The Four No No's of Buying Oklahoma Health Insurance

6/19/2008

Don’t buy on Price alone

Many people look at price first when considering health insurance.  Examine the plan carefully to see what it covers.  You may be better off to buy a high deductible plan that pays 100% of allowable costs after the deductible is met. With this plan you have a stopping place for medical expenses vs. a lower deductible plan with extra co-pays for hospital stays, or limits on medical coverage.  Many plan designs today have a schedule of benefits or extra deductibles for inpatient or outpatient procedures  This means if you have surgery for Gallbladder and the schedule only pays $2000 for Gallbladder surgery you may be left with substantial bills.

Don’t forget your medical history at Application time

Many times people do not spend time reviewing their past medical history; this is a key to avoiding problems.  Take your time, don’t be rushed when filling out the application.  The agent should help you with this process.  It is better to deal with a waiver of coverage or a rate-up for a medical condition than to be denied in a future claim.  In this process you should not be pressured by the agent, he should be an educator and helper. 

Don’t buy if you don’t understand the “Insurance Language”

Ask questions if you don’t understand.  Many times people may not understand the terms of their policy even though they have owned insurance for many years. 

Deductible is a common term which means the amount the policy owner pays before the company starts paying.  A deductible per cause vs. per year, can trip people up because they are subject to multiple deductibles in a year.  For example, if you have multiple operations or outpatient services you may have to pay a deductible for each procedure. 

Stop Loss

After reaching the Stop Loss amount, the company will pick up 100% of the allowable costs.  Stop Loss amounts vary; however, the typical amounts are $ 5000 or $ 10,000.  Ask for the family and individual maximum out of pocket expenses.  This will help separate plans you are considering.  In comparing insurance companies, one out of pocket cost may be $2000 for the individual and another company’s plan may be $3000.  You now have a good starting point to compare the companies. 

Limitations

Many companies offer limited benefits for outpatient care, certain tests, operations, or procedures.  Be sure before buying…make sure you understand these limitations. 

Many companies offer plans with co-pays for Doctors, and prescriptions but may limit their liability by offering reduced coverage for major illnesses such as organ transplants.  Don’t fall into this trap.

For the self employed, make sure the plan covers you for 24 hours a day even on the job.  This is sometimes an additional benefit that must be purchased separately.

Don’t pay additional costs for services not related to your family protection

Many times insurance is sold through associations that charge large monthly fees.  These fees go for discount rental cars, hotels, or magazines and add to the cost of the overall insurance premium. There is nothing wrong with this if you have a need for this service; however, this adds to the cost of the health insurance, without providing additional protection for your family. Beware of large application fees.  Many companies do not charge fees at all.  Your Oklahoma Independent Agent can help with this.

Additional Thoughts

I offer comparison sheets to people as an added benefit to help you shop for coverage.

Your problems should be taken care of if you have a good agent.  I will watch out for my customers, explain the terms, and make sure the application is filled out thoroughly to the best of my customers’ ability.  Purchasing health insurance in Oklahoma over the last 15 years has been difficult.   Many companies large and small have left the state, leaving people to shop again, alone for coverage. Some have been unable to purchase insurance after this because of health changes.  Insurance premiums are the largest growing expense for the self-employed and individuals…far exceeding inflation.  90% of all the new agents leave the business the first year.  These are just a few of the factors that affect Oklahomans…the # 1 plea I get is I want to buy a company I can stay with until I retire.  I believe security and affordability are based on a relationship with an agent.  Changes occur in life situations, companies come and go, and I will be here to assist you with these occurrences.