Group insurance is required to cover a wide range of pre-existing conditions. The insurer of a group understands that,statistically, a number of members will already suffer from ailments such as heart disease, diabetes, and cancer, so they charge a premium that will cover the treatment of these potential illnesses.
However, health insurance companies that cover individuals can pick (and reject) whom they choose to cover. Because individual health insurance companies offer their plans to only the relatively healthy, premiums can be substantially lower than group premiums.
A Health Savings Account operates somewhat like IRAs. An HSA is a tax-advantaged savings account for healthcare services. You must enroll in a qualified High-Deductible Health Plan (HDHP) before you can establish an HSA.
A Health Maintenance Organization is a prepaid health benefit program whereby you’ll pay monthly premiums in return for managed coverage for your checkups, hospital stays, doctors' visits, surgery, emergency care, preventive care, lab tests, and X-rays. If you join an HMO, you will have to select what’s called a “primary-care physician,” who will be responsible for coordinating your healthcare and making any referrals to specialists that you require. You’ll also have to use doctors, hospitals and clinics that are members of your HMO plan's network.
A Preferred Provider Organization is a healthcare benefit arrangement designed to supply services at a discounted cost by providing incentives for you to use designated healthcare providers (who contract with the PPO at a discount), but which also provides coverage for services rendered by healthcare providers who are not part of your PPO network.
A deductible is a flat amount you must pay before your insurer will make any benefit payments, other than for preventive care (e.g. annual physicals, doctors' office visits). Usually, the higher the deductible, the lower the premium. Typical choices for deductibles on individual health insurance policies are $500, $1000, $2500, $5000 and $10,000.
It depends on the type of policy. Most standard individual health insurance policies will apply the deductible to each family member with a “stop loss” maximum of two or three per year. HSA deductibles are usually cumulative, in that all family members’ expenses count toward the deductible total.
Co-insurance is the percentage of each claim above the deductible paid by the policyholder. For a 20-percent health insurance co-insurance clause, the policyholder pays for the deductible plus 20 percent of their covered losses. After paying 80 percent of losses up to a specified ceiling, the insurer starts paying 100 percent of losses.
Many available individual health insurance plans offer prescription-drug coverage with co-pays, but not all! Beware of purchasing a plan that does not offer this protection, as these costs, in the event of a catastrophic disease, can be excessive.
It all depends: if your family is relatively healthy and the insurance company doesn’t feel the need to look at your medical records, a decision on coverage can often be made a day or two after the submission of your application. However, if the answers on your application cause the insurance underwriters to seek more information in the form of doctors’ or other types of records, it may take several weeks.
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Unfortunately, this can happen. We often anonymously pre-screen pre-existing conditions with prospective health insurers to avoid this. However, should one of our clients get declined, we have often had success applying to other carriers who work with different guidelines.
CoverColorado is a non-profit entity created by the Colorado Legislature to provide medical insurance for eligible Colorado residents who, because of a pre-existing condition, are unable to obtain coverage from private insurers. www.covercolorado.org
This refers to any healthcare or lifestyle issues you had prior to your insurance plan's effective date. Many policies will refuse to cover the more serious pre-existing conditions, while others do so with a rate-up.
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 or over, or who meet other special criteria. It was originally signed into law on July 30, 1965, by President Lyndon B. Johnson as amendments to Social Security legislation. At the bill-signing ceremony, President Johnson enrolled former President Harry S. Truman. Below you'll find some useful websites: www.medicare.gov/coverage/Home.asp www.bouldercounty.org/cs/ag/programs/medicare.htm
Disability insurance pays an insured person an income when that person is unable to work because of an accident or illness.