FAQs
Q: What is 'Full Coverage' medical insurance and why does that matter?
A: "Full coverage" can be a confusing term and is often referred to in both medical and property insurance. This generally refers to a policy that has no stated limit on the amount of coverage available and guarantees to pay for a covered loss, per the policy language. This is still subject to deductibles, actual cash value and other factors that may limit the amount paid. Medical Insurance must have an Out Of Pocket Maximum listed to be considered full coverage.
Q: I have health insurance through my employer but it is expensive. Is there another option?
A: Yes. Employer plans may offer coverage to employees and their families but the premiums can get expensive. Typically the employer will cover the cost to insure their employee but the family members coverage is charged at full price and usually deducted from your paycheck. You may find lower cost health coverage on your own and opt-out of the employer plan. In some cases, a family may choose to insure some individuals on the employer plan and some elsewhere..
Q: I am healthy and don't even use my health insurance. Why am I paying so much?
A: Insurance rates are determined by how many claims an insurance company has to pay for and how much they pay out for those losses. Everyone who holds a policy with the same company is in a shared risk-pool so even if YOU are not the one causing the insurance to pay out for things, everyone in the pool sees their costs go up. You are paying more because either a) the people around you are having a lot of expensive claims or b) the cost of treatment and medications themselves have increased. Usually there is a combination of both factors.
Q: What is a deductible and does it matter what amount mine is?
A: Simply put, a deductible is the amount that the policy holder is required to pay toward the cost of a covered loss before the insurance company begins paying out. A lower deductible is usually preferred, as to avoid being responsible for a large payment later,. However this will mean paying a higher premium for the policy itself.
Q: Are there costs that health insurance doesn't cover when I am sick or injured?
A: Yes. Medical Insurance will cover the cost of medical treatments, medications, hospital stays, etc, but will not cover the costs for things like lost income due to illness or injury, experimental treatments, travel, modifications to your home or vehicles to accommodate a disability or the ongoing services you may require. For these things, it is a good idea to include supplemental coverage such as accident, disability, critical illness or accidental death a& dismemberment.
Q: What is coinsurance?
A: Coinsurance refers to the percentage of a bill that belongs to the policy holder and to the insurance company. If a policy states 20% coinsurance, that means the policy holder will pay 20% of the bill and the insurance company will cover the remaining 80% . In health insurance, coinsurance will apply to the cost of bills remaining AFTER the deductible has been satisfied. If your policy includes and Out OF Pocket Maximum, you will only pay your co-insurance until you have satisfied that maximum amount