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A Primer On Finding & Selecting Medical Insurance

By Joe Leech

At one time, only a few such as the self employed really had

to know much about selecting medical insurance because for

many years, the majority of the working population was

working in "employee" status and Medical Insurance was a

company benefit, and one that had very few choices involved.

Today that benefit is either disappearing or being offered

with choices ranging from family plan to PPO to HMO to no

participation; choices also include the amount of payroll

deduction based on plan choice, and it's a complex situation

to decide.. does one opt for the plan with a $500

person/$1000 max deductible which has virtually no payroll

deduction, or the plan with the $250/500 but with a $25 per

month deduction. Of course those figures are arbitrary for

the purpose of the article and cited only as examples.

But there are choices that can and need to be made.. in

fact, some times those choices now come down to "where can I

get my own insurance... period?" as so many companies have

either layed people off or cut the Medical Benefit entirely.

Let's say you are one of those people.. hopefully not, but

we need to cut to the chase.

The first thing to see is if a spouse is working, is

insurance offered from their employer? Possibly they were

not on a family plan, but this is now required.

Usually even with an employer requiring a contribution, a

employer provided plan is less costly than going out 100%

percent on your own. This should really be checked out.

Employer group rates are generally less than an individual

getting their own insurance.

But let's say this does not apply. But the principle of bulk

or group purchasing does. Your next step is to see if there

is a group that you can join that offers group rates. If

you are self employed or have your own business, chances are

that your business or profession may have a professional or

trade organization that offers Medical Insurance through the

group.

The writer of this article resides in Pittsburgh, Pa where

he has been involved quite indirectly in the construction

industry. When we say "quite indirectly" we are talking

about being in sales and having a sales business which

provides pumps and equipment to contractors. Because of

that association, the writer qualified for membership in the

local Builder's Association which had pooled its many

members to obtain group rates. This is cited in this article

because you as a reader may not have an apparent direct

connection to a group, but you might qualify through an

association as the writer has done. If you need to provide

your own medical insurance, by all means check this out.

Are, or were you involved in federal or military service?

You may find a group association here.. try your VFW, your

TROA, your American Legion. One company that advertises for

the self employed is NASE. I've never checked them out, but

I do hear advertising.

So let's assume you have found a supplier, regardless of

your status. Most suppliers offer a choice of programs

ranging from HMO to PPO. What may seem to be the best deal

may not be so at all because of length of time to coverage.

BE ABSOLUTELY CLEAR ON THE PRE-EXISTING CLAUSES. Even if you

consider yourself healthy and not under treatment, if you

had a past work related physical or other physical and a

condition was noted as detected.. but you felt it was not

worth pursuing treatment for, and in fact, you are not

having a treatment or medication... if it's on the record

SOMEwhere and you subsequently have a claim... if it's

related to the diagnosis, not only could that claim be

denied, but your entire policy voided under the provisions

of fraudulent application if you did NOT state a pre-

existing condition.

Yes, insurance companies want your money and to have you as

a client, but they are there as profit makers first, and if

they can find a way to NOT pay you that they are legally

entitled to... you won't get a claim paid. You MUST have

everything in writing including any exceptions to a

precondition. Better to be turned down up front than

canceled when you need them.

Lastly, if you can not get or pay for insurance, but have a

family with minor children: Many states have programs that

will insure your minor children at no or nominal fees. These

state programs will not necessarily seek you out and sign

you up.. you need to do your research. Do not hesitate to

call your county health association or your state insurance

commissioner. Someone will know.

We hope that this article, and the fact you probably found

it on the Internet will help. Be sure and use Internet tools

and search engines and you'll probably find more resources

than you ever thought existed. Search terms such as

"discounted medical insurance" or disease/condition specific

insurance will yield results. don't spend another day

unprotected.


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