Purchasing health insurance is not something that individuals and families do very frequently. The process is not fun. There are confusing terms and concepts that just don't make sense to most people. The concept of coinsurance is something that many agents don't take the time to explain. This is truly unfortunate, since it is so important to understand this concept if the client is going to make an informed, intelligent decision. The client needs to understand his total risk. We have put together five important areas about health insurance that the prospective client should consider when shopping for health insurance. These areas are the network provider, HSA plans, important factors, budget, and whether or not the plan is a major medical type plan. 1) Make sure that the insurance company that you choose gives you access to the doctors and hospitals you want. Another way of saying this is: "Which network providers do they work with?" This is so important, but many shoppers don't even consider this. They end up with health insurance that looks good on paper, but when they go to use it, they are frustrated. They cannot see the doctors they like and they cannot get "In-Network" billing from the hospital. This information is also available on the internet. If you go to the network provider's website, you can search for health care providers serviced by that network provider. Try this now. Find your doctor using the following links: http://www.bcbsnc.com/apps/providers/search.do?LOB=IADV Blue Cross and Blue Shield of North Carolina has the widest selection of hospitals, doctors and specialists of any health insurance provider in North Carolina. 2) Learn about Health Savings Account HSA type plans. HSA plans were introduced January 1, 2004. Most people, even today, don't have a working knowledge of HSA plans. If you are on a tight budget, HSA plans will provide you with the lowest premium costs. Compare HSA's with copay type plans. Once you understand both types of plans, you can make an informed decision. There is more information in the Frequently Asked Questions area on this website. Most importantly, your agent should be able to explains both types of plans to you in about five minutes. Take that time to understand how you can get great protection at a very competitive premium price.
3) If you are shopping for a plan, be sure to consider what the prospective plan will cover. The important factors to consider are:
An easy way to to compare various plans is to look on this website. Here is a page where you can compare BCBSNCs several insurance plans on the same page. You will be able to make comparisons on the same items very conveniently. You will find the greatest differences in copays, coinsurance, deductibles, drug coverage and mental health coverage. 4) Share your budget amount with your agent/broker. Some people are reluctant to give their agent information concerning their budget. They fear that the agent will try to use up all their money to fit the budget. This isn't likely to happen. The agent is unable to change the pricing for you. Even if you are the agent's sister, he cannot give you preferential pricing. The pricing is fixed by the state Department of Insurance. Therefore, you can help to speed up the decision / selection process by sharing your budget with your agent/broker. Then, he can show you health insurance plans that fit your budget, and not waste your time with plans that don't fit.
5) Is the plan in question a major medical plan? Be careful here. Certain less than reputable companies employ inexperienced agents that will be instructed to say that their plans are major medical plans. In fact, these plans are not major medical plans. They are actually fee schedule plans. You can ask the agent if the policy uses the words "MAJOR MEDICAL" at the top of the policy. If it says MAJOR MEDICAL, then, it is. If it is is not a major medical plan, of course, it won't say MAJOR MEDICAL at the top of the page. Why should you care? A Major Medical insurance plan provides benefits for major illness and injury. Usually it is characterized by a large benefit maximum ranging up to $5,000,000.00, or no limit. This insurance, above an initial deductible, reimburses the major part of charges for hospital, doctor, private nurses, medical appliances, prescribed out-of-hospital treatment, drugs, and medicines. There are not any limits as to how much they will pay for a particular illness. No limit on the amount they will pay out in a single year. Many fee/schedule plans cost as much as major medical plans! They have severe limitations on what they will cover. You should really purchase a major medical plan. Therefore, you can see that if you ask the right questions and consider the important factors, you will have a better chance of choosing the right major medical policy for you and your family. Take the time to make sure that you will be able to visit the doctors and hospitals you desire. Make sure that you take the time to understand HSA (Health Savings Account) type insurance plans. Compare the different plans on the same factors that really matter. Tell your agent / broker what your budget is. Get him to help you find the best plan for your money. Lastly, make sure you ask the agent / broker questions about whether you are paying for a major medical policy or a fee / schedule policy.
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