Health insurance is becoming increasingly necessary. With health care costs on the rise across the board, it is difficult to get any kind of care without breaking the bank. For this reason, it pays to evaluate as many insurers as possible to get the best health care coverage. Medicare can only cover so much, and insurance agents can help determine what the best cost for necessary coverage is. For seniors, the top 12 questions when it comes to health insurance are:
- How much coverage do I need?
- What plan is best for me?
- What can I do to lower my costs?
- What's the difference between a deductible and a co-pay?
- Can I get anything extra out of my insurance?
- Will this cover doctor visits?
- Isn't this covered by Medicare?
- Once I get insurance, am I done?
- I have a great rate now, why should I talk to anyone else?
- Can my rates change?
- Can my insurance be canceled?
- Why do I need a medical exam to get insurance?
What is necessary coverage?
Insurance is an investment for “if” things go wrong. Health insurance is a special kind of if, in that it will most likely be called upon. Insurers realize this, and they charge premiums based on how often the insurance will be used. The goal for the individual paying the insurance is to pay less for being insured. Determining necessary coverage is the first way to accomplish this goal. Younger consumers are often unaware what coverage they will need, but seniors are typically acutely aware of exactly what costs need to be covered. While this certainty can result in higher premiums, it can allow seniors to find the ideal plan for their needs.
The best way to find a lower cost in health care is to look at deductibles and co-pays. Many health insurance plans require a co-pay per service for the insured. This is significantly lower than a deductible, which is the amount an insured must pay per year before an insurer begins to pay, but frequent co-pay services may quickly add up to more than an annual deductible under another plan. Consider what services require a co-pay and how much that co-pay is (generally $20 or a percentage of the total cost). Are those services frequent enough that a co-pay is a more expensive option? Or, if on a fixed income, is the co-pay an easier cost to shoulder each month than a deductible would be in the first few months of a year?
Current medical health and, recently, mental health also play a role in premium cost. Good nutrition and fitness practices can help health and, in return, are usually rewarded in health insurance programs. Some plans now include gym membership and other incentives to be more physically fit, reducing cost to the insurer and increasing health for the insured. Many are discovering the positive effects of gym membership on women’s health, as regular muscle building exercise helps the effects of osteoporosis in post-menopausal women.
Fitness, nutrition and health management are important topics to discuss with an insurance provider. Individuals should discuss this important medical health information because it sheds light on home health lifestyles. Two different individuals may have the same current health and health risks, but one could get a better rate by taking proactive steps such as eating healthy and exercising regularly. Regular medical health and mental health checks are also a sign that the individual is reducing the chance that insurance will be needed, likely reducing premiums as well. Some plans and policies cover regular check-ups and other preventative measures as a way to safeguard against illness and reduce its cost when found. This is especially true in terms of women’s health, as women are encouraged to begin getting regular reproductive checks in their youth.
Public and Private Insurance
Medicare covers many things. Unfortunately, because it must cover all Americans over 65, the coverage it grants is limited. Part A is automatic and covers many in-patient costs, such as hospital stays. Part B has an additional cost, but it covers costs associated with out-patient care, such as physician services and medical equipment. Private insurers offer Part C, which combines parts of A and B and often offers more services, such as eye care. Very few Part C options cover drugs, which is the realm of Part D. Confusion often stems from labeling, as Part D is split into various, lettered Plans. Medicare coverage is meant to cover basic medical needs for seniors, not all medical needs. For this reason, seniors looking for a more active role in health management should look to plans that supplement Medicare coverage.
However, getting a supplemental plan is not the end of insurance talks. Rates can and do change because of the way private insurers are funded for their Medicare plans. For this reason, all individuals should shop around various health insurance plans every year in order to determine if there is a better price from someone else. Unfortunately, these rates are determined by the amount of individuals insured, so brand loyalty rarely benefits anyone.
When Coverage Can "Run Out"
Health insurance should not easily be canceled. The term “pre-existing condition” is thrown around quite often, but an individual should not fear it if he or she was completely honest when the insurance was obtained. Medical exams are often required for insurance because they are a fair and accurate way of determining if an individual does have any pre-existing conditions. Although something was not discovered or disclosed before insurance began, if an insurer discovers that it did exist, a condition may be exempted from coverage. For this reason, it is important to get regular check-ups, and this is why many insurers offer check-ups in their plans as a preventative measure. This is especially true for women’s health, as osteoporosis and other post-menopausal conditions may not become fully apparent until it is too late to cover them.
Because so many conditions can be hard to detect in their early stages, it is important to consider Home Health Care with health insurance. Regardless of what causes an individual to need Home Health Care, having it covered gives an individual a monetary amount to use at his or her discretion. So, an individual who merely needs medicine administered every few days will be able to use the coverage over a long period of time. Individuals who fear they may need complete assistance will need to look at higher coverage amounts.
In general, the adage “an ounce of prevention is worth a pound of cure” is true. The earlier one gets health insurance and begins taking health management seriously, the more it will pay off in the end. Fitness and nutrition are great preventatives, but one should always be prepared “if” things go wrong.