Finance
HMO -The Full Story
When you are searching for low cost health insurance an HMO plan is likely to come across your radar. HMOs, or health maintenance organization plans, offer some of the lowest cost full coverage insurance benefits but they have certain drawbacks.
With an HMO, you will be treated exclusively by doctors and medical treatment centers that are in the HMO network. If you receive treatment from someone outside of this network, unless it is an unpreventable emergency, your claim is likely to be denied. Unlike a PPO, HMOs do not offer any coverage for treatment received outside the network unless it is emergency treatment in an area with no network treatment centers or physicians. So if you have a favorite doctor that you or your children visit, make sure he or she is on the network list before you take out the HMO’s cheap health insurance coverage. If you don’t, then you will be forced to pay out-of-pocket for the full cost of all your visits to this physician.
With an HMO you are likely to have a copayment amount each time you visit a doctor or treatment facility. The copayments are fixed dollar amounts that will be listed out on your policy and possibly on your insurance card. They do not vary although they may be increased when your policy is renewed.
Some HMO plans have deductibles which is an amount of money that you must pay out-of-pocket before the policy kicks in and pays a benefit. These deductibles are variable and you can choose yours when you take out your policy. The larger your deductible the less expensive your insurance premium will be.
Your policy will also have a limit, or cap, in the amount of benefit you can receive over your lifetime. This protects the insurance company from having to commit to pay too much in benefits. Since the limits are usually set above one million dollars, it’s doubtful that most consumers will need to worry about exceeding them.
Remember, check your rates, choose an affordable deductible and a reasonable limit, and check that your favorite physicians are on the network list before you take out an HMO plan. Then your family will be happy, safe, well cared for and not at financial risk.
Health Insurance Underwriting Overview
There are many aspects of your health and habits that must be taken into consideration when you have a health insurance policy underwritten. These things work together to create the general risk that you life presents to the insurance company. It is not until all these factors are considered that your insurance agency can determine whether or not to issue your policy and what premiums to charge. Here are some of the main factors that health insurance underwriters consider when reviewing your health insurance application for approval.
Your medications: The meds you take give a good insight not only on the prior events of your health history, but also on what your doctor thinks might be in the future. For instance, you might not have had a heart attack yet but if your doctor has you on a cholesterol medication, then it is likely that he or she thinks you may be at risk for one in the future. That indicates to a health insurance underwriter that you could be a risky bet.
Your health history: The events that comprise your health history give an insight not only into what your health future might hold but also in how you treat and respect yourself. For instance, Type 2 diabetes is often caused by obesity and poor eating choices. If you have Type 2 diabetes then it is unlikely that you eat well or exercise, which puts you at risk for a whole host of additional health problems.
Your family history: DNA ruins a lot of things health wise. If heart disease runs in your family then you are much more likely to suffer from it eventually. The same can be said for cancer, obesity, diabetes and certain mental illnesses. Knowing that someone in your family has suffered with these issues could change how a health insurance underwriter views your application for coverage-even if you are in perfect health.
Your weight and height: Your weight and height indicate how well-proportioned you are. Someone who weighs 300 pounds and is 5’3″ is much more likely to be considered obese than someone who is 6’5″ and weights the same.
Smoking status: If you are a smoker-even an occasional lighter upper-then you are putting your body at risk for cancer, lung disease, emphysema and more. This will not be looked upon favorably by the underwriters reviewing your health insurance application.
Health Insurance Terminology
You cannot be sure that you’ve gotten the best health insurance coverage unless you understand health insurance terminology. Here are some of the most commonly used terms in the health insurance industry.
COBRA: The Act that allows for continuation of group coverage for a limited time after you leave the group.
Co-insurance: The amount you must pay for treatment after copayments and deductibles.
Copayment: The fixed amount that you must pay out-of-pocket for physician visits, medical procedures and prescription medications.
Deductible: The out-of-pocket amount you must pay before your policy benefits start kicking in.
Exclusions: Any medical conditions or illnesses whose expenses are not covered by your insurance policy.
HIPAA: A health insurance Act that sets privacy standards in an electronic world and guarantees portability of coverage and new policy issue after COBRA benefits run out, as long as there has not been a significant break in coverage (varies by state but usually at least 63 days).
HMO: A type of insurance policy that allows only treatment within a set network of physicians and facilities.
Lifetime limit: The maximum amount your insurer will pay out in benefits.
PPO: The type of insurance policy that has a network of physicians but still allows you to visit physicians and facilities outside the network for a reduced benefit.
Pre-certification: Some insurance companies require that you get preapproval from them before you have surgery or other medical procedures. This is called a pre-certification.
Pre-existing conditions: Any illness, injury or chronic disease you suffered from before you took out your insurance policy is considered a pre-existing condition.
Premiums: The fee that you pay to your insurance company monthly, annually or quarterly is your premium.
Underwriting: The process of reviewing and evaluating the risk you pose to the insurance company based on your medical history.
Waiting period: The amount of time you must wait before your pre-existing conditions are covered by your policy.
HMO – The Full Story
When you are searching for low cost health insurance an HMO plan is likely to come across your radar. HMOs, or health maintenance organization plans, offer some of the lowest cost full coverage insurance benefits but they have certain drawbacks.
With an HMO, you will be treated exclusively by doctors and medical treatment centers that are in the HMO network. If you receive treatment from someone outside of this network, unless it is an unpreventable emergency, your claim is likely to be denied. Unlike a PPO, HMOs do not offer any coverage for treatment received outside the network unless it is emergency treatment in an area with no network treatment centers or physicians. So if you have a favorite doctor that you or your children visit, make sure he or she is on the network list before you take out the HMO’s cheap health insurance coverage. If you don’t, then you will be forced to pay out-of-pocket for the full cost of all your visits to this physician.
With an HMO you are likely to have a copayment amount each time you visit a doctor or treatment facility. The copayments are fixed dollar amounts that will be listed out on your policy and possibly on your insurance card. They do not vary although they may be increased when your policy is renewed.
Some HMO plans have deductibles which is an amount of money that you must pay out-of-pocket before the policy kicks in and pays a benefit. These deductibles are variable and you can choose yours when you take out your policy. The larger your deductible the less expensive your insurance premium will be.
Your policy will also have a limit, or cap, in the amount of benefit you can receive over your lifetime. This protects the insurance company from having to commit to pay too much in benefits. Since the limits are usually set above one million dollars, it’s doubtful that most consumers will need to worry about exceeding them.
Remember, check your rates, choose an affordable deductible and a reasonable limit, and check that your favorite physicians are on the network list before you take out an HMO plan. Then your family will be happy, safe, well cared for and not at financial risk.
Health Insurance Underwriting Overview
There are many different aspects of your health and habits that are taken into consideration when you have a health insurance policy underwritten. These factors work together to create the general risk that you life presents to the insurance company. It is not until all these factors are considered that your insurer can determine whether or not to issue your policy and what premiums to charge. Here are some of the main factors that health insurance underwriters consider when reviewing your health insurance application for approval.
Your medications: The medications you take give a tremendous insight not only on the prior events of your health history, but also on what your doctor thinks might be in the future. For instance, you might not have had a heart attack yet but if your doctor has you on a cholesterol medication, then it is likely that he or she thinks you may be at risk for one in the future. That indicates to a health insurance underwriter that you could be a risky bet.
Your actual health history: The events that comprise your health history give an insight not only into what your health future might hold but also in how you treat and respect yourself. For instance, Type 2 diabetes is often caused by obesity and poor eating choices. If you have Type 2 diabetes then it is unlikely that you eat well or exercise, which puts you at risk for a whole host of additional health problems.
Your family history: DNA ruins a lot of things health wise. If heart disease runs in your family then you are much more likely to suffer from it eventually. The same can be said for cancer, obesity, diabetes and certain mental illnesses. Knowing that someone in your family has suffered with these issues could change how a health insurance underwriter views your application for coverage-even if you are in perfect health.
Your weight and height: Your weight and height indicate how well-proportioned you are. Someone who weighs 300 pounds and is 5’3″ is much more likely to be considered obese than someone who is 6’5″ and weighs the same.
Smoking status: If you are a smoker-even an occasional lighter upper-then you are putting your body at risk for cancer, lung disease, emphysema and more. This will not be looked upon favorably by the underwriters reviewing your health insurance application.
Health Insurance Terminology
You cannot be sure that you’ve gotten the best health insurance coverage unless you understand health insurance terminology. Here are some of the most commonly used terms in the health insurance industry.
COBRA: The Act that allows for continuation of group coverage for a limited time after you leave the group.
Co-insurance: The amount you must pay for treatment after copayments and deductibles.
Copayment: The fixed amount that you must pay out-of-pocket for physician visits, medical procedures and prescription medications.
Deductible: The out-of-pocket amount you must pay before your policy benefits start kicking in.
Exclusions: Any medical conditions or illnesses whose expenses are not covered by your insurance policy.
HIPAA: A health insurance Act that sets privacy standards in an electronic world and guarantees portability of coverage and new policy issue after COBRA benefits run out, as long as there has not been a significant break in coverage (varies by state but usually at least 63 days).
HMO: A type of insurance policy that allows only treatment within a set network of physicians and facilities.
Lifetime limit: The maximum amount your insurer will pay out in benefits.
PPO: The type of insurance policy that has a network of physicians but still allows you to visit physicians and facilities outside the network for a reduced benefit.
Pre-certification: Some insurance companies require that you get preapproval from them before you have surgery or other medical procedures. This is called a pre-certification.
Pre-existing conditions: Any illness, injury or chronic disease you suffered from before you took out your insurance policy is considered a pre-existing condition.
Premiums: The fee that you pay to your insurance company monthly, annually or quarterly is your premium.
Underwriting: The process of reviewing and evaluating the risk you pose to the insurance company based on your medical history.
Waiting period: The amount of time you must wait before your pre-existing conditions are covered by your policy.
Considerations in Auto Insurance Underwriting
When your auto insurance policy is underwritten, your insurance underwriter attempts to figure out whether or not you should be approved for the policy, what you should be charged and if there should be any special amendments to your policy. Many different factors and traits are considered during this process including:
Your motor vehicle report: Your motor vehicle report (MVR) is a report that shows your driving record. It shows all the tickets you’ve gotten for reckless driving, speeding, and not obeying general traffic laws. This report is extremely important in determining how risky you are to insure. If you have many tickets and incidents on the report that show you are not a responsible driver, then you are going to be expensive to insure because the auto insurance company is going to assume that your recklessness translates into expensive claims for anyone who insures you. The underwriters will then decide to charge you a higher premium than you might expect in order to offset the likelihood of claims.
Your age: The older you are, the more likely you are to be an experienced and responsible driver and the less expensive your premiums are likely to be-until you hit a certain age. Because as you start to get older, you again become more risky as a driver because you are less sharp witted, have worse eyesight and less hand-eye coordination. So whether you are too young, too old, or right in the middle, it will have an effect on your auto insurance underwriting and premiums.
Your gender: Unfortunately for the masculine set, male drivers (especially those who are young) are seen as riskier bets by insurers. Males are often considered to be risk takers and less responsible than their female counterparts.
Your relationship status: Married individuals are often seen as more stable and responsible by auto insurance underwriters. Singles get a bad rap and are often charged more for auto insurance.
Your car: If you drive a flashy, speedy, light and rocket ready sports car, then you are likely to be charged a higher premium than someone who drives a four door sedan. Sports cars are often purchased by people who want to test out the speed and handling of the car and usually want to push the car to its limits. That doesn’t always reflect well when an underwriter is looking to set the premium for your auto insurance policy.
Home Insurance on a Paid-Off Home
You might think that once your home is paid off you can drop your home insurance and live a carefree life with no insurance premiums. But just because there are no state requirements to hold home insurance on your house, that doesn’t mean that this useful coverage should be ignored after your home is paid off.
Your home could endure an insurable incident whether or not you have a mortgage. After all, it is not the fact that you owe money on your home that exposes you to risk-it is the fact that risk is everywhere and could happen to anyone. You see, when you have a mortgage your lender is at risk for damages to your home because they have more money riding on it than you do. That is why they demand that you have home insurance. But if you think that you don’t need to look for home insurance quotes once your home is paid off, then consider this: if your home catches fire, floods, is vandalized or has any other insurable event happen to it then you must pay for the damages out of pocket unless you have insurance. You might not even have a home left to live in until you can find the money to pay for all the repairs and in the mean time, you will be forced to pay out of your own pocket for your temporary living space.
Of course, you can look for less expensive home insurance quotes once your home is paid off. You could consider raising your deductible since you no longer have a mortgage to pay off and can likely afford to pay more deductible out of your own pocket. You can look for lower limits as long as you stay within the range that your home is worth so you can be fully reimbursed for an event that destroys your home. You can even determine what is and isn’t covered based on how you perceive your risk.
Remember, while saving money on home insurance quotes is important, having an insurance policy that is there for you when you need it is vital. Don’t scrimp too much on the policy and make sure you look out for your own self-interest and bottom line.
Equity Indexed Life Insurance
Whole (or permanent) life insurance policies are more than meet the eye. Sure they offer a death benefit that caries through the rest of your life as long as you pay your premium and keep the policy in force, but more than that they offer an additional benefit of premiums accruing into something called cash values. These cash values can grow in a few different ways:
- They can grow at a fixed rate like in a traditional whole life policy.
- They can grow at a variable rate by choosing a sub account to invest them in. Sub accounts in a variable policy may have fixed investments like money markets, they may have stocks, bonds or mutual funds.
- They can grow at a variable rate tracking the returns of a specific index-like the S&P 500 or the Dow Jones Industrial Average.
The third kind of growth is seen in an equity indexed life insurance policy. When you have an equity indexed life insurance policy, your cash values grow as they would in a variable policy but the sub account you choose is created to mimic the performance of a particular index. If that index goes up, then your cash value will likely go up. But if the index goes down, then so will your cash value.
One of the most important things to remember about an equity indexed life insurance policy is that there is no guarantee that you will earn money. Many illustrations for life insurance will show the great amounts of cash that can be accumulated in an equity indexed life insurance policy, but there is always the chance that the index you choose for your sub account will go down in value and will reduce the cash values you accumulate. The great things about equity indexed life insurance policies, however, is that they often have a floor, or minimum amount that you are guaranteed to gain. While this threshold is often significantly less than the fixed rate of return in a traditional life insurance policy, it at least offers some sort of gain while markets are down. On the other hand, there is also often a ceiling or maximum gain you can experience which may be less than the actual increases experienced by the index that you choose.
Can Your Insurance Company Afford Your Claim?
Choosing an auto insurance policy is often considered to be all about the price of the policy. Sure you want the best coverage you can, and you want to be sure that you will get reimbursed for the types of accidents that are likely to happen to you, and absolutely you want to have the cheapest policy you can get, but what about choosing an auto insurance company that can actually afford to pay your claims?
One of the best ways to make sure you choose an car insurance company that can afford your policy is to check the company’s AM Best rating before you take out the policy. AM Best is an insurance rating company that examines the financials of an insurer in order to determine how likely that insurer is to be able to pay the claims it receives. By checking the company’s balance sheets, income statements, insurance policy load and other information AM Best can get a good idea of whether or not they can handle their financial load.
Once they assess the financials they give a letter grade to each insurer. These letter grades give you an idea of just how capable AM Best things the insurer is. Generally, you want to choose an insurer with an A rating or higher. You don’t need a special sign in or a paid membership in order to access the ratings, you just need to go to the website and look up the insurance company.
Before you decide that you don’t need to worry about the rating of your insurer and instead can just pick the cheapest car insurance rate and move on with your life, remember-an insurance company is only as good as its ability to pay your claims. If an insurer is unable to actually pay the claims of its premium paying clients than it is nothing more than just an empty promise-one that you pay for out of your own pocket.
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