What type of health insurance is right for you?

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Buying your own health insurance coverage can be daunting. There are many options both on and off the health insurance exchange, and it’s often difficult to know which is best for you and your family. As such, finding a plan that provides the health care benefits you need at an affordable cost often requires some solid research time. This ebook can help curb your search with thoughtful information about health insurance plans.

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What type of health insurance is right for you?

  1. 1. Which Health Insurance Plan Type is Best for You? Your Quick and Easy Guide to Understanding Coverage Options A free e-book from The IHC Group © The IHC Group 2013 www.healthedeals.com HI ebook 0413 1
  2. 2. Table of Contents Introducing Your Guide to Health Insurance Options............................................................... 3 Temporary Health Insurance—Short-Term Medical Plans........................................................ 4 What short-term plans offer.............................................................................................................4 Who should buy temporary coverage?........................................................................ ................... 4 Who might consider another option?........................................................................... ................... 4 Limited Medical Insurance—Fixed Indemnity Plans.................................................................. 5 What fixed indemnity plans offer..................................................................................................... 5 Who should buy a fixed indemnity plan?..................................................................... ................... 5 Who might consider another option?........................................................................... ................... 5 Hospital and Surgical Insurance Plans......................................................................................... 6 What hospital and surgical plans offer............................................................................................ 6 Who should buy a hospital and surgical plan?............................................................................... 6 Who might consider another option?........................................................................... ................... 6 Individual Major Medical Insurance Plans................................................................................... 7 What individual plans offer.............................................................................................................. 7 Who should buy temporary insurance?....................................................................... ................... 7 Final Words......................................................................................................................................... 8 3 more tips for choosing a plan....................................................................................................... 8 Should you go it alone?............................................................................................... ................... 8 About The IHC Group....................................................................................................................... 9 © The IHC Group 2013 www.healthedeals.com HI ebook 0413 2
  3. 3. Introducing Your Guide to Health Insurance If you buy health insurance on your own, rather than through an employer, you are not alone. An estimated 14 million people under age 65 purchase health insurance plans on the individual market, according to the Kaiser Family Foundation. There are many reasons individuals and families must buy their own insurance, including but not limited to the following: • Being laid off • Gaining new employment and being subjected to a waiting period before benefits kick in • Their employer does not offer coverage • Self-employment • Entering retirement before Medicare eligibility kicks in • Working part time • Being in school • Coverage through an employer is too expensive If you are buying a plan for yourself and/or your family for the first time, you may have many questions about the different options in the marketplace. If you have been purchasing your own coverage, you may be wondering if the plan type you chose is best for your health and financial needs. We hope this guide helps you better understand the different types of health insurance plans sold to individuals and families, so you can acquire the best possible coverage. © The IHC Group 2013 www.healthedeals.com HI ebook 0413 3
  4. 4. Temporary Health Insurance—Short-Term Medical (STM) Plans It’s quick and easy to obtain. It’s designed to be affordable. Temporary health insurance can bring peace of mind when you find yourself suddenly in need of coverage. These temporary plans do not cover pre-existing conditions, but they do offer catastrophic coverage for accidents and other expensive medical bills, which are covered up to the policy maximum—often $1 million to $2 million for the policy length. Temporary plans are not subject to the Affordable Care Act, which means preventive care and essential health benefits are not likely to be covered. What short-term plans offer Easy application—Within minutes you can fill out and submit your application online. Typically, you must provide your date of birth and address in addition to answering a handful of medical questions to determine whether or not you are eligible for coverage. (Almost) immediate coverage—Your policy documents will arrive in your email inbox right away and in many cases, your policy can start as early as the next day High customization—You can customize your STM plan by selecting your deductible, coinsurance percentage, out-of-pocket maximum and coverage period. Policies can run from 30 days through 364 days, depending on your needs and state laws. Again, depending on state laws, you may also apply for a new policy once your previous policy expires. The new policy will be treated as a new policy and not an extension of the previous one. This means that any illnesses or conditions that occurred within the first coverage period will likely be considered pre-existing on the new one. Who should buy STM? These plans are ideal for individuals and families who need fast coverage for the short term, including: • Those in between jobs • The recently divorced • Young adults who have just turned 26 and are no longer eligible for coverage through their parents’ insurance plan • College students Who might consider another option? • Those temporarily visiting, studying, or living in the United States—STM plans from IHC do not require a Social Security number, just a United States mailing address • Retired persons not yet eligible for Medicare • Those who qualify for a health insurance subsidy after Jan. 1, 2014, but still cannot afford the health exchange monthly premium These plans are unsuitable for individuals and families who need long-term coverage. If you have been denied coverage due to high-risk health problems, you will unlikely qualify for short-term medical insurance. © The IHC Group 2013 www.healthedeals.com HI ebook 0413 4
  5. 5. Limited Medical Insurance—Fixed Indemnity Plans If you have had trouble affording and qualifying for health insurance, you may want to consider a fixed indemnity plan. These plans are accessible to those who have been denied coverage for medical reasons and provide limited benefits for everyday health care as well as unexpected hospital stays and surgeries. What hospital and surgical plans offer Guaranteed issue—Eligible individuals may apply and enroll without undergoing a medical exams or answering health history questions. Affordability—Choose from plan designs with fixed benefits that keep premiums lower than major medical insurance. Value—For a premium within your budget, you receive benefits for preventive care, urgent care and emergency room visits, hospital confinement, and doctor office visits. Who should buy a limited medical plan? Those who’ve been denied coverage for an individual major medical plan or who are looking to keep premiums low may find this to be a sound option. Who might consider another option? Those who want or need more comprehensive coverage should look to an individual major medical plan. If unable to qualify for major medical coverage, look into obtaining it through a state or federal high-risk pool. © The IHC Group 2013 www.healthedeals.com HI ebook 0413 5
  6. 6. Hospital and Surgical Insurance Plans If you are more concerned with saving money than obtaining comprehensive coverage, a hospital and surgical insurance plan might be the solution. These plans tend to have lower monthly premiums than traditional full coverage major medical health insurance. Since hospital, surgical and critical illness indemnity illness insurance is not major medical insurance, it provides first-dollar fixed benefits after the applicable deductible for hospital confinement related medical expenses and for certain specific outpatient surgery, maternity, chemotherapy and radiation services, and critical illness. They do not cover catastrophic events and are not subject to provisions under the Affordable Care Act. What hospital and surgical plans offer Economical coverage—Individuals on a tight budget can select from various plan options and premiums to create coverage that accommodates their financial needs. Customization—In addition to selecting a per injury or illness deductible, hospital and surgical insurance plans allow you to choose from a variety of benefit levels for inpatient and outpatient services, hospital confinement, chemotherapy, and more. Further tailor the plan to your needs with add-ons such as an additional critical illness benefit, a testing and diagnostics benefit bundle and a health maintenance benefit bundle. Flexibility—Without network restrictions, you can select the care most convenient and confortable for you. You can also visit network providers for additional savings. Who should buy a hospital and surgical insurance plan? Those looking for extra coverage might consider a hospital and surgical insurance plan. Because the monthly premium is relatively low and the plan is highly customizable, it can be a good way to obtain extra financial help for hospitalization and surgical services. Those who are in relatively good health and need to save money might consider this option; however, this type of plan is probably best suited for short-term situations. Who might consider another option? Those who see the doctor regularly or take prescription drugs on a regular basis may find this type of coverage too limited and should consider an individual medical plan instead. If you are looking to keep your monthly premium low, a high-deductible health plan with a health savings account might be the right solution. © The IHC Group 2013 www.healthedeals.com HI ebook 0413 6
  7. 7. Individual Major Medical Insurance If you want richer benefits akin to those available through an employer, comprehensive health insurance coverage through an individual major medical plan is what you are looking for. Because individual major medical plans are subject to the Affordable Care Act, you will have access to no-cost preventive care as defined by the law and essential health benefits such as maternity and pediatric services including oral and vision care. Note that this is only if you meet an insurance carriers’ underwriting criteria for the policy you are applying for. Unlike group coverage offered to employees, those purchasing individual coverage must provide evidence of insurability. This means the application will include a personal health and medical history, in addition to age, weight, and lifestyle habits. Carriers can decline coverage based on these and other factors, including income. Coverage may also be extended with restrictions on pre-existing conditions or other limitations. What individual medical plans offer Options—Individual major medical plans can be customized with a range of copays and deductibles. For those in good health who are looking to pay less in monthly premium, a high-deductible health plan with a health savings account is another possibility within the major medical landscape. Comfort—Because this type of coverage is more robust, you may feel more secure about your physical and financial wellbeing, should the unexpected occur. In addition to being subject to Affordable Care Act guidelines on preventive care, individual health insurance plans provide varying levels of benefits for doctor visits, hospitalization, medical supplies, mental health, prescription drugs and other medical services. Choice—The array of health care providers, clinics and hospitals typically available through large PPO networks allow you to pick the doctor you’re most comfortable with and the facilities most convenient for you. Who should buy an individual health insurance plan? Individual major medical is deal for those who: • Expect to purchase their own coverage for the long term • The self-employed • Individuals who work part time and are therefore not eligible for employer coverage • Those who want comprehensive coverage © The IHC Group 2013 www.healthedeals.com HI ebook 0413 7
  8. 8. Final words Purchasing health insurance is a big expense. Put adequate time, effort, and thought into shopping for health insurance. It is best to proceed cautiously to avoid unpleasant surprises, unexpected out-of-pocket expenses, and lack of benefits where and when you need them most. 3 more tips for choosing a plan Now that you are familiar with the basic plan types, here are three more actions to take before you obtain a quote, fill out an application and commit to a policy: 1. Determine what you can afford—Think about it globally, which means considering monthly premium in addition to out-of pocket expenses such as copay, coinsurance, prescription and over-the-counter drugs, medical supplies, etc. 2. Look at previous use—How often have you and your family visited the doctor in recent years? Do you have a pre-existing condition that requires maintenance drugs or frequent checkups? 3. Anticipate future needs—This can be difficult since emergencies and illnesses are often unexpected. However, there may be clues in your life about potential situations in which medical care will be needed; for instance, family medical history, school age children, participation in sports, poor dietary and lifestyle habits, etc. Should you go it alone? You may wonder whether or not to use an agent or broker. A local independent insurance agent will likely sell health insurance from multiple companies. Agents work with many plan carriers and know the market, and they serve an array of clients with various life situations, which they can explain, different plan designs and help you determine which might best work for you and your family. For help finding an agent or broker, start by seeking recommendations from family and friends or visit the National Association of Health Underwriters. You can also access a wide range of plans online and purchase them directly from the carrier. Using consumer-oriented websites such as HealthPocket.com, you can find out more about plans in your area including their quality ratings, plan details such as average cost, how to access more information, and insights as to percentage of applicants denied and percentage of those who ended up paying more than their initial quote. When open enrollment begins in October 2013, you will be able to purchase coverage for 2014 through a state or federal health insurance exchange as a part of the Affordable Care Act. © The IHC Group 2013 www.healthedeals.com HI ebook 0413 8
  9. 9. About healthedeals.com and The IHC Group Healthedeals.com is offered by IHC Specialty Benefits, Inc., a member of The IHC Group. IHC Specialty Benefits is a customer-driven company differentiating itself through knowledge, experience and integrity. We, in conjunction with our trusted insurance carriers, share a mutual desire to provide important benefits to our customers and to meet their needs in an innovative, hassle-free manner. The IHC Group is comprised of insurance carriers (shown below), and marketing and administrative affiliates committed to providing excellent service and offering competitive health, life, disability, stop-loss, short-term medical, travel and dental insurance products to groups and individuals. The IHC Group offers of the following: • Fixed indemnity insurance plans underwritten by Madison National Life Insurance Company, Inc. or in some states, Independence American Insurance Company. • Short-term medical insurance plans underwritten by Standard Security Life Insurance Company of New York or Independence American Insurance Company. • Hospital, surgical and critical illness indemnity insurance plans underwritten by Independence American Insurance Company. • Individual health insurance underwritten by Madison National Life Insurance Company, Inc., and in some states, Standard Security Life Insurance Company of New York. To speak with an insurance sales associate immediately, call 866-645-6630. This e-book is not professional advice and recommendations may not apply to individual situations. Please refer to healthedeals.com, call 866-645-6630 to speak with a sales consultant or contact your health insurance agent. Ebook last updated 4/9/13 © The IHC Group 2013 www.healthedeals.com HI ebook 0413 9

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