A SMART Guide To Understanding The 5 Key Facts On Which Health Insurance Policies Are In Bad Economy

A SMART Guide To Understanding The 5 Key Facts On Which ‘Health Insurance Policies Are In Bad Economy’ health insurance A SMART Guide To Understanding The 5 Key Facts On Which Health Insurance Policies Are In Bad Economy A SMART Guide To Understanding The 5 Key Facts On Which    Health Insurance Policies Are In Bad Economy
A SMART Guide To Understanding The 5 Key Facts On Which ‘Health Insurance Policies Are In Bad Economy’

The statistics state that when the economy grows the insurance business also grows. People normally go for insurance when their economic situation is stable.

However, when it comes to consumer perspective there are significant concerns about their plans and coverage, because many health insurance plans have particular eliminations that remove consumers benefits for anything that could have been covered under Workers Compensation (if you live in the US) or similar laws.

Considering such kind of concerns, how to perceive whether or not your health insurance policies are in a bad economy. Here in the following section we are going to focus on key characteristics of health insurance policies that are in a bad economy.

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1. Classifying whether or not you are covered ‘On and Off the Job’

There are several health insurance plans that enact some specific exclusions that remove your benefits for anything that could have been covered under Workers Compensation or similar regulations.

Many self- employed people and even some small business owners do not carry Workers Compensation on themselves. However, there are intended insurance plans that will cover you on and off the job, if you are not required by law to have Workers Compensation coverage.

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2. Understanding whether or not you are writing it off

Independent free-lancers, home based business owners, professionals and other self-employed people generally are not taking advantages of the tax laws available to them.

Many people who are paying 100% of their own costs are eligible to deduct their monthly insurance payments. Just that alone can reduce your net out-of-pocket costs of a proper plan by as much as 40%.

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The better way to approach for the process or eligibility criteria is to ask your Accounting professional. You can also check out the Internal Revenue Service website (If you live in the US) to have a detailed information.

3. Understanding the internal parameters

It is important to understand that the true insurance plans use some method of internal controls to determine how much they will pay out for a specific procedure or service. There are actually two elementary approaches.

i) Listed Benefits

Several plans, some of which are specifically promoted to self-employed and independent people, have a clear schedule of what they will pay per doctor office visit, hospital stay, or even limits on what they will pay for testing per 24-hour period.

This structure is typically associated with Indemnity Plans. If you are presented with one of these plans, make sure you understand the schedule of benefits.

It is important that you comprehend these types of limits up front because once you reach them the company will not pay anything over that amount.

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ii) Usual and Customary

“Usual and Customary” refers to the rate of pay out for a doctor office visit, procedure or hospital stay that is based on what the majority of physicians and facilities charge for that particular service in that particular geographical or comparable area.

“Usual and Customary” charges represent the highest level of coverage on most major medical plans.

4. Asking questions about plan, limits and price

In order to understand the policies, benefits, limits and price it is important to do some research. During the searching process, generally, the value, price, personal needs and general marketplace gets evaluated by the buyer.

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When it comes to health insurance plans, it is actually very alarming that most people never ask what a test, procedure or even doctor visit will cost.

Enquiring price, plans and limits will help you get the most out of your plan and reduce your costs.

5. Getting knowledge about networks and discounts

Nearly all insurance plans and benefit programs work with medical networks to access promotional rates. The discounts can vary from 10% to 40% or even more.

Medical network discounts vary, but to ensure you minimize your costs, it is important that you preview the network’s list of physicians and facilities before committing.

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This is not only to ensure that your local doctors and hospitals are in the network, but also to see what your options would be if you were to need a specialist.

Don’t hesitate to ask your agent what network you are in. You should also ask your insurance agent whether it is local or national. Based on all these clarifications you then can determine if it meets your needs and requirements.


This information is for Learning purposes only. We are indeed not financial/legal mentors. It should not be considered legal or financial advice. You should consult with a financial/legal advisor or other professional to find out what may be the optimum for your individual needs.

Please do your own research.

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