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Types of Health Insurance

by Karen Maslowski, Sewstorm Publishing

In the last issue we discussed finding health insurance, now let's take a look at what kind of coverage to look for.

Ask these questions:

First, are you and your family and employees relatively healthy? Is anyone pregnant? Does anyone have recurrent or chronic problems that may need future treatment? Is anyone under the care of a physician or psychiatrist? Does a condition require ongoing prescription medication? If you answer "yes" to any of these questions, don't cancel your present insurance if at all possible until you are positive you can replace it. These "pre-existing conditions," may include past accidents or illnesses, diabetes and many other conditions, and pregnancy, and they are specifically excluded from many policies. In addition, pre-existing conditions clauses often treat family members different than the primary insured (you, or an employee named in the contract).

What to do next:

If any of this applies to you, be sure to disclose it to the agent. He or she can advise you of companies that would be willing to insure you. Some will not; that's their privilege, and their right. They have a responsibility to their shareholders to be profitable, and accepting an insured who has a known illness with high expenditures isn't likely to make them money. It doesn't help to fib about it, either. If the company finds out that the information on the application was untrue they have the right to cancel your coverage, even in the midst of a claim.

Also be aware of how high the deductibles are per year, and whether they apply to the entire family, and how many per family. After that, there is generally a co-insurance, which means you pay a percentage, or set amount of any claim, and the company pays the rest. Study this carefully. Determine how much money you might have to pay doctors and hospitals, given a worse-case scenario. Can you afford this comfortably, or does it make sense to have a lower co-insurance? Often you're just trading dollars with a co-insurance -- you either pay it as a monthly premium, or you pay it if and when you have a claim. (This is almost always true of dental insurance, by the way.) If you're fairly healthy, saving premium by choosing a higher deductible and co-insurance is a good idea. Reputable agents will be happy to show you how to cut costs, without sacrificing coverage.

SewStorm Publishing 1998


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