<ul><li>Your medical history, current health, and lifestyle choices influence your costs for health insurance.
Pre-existing conditions like chronic illness or diabetes can increase your premiums and may also be subject to “waiting pe...
Lifestyle choices such as smoking will increase your premiums.</li></ul>HealthCompare.org<br />
<ul><li>If you want lower premium payments, opt for high deductible plans.
Choose a co-payment plan – the premium is lower but you pay a percentage of costs for services you receive. Consider the m...
<ul><li>Insurance companies employ actuaries who calculate the framework for determining insurance premiums.
Underwriters will calculate your particular premiums based on a variety of factors including your health status and histor...
In addition, your premium costs will vary based on several coverage variables:<br />Deductible amounts –The total amount o...
Copay - The amount that you pay towards your medical bill. It is your share of the costs. They are usually described as se...
<ul><li>Economists tell us that rising health care costs directly correlate with significant drops in health insurance cov...
A study by Harvard University researchers showed an average out-of-pocket medical debt of $12,000 for individuals who file...
<ul><li>Every 30 seconds in the United States someone files for bankruptcy resulting from the aftermath of a serious healt...
Medical expenses can lead to housing trouble. Many consumers can’t pay their mortgage or get credit approval due to outsta...
Do You Understand ‘In-Network’ Services?<br /><ul><li>Network coverage refers to medical services covered by a defined gro...
When you use the services offered by the pre-approved providers you are using “in network” services.
There are two different types of plans to choose from: managed care plans and indemnity plans.</li></ul>HealthCompare.org<...
Do You Understand ‘In-Network’ Services?<br /><ul><li>Managed care plans (HMOs, PPOs, POS plans, and EPOs) have negotiated...
<ul><li>By using the provider network for medical services, you qualify for the special rates and range of services outlin...
With certain types of managed health care coverage such as HMOs, you’ll be asked to select a primary care physician from a...
Do You Understand ‘Out of Network’ Costs?<br /><ul><li>Managed care plans have negotiated agreements with specific doctors...
When you use a doctor in a provider network you are using “in network” services. For their services you inquire a lower ou...
<ul><li>When you have a managed care plan, your network of preferred or participating providers make all decisions for you...
If you opt to go outside the network for medical services, you will likely be responsible for part or all of the associate...
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Health Plans: Confused by all of your options?

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At HealthCompare we field many calls from people who would like to understand their options better. Our philosophy over the past 25 years has been to provide customers with the right information so they can be empowered to make the right decision for their Insurance needs. This presentation aims to do just that.

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  • As I mentioned, we work with the largest selection of insurance companies. This is the list of companies we currently represent. Did you realize there were so many of them? It is nice to know that we are checking with all of these companies to find you the right plan and not just two or three, isn’t it? Of course it is.Who are a couple of people that you know that are struggling trying to find insurance right now? Are they open minded people? Do you think they would mind if I sent them a letter or email?Great. What are their names and address or email address?John &amp; Mary, the information I will go through should answer most of your questions,   Option 1. But I would like you to use this notepad to write down any questions that come up so we can address those at the end. Would that be okay? GreatOption 2. But if you have a question, stop me, because I can only help if this makes sense. Fair enough? Great.
  • Health Plans: Confused by all of your options?

    1. 1.
    2. 2. <ul><li>Your medical history, current health, and lifestyle choices influence your costs for health insurance.
    3. 3. Pre-existing conditions like chronic illness or diabetes can increase your premiums and may also be subject to “waiting periods” before you benefit from coverage.
    4. 4. Lifestyle choices such as smoking will increase your premiums.</li></ul>HealthCompare.org<br />
    5. 5. <ul><li>If you want lower premium payments, opt for high deductible plans.
    6. 6. Choose a co-payment plan – the premium is lower but you pay a percentage of costs for services you receive. Consider the monthly premium costs along with additional out-of-pocket expenses for care.</li></ul>HealthCompare.org<br />
    7. 7. <ul><li>Insurance companies employ actuaries who calculate the framework for determining insurance premiums.
    8. 8. Underwriters will calculate your particular premiums based on a variety of factors including your health status and history, lifestyle choices, and age.</li></ul>HealthCompare.org<br />
    9. 9. In addition, your premium costs will vary based on several coverage variables:<br />Deductible amounts –The total amount of money you need to pay before your health insurance provider takes over. These are usually set on a yearly basis<br /> Many insurance companies offer high deductible plan options, which will likely lower your monthly premiums.<br />Co-insurance – This is how you and your insurance provider share the costs of your medical costs. They are usually described in terms of percentages.<br />Example, Insurance company pays 80%, you pay 20%<br />HealthCompare.org<br />
    10. 10. Copay - The amount that you pay towards your medical bill. It is your share of the costs. They are usually described as set dollar amounts. Copay amounts vary according to your policy and can change within a policy if, for example, you <br /> Seek treatment outside of your network, or choose to see a specialist; or<br /> Choose brand drugs over generic drugs<br />Out-of-pocket maximums – An out-of-pocket maximum is the dollar limit that you will be responsible for during the course of the policy term. This amount typically includes deductibles, co-payments, and co-insurance but not premiums.<br />Lifetime maximums – this is the maximum amount your insurance company will pay in your lifetime for your policy.<br />HealthCompare.org<br />
    11. 11. <ul><li>Economists tell us that rising health care costs directly correlate with significant drops in health insurance coverage.
    12. 12. A study by Harvard University researchers showed an average out-of-pocket medical debt of $12,000 for individuals who filed for bankruptcy. The study also found that 50 percent of all bankruptcy filings were partly the result of medical expenses. </li></ul>HealthCompare.org<br />
    13. 13. <ul><li>Every 30 seconds in the United States someone files for bankruptcy resulting from the aftermath of a serious health problem.
    14. 14. Medical expenses can lead to housing trouble. Many consumers can’t pay their mortgage or get credit approval due to outstanding medical debt. </li></ul>HealthCompare.org<br />
    15. 15. Do You Understand ‘In-Network’ Services?<br /><ul><li>Network coverage refers to medical services covered by a defined group of physicians, caregivers and facilities, who are all pre-approved through your health care plan.
    16. 16. When you use the services offered by the pre-approved providers you are using “in network” services.
    17. 17. There are two different types of plans to choose from: managed care plans and indemnity plans.</li></ul>HealthCompare.org<br />
    18. 18. Do You Understand ‘In-Network’ Services?<br /><ul><li>Managed care plans (HMOs, PPOs, POS plans, and EPOs) have negotiated agreements with specific doctors, hospitals and health providers. Managed care plans typically involve the insurance company directly reimbursing providers for claims that you incur.  </li></ul>HealthCompare.org<br />
    19. 19. <ul><li>By using the provider network for medical services, you qualify for the special rates and range of services outlined in your policy.
    20. 20. With certain types of managed health care coverage such as HMOs, you’ll be asked to select a primary care physician from a roster of doctors who belong to the provider network. </li></ul>HealthCompare.org<br />
    21. 21. Do You Understand ‘Out of Network’ Costs?<br /><ul><li>Managed care plans have negotiated agreements with specific doctors, hospitals and health providers. This pre-approved group is referred to as the provider network.
    22. 22. When you use a doctor in a provider network you are using “in network” services. For their services you inquire a lower out-of-pocket cost than if you had an indemnity plan, which does not rely on provider network agreements. </li></ul>HealthCompare.org<br />
    23. 23. <ul><li>When you have a managed care plan, your network of preferred or participating providers make all decisions for your health care needs, including—with HMOs—referrals to obtain specialized medical care.
    24. 24. If you opt to go outside the network for medical services, you will likely be responsible for part or all of the associated fees for the service, regardless of whether or not you have reached your in network out-of-pocket maximum.</li></ul>HealthCompare.org<br />
    25. 25. What are UCR Expenses?<br /> Health insurers use Usual, Customary and Reasonable (UCR) expenses to determine reimbursement rates and to prevent doctors or hospitals for overcharging for services. UCR costs reflect the average total costs for medical services or doctor visits. UCR refers to:<br /><ul><li>Usual: The usual fee is the cost of services regularly charged to all patients for a specific type of service. The fee can change if the patient makes an appointment to be treated for one condition, but complains of other problems that must be addressed during the visit.</li></ul>HealthCompare.org<br />
    26. 26. <ul><li>Customary: A customary fee is comparable to fees charged by health care providers offering the same services and who meet the same criteria for comparison.
    27. 27. Reasonable: A fee is considered reasonable when it meets both the usual and customary criteria. A reasonable fee may also be determined on a case-by-case basis by the insurer.</li></ul>HealthCompare.org<br />
    28. 28. Ways to Trim Health Care Costs<br />1. Comparison shop for tests. As costs for tests can vary greatly between different facilities. <br />2. Haggle over the hospital bill. Hospitals may be willing to reduce an account balance if the patient can demonstrate that the payment of a co-pay or deductible is a hardship. If you don’t ask for it, you won’t get it.<br />3. Eliminate unnecessary follow-up appointments. Question whether or not you need a follow up appointment or if it can be handled with a simple phone call.<br />HealthCompare.org<br />
    29. 29. 4. Inquire about less expensive prescriptions. When prescribed a name brand prescription, ask if a generic will suffice.<br />5. Talk prices directly with your doctor. If you are experiencing financial hardship, talk directly with your doctor about getting a reduction in your bill.<br />HealthCompare.org<br />
    30. 30. Who is HealthCompare:<br />HealthCompare is your online one-stop-shop for health insurance where you can research and compare plans onlinefrom over 150 national carriers.<br />We Promise:<br /> To give you the best results for YOU, we never promote one carrier over the other. We just assess your needs and show you the best options from national carriers with plans in your area.<br />Our Commitment is to YOU:<br /> As a division of The Word & Brown Company who has been the leading source for small group health insurance for over 20 years, we have leveraged technology to build an easy-to-use research tool, supported by a world class customer service team. <br />Our<br />Promise<br />#1<br />HealthCompare.org<br />
    31. 31. 1. You can enter your information anonymously<br />HealthCompare.org<br />
    32. 32. 2. You can review your plan options online in seconds<br />HealthCompare.org<br />
    33. 33. 3. You can even compare plans side-by-side<br />HealthCompare.org<br />
    34. 34. 4. Then, you can apply online or call one of our trained Benefits Advisors for help!<br />HealthCompare.org<br />
    35. 35. Call toll free <br />877-641-1101<br />to speak to a trained <br />Benefits Advisor <br />or…<br />Go to HealthCompare.org today!<br />HealthCompare.org<br />

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