved ones.  So, whether it be the mortgage, car payments, education costs or the water bill, the money your loved ones receive from your life insurance policy helps to cover the monetary gap you may leave behind.

How difficult and time-consuming is the application process?
The application process is fairly quick and easy.  You’ll find that the peace of mind that comes with taking this off your to-do list is definitely worth it.

How expensive is life insurance?
If you are in good health, you will probably be shocked at how affordable it is.  In addition, there many levels from which to choose.

Give me a call today and end the procrastination!

So why bother with an agent?  Well, for one thing… an independent insurance agent, like me,  is not tied to just one company, so you are empowered by options – whether it be cost, companies or policies.  Since an independent insurance agent is familiar with these things, he/she can cut to the chase and find the best solution for your needs without you having to: a.) get the pitch from several companies yourself and b.) spend hours glazed over the fine print on an impersonal website.  Once I gain an understanding of what you are looking for, I can run health and/or life insurance quotes with all of the top-rated companies to find not only the best price, but the best coverage for your needs.

With an independent agent, you get your own personal expert. A good independent insurance agent will pour over product documentation – finding the strengths and weaknesses of each product.  As a dedicated insurance agent, I attend training sessions, take Continuing Education, develop relationships with the reps at the insurance companies, and generally become immersed in the insurance world – it’s a lot of information and that’s why I’m there – to explain, counsel and break it all down for you. I can look at your current policy and make sure that it’s exactly what you need.

Another reason to use an independent agent is that a good agent will monitor your policy for you.  Rates tend to go up every year and if you’re not careful you could be paying more than you should be. I will watch your policies and recommend changes when needed. Generally speaking, you won’t get that kind of personalized attention when you deal direct or online.

In summary, it’s a no brainer to use an independent insurance agent versus buying direct or online -  you get a wider option-base, an expert helping hand, and a personal advocate – all at no additional cost!  My advice and quotes are always free, whether you buy anything or just want assurance that your policy is a good one – give me a call.

Decisions should be made based on your risk now, not on what might happen if the government decides to make changes to the whole system. Many of the people I talk to who are uninsured are in that situation because it either isn’t a priority or they think it’s too expensive. These same people usually have a nice cell phone and/or drive a nice car and are telling me this over a cup of coffee at the local hang.

I say it’s more expensive to not be insured – like my friend who broke her ankle, didn’t have any health insurance and faces a $27,000 hospital bill. The hospital gave her the good news that as an uninsured patient she may qualify for a discount of up to 15% off! When it comes to the cost, as long as you dont expect your health insurance to cover every possible medical expense it can be pretty reasonable. Just today I quoted a higher deductible plan for a 35 year old male that was under $85 a month. I would say that is pretty reasonable.

Whatever form the health initiative takes, it will most likely mandate that everyone carry health insurance or pay a fine. It’s going to have to be a priority for everybody, much like auto or homeowner’s insurance is. So my advice is to go ahead and get the coverage you and your family need and not wait around trying to guess what the government will do next.