Understanding affordable health insurance is a difficult task for many people. Thankfully, help exists in the form of your human resources department, insurance agents and advisors, and online resources. With the right kind of help you should be able to understand the process at least well enough to make an informed decision.
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The key to understanding health insurance is to keep asking questions until all have been answered. Keep in mind that there’s no such thing as a dumb question. That old adage about questions being the only way to learn certainly holds true when it comes to health insurance. The more you ask, the more information you’ll get in return.
Your Human Resources Department
Why would I ask my human resources department for help?
If your employer offers group health insurance, the human resources department will most likely have the responsibility of administering it at the employee level.
In other words, they are the ones who distribute the forms, act as the intermediary between insurance carrier and employee, and make the information available to workers. If nothing else, HR managers are normally trained in this area so that they’re able to digest information about the employee health insurance plan and pass it along to you.
In 2010, approximately 55% of American adults had health insurance through their employers. According to the Department of Health and Human Services (HHS) website approximately 10% of U.S. workers in 2010 had individual health insurance as opposed to the plan provided by their employer. For that same year the Kaiser Family Foundation estimates that approximately 45% of those individuals were self-employed. If you fall into this category you probably won’t be going to your human resources department.
Self-Employed Health Insurance Choices
You may have a difficult time comparing health insurance choices for self-employed people. You’re probably too busy to take the time to sit down and thoroughly read policy documents. Even when you find the time, the language of insurance policy documents can be very confusing and tedious to read.
Fortunately you have several options for finding help. The first is to contact a trade group relevant to your business or perhaps your local chamber of commerce. In many cases these types of groups have insurance professionals on staff who specialize in helping members figure out their options. One of the benefits of going this route is that services are usually offered for free or as part of your membership fee.
If you’re unable to find the help you need through one of those organizations then you may need to search for a health insurance broker. Health insurance brokers are ethically bonded, so you can trust them to help you get the best policy.
Insurance advisors sometimes deal only with the insurance industry, while other times they combine insurance with all types of financial advice.
Keep in mind that advisors of this type are typically affiliated with health insurance companies and are trying to sell you a policy.
Nonetheless, they are good sources of information if you’re willing to put up with a sales pitch or two.
Questions You Should Ask
What kind of questions should I be asking? What appears to be most confusing to the average consumer is the idea of coverage limits. Such limits are restrictions imposed by an insurance company regarding how much they will pay in a given year for certain types of care. For example, your plan might have a $50,000 limit on non-life-threatening dermatological treatments. If the bills from your dermatologist exceed $50,000 in a 12-month period you will be responsible for making up the difference.
If you’re unsure about what health insurance companies for self-employed people can offer you, there are a number of online resources like Consumer’s Union that provide free checklists. Some of the common questions you should ask include:
- Is the plan you’re offering an HMO, PPO, or major medical policy?
- Does the plan have any limitations on preexisting conditions?
- Is there a maximum lifetime benefits limit?
- What are the annual limits and to what do they apply?
- What will be my out of pocket expenses?
- Do I need to acquire my health care services through a specific network of providers?
If you ask the right questions and insist on straightforward answers, you can get a good understanding of how affordable health insurance works. Be sure when you’re seeking help to be direct, to the point, and insistent on clear answers. With a proper understanding of your health insurance options you’ll be able to choose the plan that’s right for you.
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