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Posts Tagged ‘medical coverage’

For the individuals that are most afflicted in our country today, is there a cure-all in sight? When does the health insurance industry plan to stop restricting insurance coverage for those afflicted with a pre-existing condition? The attitude is a little old-fashioned and it is time that this practice changes into an insurance coverage that is more suited for the mass public. It seems the individuals that need the health coverage the most are the same individuals who are desperate.

Part of the difficulty is with the undefined term of pre-existing condition, as it is very vague. Until the present time it has been to the discretion of the various New York insurance firms to define as they see fit. The insurance firms have made this decision long before they established the health insurance quotes they recite to a multitude of individuals. Yet, the thousands of medical doctors who care for these patients have a different list which conflicts with the insurance companies. The main reason why defining what a pre-existing condition is so difficult and vague.

Even with these hurdles to overcome there are a few things the self-employed can do to reach the desired goals of full medical coverage.

1.It is best to talk with your physician to make sure that one condition is not related to another. Copy of your medical records for submission is important.

2.Do a research on the HIPAA (Health Insurance Portability and Accountability Act) program. Individuals who had insurance before under a group medical care plan and are obtaining a new type of medical insurance are able to have their pre- existing condition covered as long as they meet the criteria.

There is various form of pre-existing conditions in the medical community today. Some of the more common pre-existing conditions that raise the average monthly cost for health insurance today:

1.    Fibromyalgia, diabetes, rheumatoid arthritis, and obesity

2.Obesity and even pregnancy are pre-existing conditions.

With that said, if you fall into this category, take advantage of HIPAA by switching from one group policy to another group policy. This will keep the individual from having to pay for costly individual health insurance, because of a pre-existing condition or having a difficult time obtaining medical insurance. A lot of these insurance companies which offer individual insurance require a waiting period of 12 to 18 months before they will consider paying medical bills related to pre-existing conditions. It is unfortunate, but the individual will have to do much research in this area.

An alarming trend is developing within New York and the rest of the United States. Fewer citizens are able to claim their share of health insurance coverage. An average of seventy five percent of adults have spent time researching all the various insurance policies only to be discouraged by the high cost for health coverage. This is an alarming trend that has been developing over the past few years as insurance companies readjust the cost to health providers and hospitals.

A small percentage of these individuals denied health coverage  because of their pre-existing condition or conditions. The high cost of health has caused many employers to drop medical coverage leaving more individuals to search for low cost health insurance for themselves and their families. The individuals are turning away from necessary health assistance due to the expensive rates and this places the healthy individuals in a predicament too.

Over the years there is a return of tuberculosis, polio, and small pox that were once erradicated from this country. A lot of diseases have spread as more and more people come to live in the state of New York and around the country. Based on statistics, the research has unveiled the uncertainty that soon, we as citizens will all have to face and deal with.

1.               Those with medical insurance are paying over ten percent out-of-pocket expenses and the cost is increasing by the day.

2.Almost 60% of the population is not able to find an affordable health insurance coverage.

3.Almost 50% of the polulation found it next to impossible to search for a health coverage to suit their individual needs.

4.               Almost forty percent denied any medical coverage because of a pre-existing condition that they need assistance with most.

Individuals who have health coverage through an employer have an estimated out-of-pocket expense of $2200.00 per year. Individuals with health coverage have an estimated out of pocket expense of 00.00 per year. This is a huge discrepancy within our health provider industry and leaves many, including children without the option of medical assistance.

Of course age is a factor that weighs into the health insurance quotes when an individual is shopping around for affordable care. The younger and healthier an individual is, the more affordable the insurance coverage is. This is not good for the population as a whole though, because statically the majority of our population is aging.

The system of using the young adults to pay into a health care system to foot the expense of the elderly or senior citizens was not the best of ideas. Keeping this system in its prime, every family is obliged to have large families, but then the government has been preaching for years for families to downsize instead. Well, this working against the medical insurance system still remains in place today.

What do the residents and the medical staff of New York, and the rest of the country do now? Hospitals are overcrowded with nurses working extra long shifts, equipments beginning to get scarce, and technology is available, but so costly it is no longer useable. Medical doctors work hours they never thought possible and are caught between doing what is best for the patient and following insurance guidelines.

Patients needing surgery must make all kinds of appointments to have blood test run, physical check-ups for pre-op and are having outpatient surgery in a medical building instead of a hospital. Patients with individual health insurance receive an insurance policy and then every six months to a year receive an addendum with changes on the policy.

After a while the medical insurance policy is unrecognizable from what it was in the beginning.When these same people or individuals want to make an appointment with the family medical physician, it is almost next to impossible. When you call to make an appointment first you have to get past the medical receptionist who will ask who the health insurance carrier is. When it is permitted and the insurance carrier is acceptable, you MUST request a medical doctor or that individual will never get to see one.

The individual requesting medical attention will receive an appointment with a physician’s assistant (PA) or an Osteopathic Doctor (OD), but the chances of seeing a medical doctor is almost only by request, why? This same individual has been paying the average monthly cost for health insurance for years and now when treatment is required this same individual is not getting it.

The list of pre-conditions runs on for pages now and just about every know ailment is on this list as a pre-condition when at one time the list was short.  Now you have families who have health coverage and they are paying for this medical coverage that is no longer worth very much.

Demands that the society has placed on the insurance companies today have become very difficult. The self-employed individual is insisting on more and more medical coverage and prescription drug coverage and the insurance companies are offering less. Everyone wants to make money, and everyone wants more for their services rendered and there is no difference with the health insurance industry.

The demands of today come with an insatiable appetite and this is now pitting the self-employed and the individual against the insurance industry that these same individuals once relied upon. Those who are currently self-employed are finding it is next to impossible to even find affordable health insurance. The problem is the cost keeps rising and there is no limit set as to how high it will continue to rise.

This is most notable in New York where the self-employed have almost tripled in strength. This is causing the health industry to take a second look because they now are realizing the new market that is out there. The health industry is beginning to learn that even the self-employed are consumers and they have been ignoring a fairly sizeable market.

In the past few years they have begun to take a second look and are offering individual health insurance to help satisfy this new market. The self-employed on the other hand must understand they are going to pay more for medical insurance coverage simply because they are not in a group. In a group policy the cost will come down some because the insurance industry will have a gauge to measure.

Unless the self-employed are adding other individuals to the policy the cost will remain high. This is explainable very clearly where they list for anyone to read all of the pros and cons facing the self-employed entrepreneur. If the self-employed have other family members helping them in their line of business they are eligible to add to the policy.

If the self-employed individual has a spouse who is employed full time there is a chance the spouse can add the individual to that health policy. Many insurance companies offer a variety of coverage so that is something else to look into before making a decision.

By researching the self-employed individual will be able to narrow down which insurance company offers the best health insurance quotes for the type of medical coverage expecting. At the start it could be very time consuming, but over time it will work out for the individual.

Individuals out and about in the working world have been very absorbed in the daily chore of splitting time between employment and home life with little concern for health care. This is probably due to the fact that while under the employment of a large corporation, a minimal amount of the income was to collect from the paycheck. It is not that difficult for any individual to overlook this one small detail. Easy to overlook until the individual is considering purchasing low cost health insurance for a new business just getting started.

At some point this eats away into the individual’s eternal core until something finally snaps. Perhaps starting a new method is in order to integrate eternal peace within. This is the time for taking that first step and trying your own hand.  Life as an entrepreneur competing joining others in a very busy world. At the start, the individual might venture into a part-time position, but ultimately spends more and more time in your own adventure.

Starting your own business is one of the most difficult things to attempt, but in the long run, it is well worth the added effort. The stumbling block is in the addition of health insurance coverage. Over the past few months the individual has managed to research many important factors to opening up a small business and though all the potential problems reached a compromising conclusion the area of insurance still remains monumental.

The majority of the population remain in a full time employment because they know that the employer paid benefits.  However, these are the same individuals, now that their children are grown, who are trying their hand at becoming an entrepreneur and even affordable health insurance is causing sticker shock.

The choices left for any new entrepreneur come down to three main points of interest involving individual health insurance coverage. The first choice is to look to your spouse. If your spouse is currently in employ full time there is a very good chance your spouse has full medical benefits and can add you to the employment policy. The second choice is group health coverage. There are many advantages for the solo entrepreneur and the cost is low to help gather more entrepreneurs into the group. Since the second choice is not available in every state individual must give little time to research on it.

Getting an individual health is the third choice available for the new entrepreneurs. These are subject to medical underwriting and the individual will have homework to research with the state offered health plans. It will be difficult to individuals who have pre-conditions because most health care providers pre-conditions are unacceptable.

Are you a resident of New York and find out after many years working as an employee, wants to spread your wings and start to have a business of your own? Begin your search with step one, finding the insurance company policies that work against you. The insurance industry sometimes fails to be as transparent as the self-employed may want them to be. Researching and trying to find some transparency among the many insurance companies is very difficult.

Many will advertise they have low cost health insurance but when you try to gather up the necessary information is becomes next to impossible to figure it all out. This website has advised the many ways to ascertain the hidden messages with various insurance policies. They will also offer advice on how to find the difference between one insurance company and the next.

The main problem is that there are very few health insurance companies that will expose all of their hidden fees before the small business entrepreneur signs on the dotted line. In many instances, small business entrepreneur will find out exactly what they have to received after the insurance policy is in the mail. What you ultimately end up paying monthly is different from the original quote because of the hidden fees.

However there are other insurance companies that are willing to alter and streamline their insurance polices specifically to gain the audience of the self- employed. The market has grown tremendously over the years and all the entrepreneurs are now recognizable. The average monthly cost for health insurance is slowly coming down, but at the cost of the deductible going up. More and more self-employed are willing to take on the responsibility of the out-of-pocket expense just to have some type of coverage.

The other obvious problem is with pre-conditions and each year the list grows longer and for no apparent reason. The preconditions illnesses such as diabetes, heart disease, various eye disorders, arthritis are factors to be considered when searching for an insurance policy that will cover the self-employed, immediate family and few employees. An affordable health insurance policy for a self-employed individual including only immediate family members can cost 5.26 a month with a 00.00 deductible.

This will include the office visit co-payment and a prescription drug benefit program. This will also cover inpatient hospitalization and outpatient hospitalization. However, if the self-employed or family members have any of the known pre-conditions the waiting period can be up to twelve months before coverage will begin.

Today we have families and single individuals who are paying their portion of the health expense through their employer who is still generous enough to afford the medical coverage. Yet, the insurance policies are almost worthless in what they will cover medically. What there are today are many young adults who have no options for medical coverage for any number of reasons.

Mothers and fathers are doing their best and trying to buy health insurance for their children, but the cost is too high. This breaks a parent’s heart and causes so much anxiety within the home, but it is what it is. There are plenty of adults without health coverage too, but mostly they are those who walk amongst the unemployed.

This is a temporary situation for the majority and when they have new employment found these same individuals will have medical health coverage again. However, obtaining individual health insurance is not a license to medical coverage when assistance is a requirement.

The reason for this is because, first the individual must make an appointment with a doctor the insurance company requires. Once the individual health insurance is acceptable by the doctor’s office the doctor and the insurance company take over from there and the individual is nothing more than a pawn along for the ride.

Reforming the industry through universal health care is necessary, but must the entire system go hand over heals. There are currently many good points the insurance industry and to now lose the quality investments would hurt the mass population. The current relationship between a medical physician and a patient is a good one and needs to continue.

Medical physicians have an opportunity to learn more information about their patients which can only help. In order for trust to become a factor, the patient on the one hand needs time to build a cordial relationship with the medical physician. This does not occur right away, say one or two meetings, but takes some time to develop. Besides, when an individual finally finds a medical physician they feel comfortable with the health care usually runs more smoothly and freely.

Would it not make more sense to only upgrade those things that need upgrading? Besides it would take less effort and so many people would have access to the kind of medical care they so desperately need. It is not only the cost for health insurance that is in need of coming down. If the individual wants an additional optional coverage they need to revise the annual policy.

Self-employed and family medical insurance is a preferred type of insurance coverage made available to all entrepreneurs and their families. This is for the medical insurance corporations to direct sell to the individual forming a bound contract between the person and the insurance provider. This is the high priced and specialized insurance policy available to the unemployed or self-employed; an individual health insurance policy is always an option, but not an inexpensive one.

Medical health benefits will further classify into fee-for-service or as they are called, indemnity or traditional insurance, and to managed care policies. The group insurance plan and the individual insurance plan can both be classified either a fee-for-service or a managed care plan. There are three managed care insurance plans to choose.

1.               The Health Maintenance Organizations or HMO

2.               The Preferred Provider Organizations or PPO

3.               The Point-of-Service or POS

The managed care insurance plans typically use medical health provider networks. These networks agree to service for managed care plan patients at pre-negotiated rates and will usually submit the claim(s) to the insurance company. In general the self-employed have a lower out-of-pocket expense with the managed care health insurance plan and a broader choice of medical care providers with an indemnity plan.

Each of the three provider insurance plans offer substantial health care coverage benefits to the individual members as stated through some articles published here. If the individual is fortunate enough to have a choice of plan, think of the advantages, and disadvantages.

Compare the cost of care, the difference in premiums, deductible amounts and the freedom to choose a medical doctor outside the insurance provider plan. It is important to cosider the variety of other coverage from the prescription drug programs to dental to alternative therapies.

The fee-for-service or indemnity medical insurance plans usually cover the same expenses as managed care does operating with low cosy health insurance. The main difference is the medical doctor is asking for pay for each visit with the claim filed by either the individual patient or the medical insurance provider. Unlike many of the managed care insurance plans, fee-for=service allows the individual a large amount of personal freedom to choose which medical doctors and hospitals to utilize.

However, the individual prepares to pay an annual deductible before the medical insurance provider begins to pay on the turned in claims. There are also times when an Indemnity plan will require the individual to pay up front for services rendered before submitting the insurance claims.

Endeavoring to open a small independent business is like opening a brand new jigsaw puzzle and tossing all the pieces into a pile on a table. There are countable guidelines that the individual must be aware of before deciding into a new realm or the new stage of life.

1.               Understanding self-employment tax

2.               Estimate your taxes and pay on time

3.               Involve family members and closest of friends

4.               Establish a retirement plan such as a 401K

5.               Take advantage of all tax deductions

As an independent entrepreneur items such as medical health insurance premiums, according to Federal Law also state that when paid throughout the year in behalf of the individual, family members also covered and other individuals is a deductible item when the Federal Form 1040 is filed. Although, a lot of this depends whether the independent entrepreneur can afford the high cost of medical insurance in the first place.

The whole program or system works for the betterment of all individuals, especially with the independent business owner. The average monthly cost for health insurance and how requesting family members to work alongside in the new adventure will keep costs down and help the independent entrepreneur attain affordable rates without too much stress and strain.

Keep in mind that when you are responsible for your own business you are also responsible for all the insurance and the necessary taxes. Knowing how to adjust takes a while because all income technically is not yours alone. If family members are involved, they must get a compensation according to the position they are holding, hours worked, and the compatibilities according to the Department of Labor. Attempting to balance the monthly expense, including health insurance quotes from various medical insurance companies will take time to sort.

The new self-employed individual needs to make a list of items the new business is in need of in order to plan ahead and figure out what is necessary now and what can wait until a little later. Keep in check that once a new entrepreneir decides upon an insurance plan, the monthly cost for healthcare is a consideration that will eat into the profits. Remaining healthy and physically fit is another consideration to keeping the medical costs down.

The fewer claims sent to the insurance company are a benefit for the new entrepreneur. As insurance claims mount and turned in for payment the cost of the medical insurance will go higher to compensate for the previous year. Another thing to consider for the new entrepreneur is somwhat family members relying and ask for assistance.

There are three major health plans in the medical health system today. Each of the 3 plans offers a substantial medical health benefit to the self-employed and the small business owner including their families. The comparison of the medical care provider’s price, the premium differential rates, and the varied deductible amount is one issue.

Take into account the individual freedom for the self-employed entrepreneur and the small business proprietor to choose an individual’s own medical doctor both inside a plan and outside a plan. The major health insurance medical plans that are of significant value and play a very important role in society today are:

1.               Health Maintenance (HMO’s)

2.               POS or Point of Service

3.               PPO Preferred Provider Organization

Many of these different health provider insurance plans for the self-employed entrepreneur and the small business proprietor offer substantial comprehensive benefits to the enrolled members and their families. The intelligent shopper for comprehensive cost-effective health insurance will compare the difference in insurance premiums.  The self-employed entrepreneur and the small business proprietor will gather and compare a number of health provider health insurance price quotes.

One additional factor that is also important to keep in mind is to research what the deductibles would be per family or per individual for those that are inquisitive because there are those that have more employees working for them. Try to do some investigation and check out if there is a prescription drug program, dental benefits and vision testing included in the insurance policies which you find interesting and affordable. Another effective and comprehensive type of insurance provider policy for the self-employed entrepreneur and the small business proprietor is a fee for service insurance policy.

A fee for service health care policy on average normally offers comprehensive insurance coverage at the same out of pocket expense as the various managed care insurance programs do. There is just one major difference between the fee for service healthcare policy and the managed care insurance policy which is the medical doctor entitled to receive the payment for each medical doctor office visits with the initial claim filed by either the prosppective patient or the initial medcical provider.

One major advantage is the fee for service medical insurance allows the patient to visit with the medical doctor that is personally chosen. While searching for a low cost health insurance the self-employed entrepreneur will have many variables to research before deciding upon the one medical insurance plan that will work the best.