Health Law

Getting Your Own Health Insurance – Some Tips

Here is the current health law clarified for you.

Healthcare insurance is a loosely regulated monopoly. So it is limited to your state. Insurance providers have to write different policies for different states since they cannot cross sell.
There are essentially three parties involved in healthcare insurance–patient (that is you and your family or employees), healthcare provider (doctor, nurse, diagnotician, hospital etc.) and carrier (insurance company)
There are basically two types of health care insurance—employer sponsored and individual/family. employer sponsored insurance is called group insurance.

One of the most nettling things in insurance is pre-existing conditions (PEC). There is no standard definition for it–it generally means an ailment, or disease that is disabling and requires constant medication. Most group coverage ignore PEC’s, but insurance companies can deny you coverage under individual/family plan for PEC.
New so called reform law is both good and bad news. Some of the uninsured people wil get immediate coverage–but only children from Sept 2010. Adults who are not insured and seek insurance under the law can be denied insurance for PEC or other health reasons until 2014.
So how to go about getting insurance?

Depending upon your state of residence, there are insurance carriers that can be generous or rigorous. Find an experienced insurance broker who can guide you through it. You may go online, but you will be dealing with a computer. In a matter of healthcare, do not take the easy route. Better to sit down with the broker and get his views and experience.

Review your and your family’s health needs for the next 3-5 years and do it critically. No need to assume the worst, but include regular checkups, medication and at least one serious ailment or injury–the so called catastrophic coverage. This review should include number of doctor and hospital visits, total out of pocket expense if there was zero coverage, and what you can afford as out of pocket if you did have insurance.