Find Better Health Insurance

Health insurance chartFind Affordable Health Insurance for Individuals, Families and Businesses

Compare Medical Insurance Quotes and Find the Right Plan

Finding affordable health insurance may seem like a daunting task. With the Affordable Healthcare Act and new regulations taking effect, people are more confused than ever. How do you sort through plans, deductibles, and networks, and choose a policy that makes sense for you, your family or your employees?

Our independent insurance agents who specialize in health insurance can be an excellent resource when you want to evaluate health plans. You may discover that you can find a lower cost option through an independent agent than you can through your employer. This is because these agents can compare plans from multiple carriers to find the best fit and rates. Contact us for assistance and get all your questions answered right away.


How to Buy Health Insurance for Individuals and Families

If you are self-employed or you are not obtaining healthcare coverage through your employer, you need at least a basic health insurance plan to ensure that you are prepared for an unforeseen health condition or injury.

A full-coverage health insurance plan may be more suitable for your needs if you have dependents, you are getting ready to start a family, or you have a family history of certain health risks, such as heart disease. You should ensure that your healthcare plan helps you to pay for the broader set of services you need.

Use the handy checklist below to help you decide what kind of coverage may be right for you.

Healthcare Costs, Co-pays and Coinsurance

Your healthcare costs are an important factor to consider when you want to buy health insurance, and you have a number of options for managing those costs. You can choose to pay a higher deductible to lower your regular premiums, which means you need to pay that deductible amount for doctor’s visits and medical bills before your health insurance kicks in. Alternatively you can pay a higher premium in order to avoid a high out-of-pocket cost in the event of a serious illness.

Co-pays and coinsurance are two methods health insurance companies use to share the cost of healthcare. Co-pays are a small amount you pay for every doctor’s visit, whereas coinsurance is an amount you pay in the event you need additional care. Be sure to fully understand any coinsurance payments your health insurance plan requires. In the event of a serious illness or injury, these costs can become very high.

Our independent agents in the Trusted Choice network can help you compare medical insurance quotes and find the right healthcare plan to match your current and anticipated needs.


Health Insurance Coverage Plans

There are a number of different types of health insurance plans for individuals and families. The following table provides a brief overview of the most common health insurance plans.

Chart that explains health insurance options

Our independent agents in the Trusted Choice network specializing in healthcare insurance can answer all of your questions. You can also learn more from the following Healthcare and Health Insurance Frequently Asked Questions:

  • Q: Is it possible to buy good yet cheap health insurance?
  • A: Low-cost health insurance plans are often sold by telemarketers and companies that sell volume, not quality. Unfortunately, what this means for many people is that they do not have the coverage they need in the event of a serious illness, hospitalization, or a condition requiring surgery and expensive medications. Talk to a qualified agent about ways to cut expenses without sacrificing needed care or putting your family at risk of a large burden of debt.
  • Q: How does the Affordable Health Care Act affect health insurance?
  • A: The Affordable Health Care Act is an extensive overhaul of the healthcare system designed to ensure that everyone’s basic needs are met and those with pre-existing conditions can get the care they need. To fully understand what this legislation means to you, talk to one of our qualified agents and get your questions answered.
  • Q: Does health insurance cover long-term care?
  • A: Health insurance plans typically cover your regular health care and major medical care, such as hospital stays and surgeries, with costs and limitations varying considerably from one plan to another. Long-term care insurance is a supplemental insurance policy that helps individuals get the care they need in the event of a chronic condition, such as an injury requiring rehabilitation in a care facility, or the onset of Alzheimer’s Disease.
  • Q: Does Medicare include long term care?
  • A: Medicare is a government health insurance program designed to help those over 65, and those with certain severe illnesses such as Lou Gehrig’s Disease. It helps to cover the costs of hospital stays, doctor’s visits, and prescription drugs. Long-term care insurance is a supplemental insurance plan that helps to cover the costs associated with care for individuals with chronic conditions and disabilities.
  • Q: Can I get a free health insurance quote?
  • A: Yes. Our agents in the Trusted Choice network offer free insurance quotes and can help you assess your needs as well. Our independent agents work with multiple health insurance companies, which means they can compare a range of policies and options for you, and help you evaluate the right coverage for your needs.

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The 7 Hidden Costs of Having a Baby

Newborn baby photoHaving a baby is a life-changing event. Not only are you adding a person into your family, but that little mini — you needs things like diapers, food, and furniture — which all adds up very quickly. CNN Money estimates that raising a child to the age of 18 costs more than $225,000.

Our partners at Trusted Choice have outlined seven items that may include some unexpected sticker shock, along with some tips on how to save:

Diapers

Diapers may be the single most expensive item you invest in for your baby. From birth to their second birthday, you will spend an average of $2,500 on disposable diapers – not including wipes or diaper rash cream. What’s worse is that as of October 2013, diaper companies are now “downsizing” their product packages, but keeping prices consistent-which means that parents are paying the same amount for fewer diapers.

How do you save on diapers? Go cloth! Cloth diapers are much cheaper than disposables (anywhere from $250-$500 for a complete set) and can be used on other kids. They are also easily washable in home washing machines. Cloth diapers have evolved from the prefold and “trash bag” pants of the past. They now offer options that make them just as easy (and way cuter) than disposables.

Formula

At an average of $30 a can, formula costs can add up quickly. One can lasts roughly a week. On average, a formula feeding parent will spend $1,800 during the first year alone on formula.

One solution? Breastfeed! Many women encounter issues while breastfeeding, but statistics show that 90% of women can successfully breastfeed when given the correct support. Breastfeeding is scientifically proven to be better for your baby, better for post-partum weight loss, lowers cancer risks, and helps fight post-partum depression. There are many lactation consultants across the world dedicated to helping nursing mothers breastfeed successfully.

Nursery Furniture

Cribs, changing tables, mattresses – all of these items add up quickly for a nursery. The average price of a crib is $350. That does not include a mattress, changing table, or dresser. All of these items together will run an average of $700.

How to get the biggest bang for your buck? Buy convertible beds/furniture, or just purchase a crib, and use previously-owned pieces to finish off the nursery. Many changing tables go completely unused, so discuss what works best for your family. Buying a used crib is risky. Many manufacturers warn against purchasing used cribs as previous wear and tear may render the crib unstable.

Car seats

Car seats are an absolutely necessary cost for new parents – a cost that you will shell out at least three times during your child’s life. An infant car seat will cost anywhere from $50-$400, and will fit the child from birth until around 30 lbs. Next up is a convertible car seat, which will fit the child from 30-65 pounds. A convertible car seat can face forward or toward the rear of the vehicle, as most experts recommend having the child face forward until at least a year old. These seats range in price from $60-$500. The final piece you will buy for your child is a booster seat, which will cost $20-200. The major reason for the price differences is safety features.

Saving money on a car seat can be tricky. Attempt to find a car seat that fits the widest size ranges available. Buying used car seats is considered acceptable; however, you should always inspect the car seat before purchasing. Lift off all the fabric parts and inspect for cracks and dents. Car seats also have expiration dates, so be sure to double check that the car seat will be good for the entire usage period you are purchasing it for.

Hospital Bill

Childbirth is an intense experience, and can be costly as well. Depending on the birthing method, one can expect to pay anywhere from $3,000-$40,000.

While uncomplicated births are the most affordable, C-sections and other higher-involvement births rack up costs quickly. Epidurals and other pain relief methods will raise the price of the birth exponentially. Since many hospitals are aware of the financial constraints on new parents, many will have payment options available to help ease the sticker shock.

Childcare

Childcare is a cost that many parents have to consider when planning a family. There is no strict average for childcare costs, as the numbers range due to factors such as the age of the child, health considerations, and length of stay. The average cost for childcare will depend on your region as well. Most daycares will range from $300 to $600 monthly for a two year old. Higher-income areas, like Boston and New York, average $1,000 a month for a two-year-old child in full time care.

While there is no direct way to save money on childcare, limiting the use of childcare, or applying for tax credits (where available) are wonderful ways to save.

Breast Pump

While breastfeeding is free, there are some parents who decide to purchase a breast pump so that family members and friends to feed the infant. Breast pumps can average in price from $100-$300.

Many new mothers find good prices online, and some even find that pumps are covered on their health insurance. So, before throwing down your hard earned money on a pump, make sure it’s not covered by your health insurance first.

Having a child is an expensive endeavor, to be sure. As you prepare for a little one entering the world, it’s smart to start budgeting and making financial decisions that will help your family thrive.

Over 55? You Can’t Live Without This

Photo of elderly couple sitting outsideAging is inevitable, and in today’s modern society, people are living longer than ever.

Right now, there are close to 600 million senior citizens in the world, a number that will continue to grow. Access to healthcare is one reason we are living longer and as you get older, the need for quality senior health insurance grows.

There are several options that people over 55 can use but finding the right coverage can be tricky.

Our Aging Population

  • In 2010, there were 40 million people 65 and older living in the United States
  • By 2030, the 65+ population will grow to more than 72 million people
  • Only 11% of elderly people participate in exercise to strengthen muscles
  • 38% of senior citizens are obese

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Elderly Health Care Options

As a senior citizen, you can have access to several different methods for getting senior medical insurance. With the rising cost of healthcare, having just one plan may not provide the coverage you need. As you age, you can become increasingly prone to disease and injury, so it’s important to be properly protected.

Many adult children assist aging parents in the search for senior health insurance, so understanding the options is essential for everyone involved.

The following are some of the most common forms of health insurance for senior citizens:

  • Medicare
  • Medicaid
  • Private health insurance
  • Medicare supplemental insurance

Each of these is described in more detail below.

Medicare

Medicare is a federal health insurance program for people age 65 and older, as well as people with disabilities and severe health conditions. It is divided up into four different parts:

  • Medicare Part A, also known as hospital insurance, will cover hospitalization and home healthcare. This is free if you’ve worked for 10+ years and paid social security taxes. You will need to fill out an application for Medicare in order to be covered.
  • Medicare Part B includes medical insurance. This will cover a range of medical services like doctor’s visits and annual check-ups, mental healthcare and x-rays. As with all plans, there are coverage limits, and this option isn’t free. The annual premium for Part B is $104.90 and you are automatically enrolled when you become eligible for social security.
  • Medicare Part C is known as Medicare Advantage. It allows you to get Medicare coverage through private companies. The advantage of Medicare Part C is that it often provides better coverage, but you must have Part A and B to be considered eligible. Costs vary according to state and providers.
  • Medicare Part D covers prescription drugs. You don’t have to enroll in this part of Medicare, but if you take regular medication, it might be a good idea for you to pursue it. This also comes with a monthly premium based on coverage amount.

Medicaid

This federal program provides medical insurance for low income seniors often used in conjunction with Medicare. It will provide coverage for certain medical services and prescriptions. There is an application process you’ll need to go through, and you need to meet certain income limitations to qualify. If you qualify for Medicaid, it’s a good method to get affordable senior citizen health insurance.

Private Health Insurance

If cost isn’t a factor and you are trying to find health insurance for elderly parents, a private health insurance plan can be paired with Medicare. This is a good way to make sure you are completely covered as Medicare does have limitations. Be sure to check your private plan to understand the exclusions on that policy and avoid gaps in coverage.

There is one big disadvantage that senior citizens may face when searching for private senior health insurance: pre-existing conditions.

Seniors with pre-existing conditions should be able to find coverage with the passage of the Affordable Healthcare Act. If you need a private health insurance plan, there are options available right now, but hopefully the future will bring more affordable options to all seniors.

Medicare Supplemental Insurance

Medicare supplemental health insurance, called “Medigap” is meant to provide coverage for the things that Medicare doesn’t cover.

To qualify for Medigap, you must be enrolled in Medicare Part A and Medicare Part B. Your Medigap coverage will help cover excess costs, such as co-insurance costs for stays in the hospital or a nursing facility, and even the deductibles in your Part A and Part B Medicare plans.

You can find this plan through private insurers and organizations that cater to the elderly. Costs will vary according to coverage.

Buying the Right Health Insurance for Elderly People

With all the various options that are available and the many combinations, finding the right senior health insurance can be confusing. It’s a good idea to familiarize yourself with federal insurance programs and to examine private policies as well.

Under the Affordable Care Act, you’ll be able to search for policies that meet your needs on an online marketplace. Each state will have a marketplace (or, if your state does not have its own marketplace, it will be run by the federal government), so everyone will have access.

Remember that you are encouraged to ask questions of your potential insurer, and to advocate for yourself to make sure you’re getting the coverage that makes the most sense for your needs. Our independent agents are available to answer your questions and to provide the information you need. Contact us today.

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Filing a Health Insurance Claim

Health Insurance Approved Form Showing Successful Medical ApplicationHealth insurance claims are health insurance in action. The very reason we buy healthcare in the first place is because we want coverage for our doctor visits, especially in the event of a critical health need.

When you use certain healthcare services, such as urgent care, emergency services and specialty healthcare treatments, you may need to file claims.

Filing a health insurance claim is usually not difficult. However, the claims process does not always happen quickly, and in some cases can result in a health insurance claim denial.

If you are looking for a new policy or a better customer experience, contact one of our independent agents in the Trusted Choice® network who specializes in healthcare coverage. Our agents can make sure you have the right health plan for your needs and can help your health insurance claims go smoothly.

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Common Reasons Why a Healthcare Claim Is Denied

  • Seeking treatment without authorization
  • Making mistakes in claim filing
  • Filing healthcare insurance claims outside time limits
  • Getting treatment or medical services not covered by the healthcare policy
  • Opting for medical procedures that are not necessary

When Should You File a Health Insurance Claim?

Insurance companies watch the bottom line and keep an eye out for fraudulent health insurance claims. To avoid having your healthcare claims denied, make sure the medical service, procedure or treatment you seek is recommended and authorized by your primary care physician or a doctor you have been referred to for care by your doctor or clinic staff.

The typical times when you may need to file a health insurance claim are when you are sick or injured, when you have a procedure done that your physician has prescribed, or a family member is sick, injured, or needs surgery. You may also need to file a claim if you need urgent care services outside of regular clinic hours.

Be sure to coordinate with your health insurance company representative before any care or procedure, whenever possible, to determine which aspects of your medical treatment are covered.

Types of Health Insurance Claims

  • Preferred Provider Organization (PPO)

Preferred provider organizations allow the healthcare policyholder to seek treatment from a preferred healthcare provider. When you are a PPO member and use services within your PPO network, your policy typically covers those expenses.

  • Health Maintenance Organization (HMO)

In an HMO plan, the healthcare policy covers only the treatment sought from accredited physicians, clinics and hospitals specified in the policy.

  • Group Health Insurance Plan

Any individual member of a group health insurance plan can apply for claims for a range of medical expenses. With group long-term health insurance plans, the members can also claim reimbursements for treatment sought for prolonged illness, cognitive disorder, degenerative conditions or other chronic health issues.

  • Claim Benefits

With some health insurance policies, you can use pre-tax dollars for medical treatment, medical costs and other healthcare expenses. A health reimbursement is arranged, and you can file a claim for reimbursements for any covered family member’s medical expenses.

Another common feature in group plans today is the Health Savings Account (HSA). With an HSA, the person insured can save money for medical costs and enjoy tax advantages as well. HSA plans are associated with high-deductible health insurance. Contact a local independent agent for additional information.

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Make Sure Your Claim Is Valid

A health insurance claim is simply the bill that you or your health provider must send in to your insurer for payment of the medical services rendered to you.

For example, if the bill for your care services is $100, you pay your share of $25 and the health care provider collects the $75 from your insurance company. Or if you are in a plan that allows you to use services outside of your network, you may need to cover the costs first and then submit the bill to your insurance company yourself.

When receiving healthcare services and filing claims, read through your benefits and coverage specified in your policy, or contact your insurance company to determine if your services are covered. Do not hesitate to ask questions or clarify the things that you do not understand. This will help you avoid guesswork about whether your insurance company will cover your health insurance claim.

As long as you understand your benefits and your claims are within the limits of your coverage, you should have no problem with the claims process.

What to Do With a Health Insurance Claim Denial

Health insurance denied photoIn the event your health insurer denies your health insurance claim, you have the right to appeal.

As per the Affordable Care Act passed in 2010, health plans are required to meet basic standards regarding processes of internal appeals and external reviews.

You have the right to know why your claim is denied. Your insurer has to tell you the reason for your health insurance claim denial or reconsider the claim. This is called internal appeal.

If the internal appeal does not change your insurer’s decision, you have the right to ask another party to review the decision of your insurance company. This is called external review.

Working with an Agent for Your Healthcare Needs

Our local independent agents in the Trusted Choice network who specialize in health insurance can find the right coverage for your family and help you understand your policy’s coverage. They can also assist with the claims process. Contact us today and get the right healthcare coverage for your needs and budget.

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Learn Medical Insurance 101

Wade Insurance Agency Health and Life InsuranceWade Insurance Agency Health and Life Insurance

Photo of doctor in surgical mask Wade Insurance Agency Springboro OhioWhat Is Health Insurance?

Health insurance is a type of coverage that can protect you from the full expense of regular health care, as well as the costs of medical and surgical procedures. In exchange for paying a premium, your insurance company will cover the costs of your healthcare and certain types of medical procedures.

Health plans may be available from your employer, but you also have the option of purchasing your healthcare coverage privately. If you are self-employed or unemployed, you may have group insurance options through professional associations, in addition to private health insurance.

One of our agents in the Trusted Choice® network can help you compare plans, options and quotes from multiple insurance companies and can customize a plan for your unique situation. Contact us today.

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What Does Health Insurance Cover?

Health insurance can cover a variety of things, from your regular checkups and family care to your major medical expenses. The types of services that are covered will vary with different healthcare providers and plan types, so it is important to determine your needs before buying a specific health insurance plan.

Physician office visits are one of the most common things that health insurance covers. Other common covered services include hospital room and board, emergency room visits, and inpatient substance abuse treatment. Some things that you might think would be covered under a majority of policies may not be; some of the common excluded health care needs are maternity care and diabetes care management.

Some insurance policies will cover vision services and surgeries while others will not. Special tests may not be covered and you should not expect all services to be covered 100 percent. There is normally an out-of-pocket expense, through a co-pay, coinsurance or deductible.

Make sure that you know what your policy covers, whether all of your family members are covered, and how it will be paid for. Some health insurance policies, like HMOs (health maintenance organizations), will only cover procedures performed by certain professionals in a network. A PPO (preferred provider organization) will allow you to choose your provider and then pay based on that provider’s preferred status.

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How Does Health Insurance Work?

Health insurance can help you pay for your regular healthcare costs as well as your major medical expenses, depending on the type of plan you choose.

You will pay a premium of some kind, based on your plan and coverage, whether you get your health insurance through your employer or privately. Depending on your type of plan, you may have co-pays, deductibles and coinsurance.

Here is an overview of these costs:

  • Co-payments: With a co-payment, the insurance company agrees to pay for a service but you must cover a pre-set cost, such as $20. This cost applies every time you schedule that service; co-pays can be lower or higher depending on the plan.
  • Deductibles: A deductible is the amount of money that you are required to pay before your insurance begins to cover services. Normally, you will either need to meet a deductible or pay a co-pay amount.
  • Coinsurance: Some policies may have coinsurance, which requires you to pay a certain percentage of services rendered. Your coinsurance may be an amount you pay in addition to your co-pay and may apply towards your deductible.

Choosing the best plan really depends on your personal circumstances. An independent agent in the Trusted Choice network who specializes in health insurance can help you navigate the many options and find the most sensible and affordable plan for your needs.

Why Is Health Insurance So Important?

Health insurance helps you to manage the costs of your family’s care, including regular doctor’s visits and unexpected illnesses and injuries.

Just one serious illness, or an emergency procedure can have dire consequences for your financial portfolio if you aren’t insured properly. Health insurance coverage may seem expensive, but if you compare your premiums to the cost of surgery and other medical procedures out of pocket, there’s no question that healthcare insurance premiums are far lower in cost.

Also, having adequate health insurance can help you live a healthier, longer life. Many policies cover preventive care, which helps you manage your health proactively. These plans can help with early detection for common conditions and diseases, such as diabetes, heart conditions, and thyroid problems that can require much more extensive and costly care if they go untreated.

By contrast, if you are uninsured, you’re less likely to visit the doctor, which can be a disincentive to get routine physicals and take charge of your good health.

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How to Get Health Insurance?

When you begin to search for health insurance, it can be extremely overwhelming. Start by assessing your needs. If you’re prone to illness, play high impact sports or have a risky profession, it may be better to have a co-pay plan rather than one with a high deductible.

If you have children, you will need a different plan than if you’re single with no kids. If you have a favorite doctor, make sure that your favorite doctor is “in-network” if you opt for an HMO. You also need to think about your budget, and whether a plan that involves coinsurance or higher deductibles makes the most sense for you. By assessing your needs and comparing plans, you can find an affordable healthcare plan that meets your needs.

Many people don’t know where to start because the number of plans and variety of coverage options is very confusing. One of our Trusted Choice agents who specializes in health insurance is an excellent resource. These agents can help individuals and families to review a range of plans from different health insurance companies and choose one that will help with preventive care and major medical care at an affordable cost.

Is Health Insurance Required by Law?

With the passage of federal healthcare reform, in 2014 most people will be required to have health insurance. If you don’t have health insurance, you could face a tax penalty. There will be certain exemptions to the law but the aim of health reform is to lower costs, making it easier to get the health insurance you need.

When many people are uninsured, the result is that tax payers must shoulder the burden of healthcare costs for those who are not able to pay for care. One challenge is that by the time uninsured individuals visit the doctor, the health condition has often declined and the treatment procedures are more prolonged and expensive.

Healthcare reform is designed to get everyone covered so they are managing their health before health conditions get out of control.

What Does Health Insurance Cost?

The cost of health insurance depends on several factors. Costs vary based on your plan type, whether you have insurance through an employer or private insurer, what state you live in, and how much of the insurance you cover.

On average, individual policies cost anywhere from $150 to $200 per month and family policies can cost $350 to $425 per month. With some plans, you will pay these premiums entirely out of pocket and for others, the majority of premiums are covered by an employer. You can adjust your premium based on your coverage amounts as well as your deductible amount.

If you need more affordable healthcare but aren’t sure where to start, you can shop for a lower cost plan through one of our independent agents in the Trusted Choice network.

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Is Health Insurance Tax Deductible?

Health insurance is tax deductible if you are self-employed or have a health savings account. If you are self-employed, the premiums that you pay for health insurance for yourself and your dependent can be deducted from your taxes. If your dependents are covered under another insurance plan, you cannot deduct that premium.

A health savings account (or HSA) is used in conjunction with a high deductible health plan. You typically must buy these plans from an employer, although they are also offered through private insurance companies. Any amount of money that you contribute to your HSA account, up to a certain limit, is tax deductible.

What Is a Health Insurance Deductible?

A deductible is the amount of money that you need to pay out of pocket before your insurance begins to provide coverage. Deductibles will renew each year and some services may be covered without having to meet your deductible amount.

If you have a high deductible, it can save you money on your monthly premiums; just be sure you have the funds set aside to pay the deductible in the event that you need major medical care.

What Does Health Insurance Cost an Employer?

If you have health insurance through your employer, the employer generally pays significantly more for the policy, but you still pay a portion of the cost out of your paycheck. Average costs for single persons and families have increased each year. In 2012, the average employer paid just over $15,000 for a health care plan.

Employers have the right to raise the premium that an employee pays for healthcare to help offset business costs, but employees must be informed.

Whether you choose a healthcare plan through your employer or a private insurance company, the most important thing is finding the best policy for your needs. If you contact a local independent agent in the Trusted Choice network for assistance, you can feel more confident about your insurance coverage, not because you will have more choices but because you also will receive more help.

Work with one of our independent agents to find the right policy for you.

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