I was told I’d still have to shell out some cash if I needed some kind of medical attention. Can you explain to me the how out-of-pocket costs are determined? This is Berny from Arizona.

Berny

Glendale, AZ

You’re right. Even though you have pretty broad health insurance coverage, some of the expenses will have to come from you. First of all, you’ll have to pay for the deductible. The lower the premium of your health insurance policy is, the greater the deductible. So this one really depends on how much you have agreed to pay as deductible.

Second, there are certain cost-sharing amounts that you take out of your own pocket. Health insurance policies have a “coinsurance clause,” which states that you must share the cost of your medical bills. For example, if you have a 90/10 coinsurance arrangement, you must pay ten percent of your medical expense. It comes in different proportions such as 80/20 or 70/30. This should have been explained to you when you purchased your health insurance policy there in Arizona.

Finally, if you opt to hire the services of a top physician who charges you a whole lot, or you go through an expensive medical or surgical procedure, you might also end up shelling out more. Health insurance companies set “customary” charges for certain medical procedures. This is the amount they consider reasonable. If they find that you were charged unreasonably high rates by a health provider, they may choose to cover only a certain percentage of it.

Tags: Health Care, health insurance

I need to purchase a private health insurance for my 22 year old son who is already in college in Glendale, Arizona AZ. What will I purchase for a plan with a choice of doctors which also reimburses for medical care in other states? Will it be best to pick the university health insurance?

Barry

Glendale, AZ

I remember being on the same boat in the past when our daughter was still in college, too. Back then, she would be covered both through college health insurance (HMO style) which was expensive and convenient with an on-campus clinic. It was through our own family’s health insurance policy. Our daughter then was very actively participating in sports programs, she had 2 episodes of memory lapse, black out, and difficulty in breathing. She needed to go to the on-campus clinic and was found out that she had no problem at all. She was already in a non-stress physical condition at the time of the checkup. She was told she probably just hyperventilating and that she had to wear a mask during her strenuous physical activities to keep her oxygen level from going too high. The coach however, decided she should see a real doctor…a specialist.

Since the college medical insurance plan was an HMO style, she had to get referral to see a skilled practitioner in sports medicine. My husband and I had to intervene from a distance to help through the appeal such that my daughter should get the medical attention by an expert, which I think she badly needed at that time.

I eventually decided we use our family’s health insurance. By doing that, my daughter was immediately attended by a sports medicine specialist in a great facility with renowned sports medicine staff. The cause of her problem was quickly determined, which tuned out to be a defect in her heart resulting to his referral to a cardiologist.

With that experienced, I learned that HMO structure can sometimes be cumbersome in emergency situations. Individual health insurance policies are still almost always better with my experience, so I hope you learn from that too.

Tags: health insurance

Things have happened recently that make me wonder if I have enough life insurance in Peoria Arizona AZ. I do not want my family to suffer if anything bad happens. Should I replace my existing life insurance in Arizona? Anxious to hear your suggestions, thank you.

Anthony

Peoria, AZ

Hello Anthony,

Here’s hoping all is well. You should meet with your agent in Peoria Arizona AZ. Generally, you can replace your existing life insurance policy. That may not be the most prudent path that you can take but remember that new life insurance policies always have higher startup costs for the first few years. You may very well be in a position to increase your coverage with your existing carrier. That may be the least expensive way to go for your insurance in Arizona.

Another possibility is to supplement your whole life insurance with a new term life policy. This you might purchase from the same or a different carrier in Peoria AZ. The new carrier will want to verify all your information and you may need a new physical examination. Most life insurance companies have a grace period during which time they can review your information. Life insurance companies reserve the right to cancel coverage if the provided information is inaccurate.

The most cost effective options are usually to increase the value of your life insurance and therefore your death benefit with your existing carrier. The second option would be to maintain your existing life insurance and purchase a new policy for an additional amount. Please review these recommendations with your agent in Arizona AZ. Thanks, Anthony!

Tags: health insurance, health insurance costs, health insurance replacement

Recently I had a meeting with my employees. My company is a small enterprise in Thatcher Arizona. We are fortunate. Good employees are hard to find, and sometimes hard to keep. At our meeting, a long-term employee asked if I had considered an employees term life insurance program. Does he know something about insurance that I don’t?

Curt

Thatcher, AZ

Good question, Curt!

Sounds like your employee has an idea. Usually employees can provide term life insurance benefits to company employees. This is an excellent benefit that shows you are a concerned employer. Who would not appreciate a boss who provided a term life insurance policy to benefit their loved ones? That is certainly a nice incentive.

This type group term life insurance should be worked out with your local agent in Thatcher, Arizona AZ. He can probably help tailor a nice tax break for the company that provides such coverage. The agent will be able to help prepare the applications. In some cases he may even be able to waive the physical examinations for these original term life policies. Regulations tend to vary from state to state so please check what’s in store for you in Arizona AZ.

Your employee has touched upon a very effective way to motivate and unify your employees. You can set the amount of the term insurance policies and as you know they will to be very expensive. We think you will be surprised at how affordable and how well received this employee term life benefit will be. Please check it out with your local insurer in Thatcher!

Tags: group health insurance, health insurance

What are the things I need to know before I consider purchasing any health insurance policy in Arizona?

Jason

Chandler, AZ

It’s good that you asked, Jason.

You see, regardless of its type, you need to know if the plan will let you choose the doctors and hospitals that you might want to choose. Otherwise, you have to know how much more you will need to pay if you choose a doctor, hospital, or any medical provider that is not within the insurer’s network. Also, better know the monthly premium and your probable yearly deductible. There are also some health insurers in Arizona which will let you pay a percentage of your health care bills which most health insurance companies call ‘co-pay’. Get to know the ceiling on how much you will pay in a year as your out-of-pocket limit. Health insurance policies have lifetime limits, so know yours too. There are also rules for coverage on prescription drugs in case you health insurance policy will have coverage for that and it is best that you familiarize yourself on how you can save money on this aspect. It is also very important that you see a list of services and benefits for your prospective health insurance plan. For any serious health problems, some health insurance companies will not cover, or if it does will hardly cover right away. You better ask questions if serious illnesses will be covered by your health insurance plan. And the most important thing to watch out for, see to it that your health insurance plan has guaranteed renewability. There are cases of health insurance policies that got cancelled when the policyholder got sick, and that’s the last thing that you want to happen to you.

I have a group health insurance policy which the company I am working for gives to its employees. Is this enough to help me get protected?

Michelle

Chandler, AZ

Hi there, Michelle.

I cannot answer you with a yes or no since there are many factors that we have to consider to verify if your group health insurance will be adequate for your medical protection in Candler AZ. First, I’d like to state that a group health insurance can be sponsored by your employer and mostly you are given an option to include your other family members at your own expense. An individual health insurance, sometimes called disability insurance, is a health insurance you get for your own. With the group insurance, of course it comes cheaper for your employer since there is a corresponding group discount for a certain number of headcount who gets a health insurance from them. With individual policy, it might be a little higher on premiums but with more extensive benefits.

There can be numerous types of health insurance policies such as managed care insurances like HMO, PPO, & POS plans. HMOs are normally prepaid fixed fee. PPO has no separate physical facility in which patients are normally being checked. You can check first if your current health insurance plan under your employer is any of these types. Also, some employers would have you to participate in paying your premiums at a certain percentage. IN relevance to your needs, you have to verify your current coverage. You can take a closer look at your policy provisions which your employer has probably given you and shop around for specifications of individual health insurance policies and try to compare.

My daughter just turned 23 and his coverage under my health insurance was removed. I tried to reach my health insurance agent I found online. What she recommends is a health net plan that will cost me $51 monthly. It has a 25% deductible for every visit made up to $1500 annually. Apparently, my daughter can get a physical exam free of charge. This covers only a few generic medications except birth control or pregnancy. I got her plan by answering NO to all questions in the application form. Is this a good deal? We live In Arizona.

Peter

Glendale, AZ

Hello there, Pete!

Tough question for me, but I’d have to say, everything depends on how much of a gambler you really are. First of all, none of us can predict whether or not your daughter gets sick or gets injured in college. Another thing that you should also consider is that if your daughter does not have a car and will have to look for a new doctor in a new town, at the time when she’s sick, then that might be too bothersome.

For me, what’s more important here is that your daughter is insured so that she can seek medical treatment in cases of emergencies in a place away from home, in the most convenient way possible. You never know what happens especially that you are not actually physically present to attend to your daughter’s needs when she is sick in a far place.

I think what’s the safest choice for you at this point in time is to opt for a college insurance in Arizona, and I should say it is also what I did for my son. There are also health insurance companies out there in Arizona that offer individual health insurance policy for students like your daughter. Among the few I know are individual health policies like Blue Cross, Atena, and Blue Shield, but these are also among which have high deductibles. However, it might not be a very good decision to skimp much on a health insurance policy for your daughter, so you better get one!