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I applied for health insurance and the rate came back higher than I was quoted–what can I do?

2010-04-20 by Colleen King

Even though the big, massive health care reform bill has passed, not much will be changing for the next couple of years. So if you’re on your own and needing to buy an individual plan for you and/or your family, how should you do it? Call an independent agent, call an insurance company, or just go online and not deal with any of those pesky people?


Well you know what I’m probably going to suggest, but here’s why. If you go directly to a carrier, they can only tell you about their products. You can go to one of the big online ‘anonymous’ type sites, but do you really know what you are looking at? If you are versed in health insurance, of course you can do this on your own, no sweat. But I find most people are still confused and if they do it on their own, they are surprised with what they end up with.


Here’s another reason to go with an agent. I had a client approved this week, and she had a couple of relatively minor issues, but instead of getting approved at a standard rate, she was rated up 50%! I called her, clarified what the circumstances were for the two reasons given for the increased rate and then emailed my account executive at the carrier. I explained the circumstances, and was hoping he could get the rate from a 50% increase to maybe just a 25%. Imagine my surprise when he came back with a STANDARD rate. I was thrilled, my client ecstatic, the world was a happy place.


Does this happen all of the time? No, not even most of the time. To me, in looking at the situations these issues were borderline. And my account guy being the gem that he is, he agreed. There’s a strong probability that if I had just called underwriting, I wouldn’t have gotten the standard rate back. But maybe I would have.


Point is in all this, most individuals wouldn’t have known where to go with this, would have just said oh well, and either kept the plan at the higher rate or dropped it all together. One of the big reasons for health care reform was for the states where there was little or not competition. And there are some states with only 1-2 carriers. But in California we have 6-7 major carriers and some smaller ones, so there is plenty to chose from. That’s another reason to use an independent agent, so they can help you find what you want and with a carrier that’s best suited for your situation.

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COBRA subsidy is extended–good thing, since California’s unemployment rate is up!

2010-04-17 by Colleen King


On April 15th, Tax Day ironically, Congress voted to extend the 65% COBRA subsidy eligibility period through May 31. Meaning, if you are ‘involuntarily terminated’ from your job and not for ’cause’ (’cause’ meaning you did something wrong) you will be eligible for this extension. Eligible folks can have the subsidy of 65% up to 15 months under the current program. Depending on how much that brings down your cost, you might also consider looking at an individual plan but I know that subsidy is tempting.


Since the news came out today that California’s unemployment in March is the highest ever, 12.6%, up from 12.5% in February, that’s probably a good thing. And most likely California’s CalCOBRA program will follow suit as it has before. From the article above, it sounds like Republicans were balking at this bill which also included increasing unemployment benefits and a few other things (click here to see what all) because it supposedly will add $9 billion to the budget deficit.


After health care reform, what’s another $9 billion?


Be well!

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Health insurance and preventive services–is it all going to be covered now?

2010-04-06 by Colleen King

In the recently passed health care reform bill (yes, THAT again) one of the things that was addressed was eliminating co-pays or cost sharing for preventive services. I haven’t heard how that exactly is going to work, but if it’s like other things I’ve seen, not all things labeled ‘preventive’ will be covered. This link is from another state, but the types of services recommended are pretty standard.


Some carriers on their plans already have low or no co-pays for mammograms, Pap smears and PSA blood tests. Colon cancer screening, usually just a smear but sometimes colonoscopy, is included. Check your plan documents or call your carrier to know for sure. But more expensive things, like most ultrasounds, scans, etc., are not considered regular preventive care. Those are considered more diagnostic in nature, meaning someone is probably looking for a problem, so it’s going to be subject to your deductible.


I’ve come across something in the newspaper and television lately that I’m going to check out and you might want to also. And organization called HealthFair.com offers screening packages of tests. You can get a cardiac screening which includes an EKG, ultrasound and arterial stiffness exam, a vascular/stroke screening which includes a carotid artery ultrasound, abdominal aorta ultrasound checking for an aortic aneurysm, and another test that checks for peripheral artery disease. Or you can do both for $199.


These mobile fairs are all over Southern California and I believe across the country. I’m not endorsing yet them as I’ve not used them before but I’m going to check this out. I had a carotid ultrasound earlier this year that WITH the insurance company discount was over $400. I think it’s something to look into though, if you are in your late 40s and up. They offer different series of blood tests, there’s all kinds of things. Cost for these screenings may vary by locations, so don’t hold me to this, check it out for yourself.


This sounds like a cost effective way to at least get a baseline, but is not intended to replace an exam by your doctor. I’m signing up, you might want to check out their site. Got to save where you can!


<a href=" https://www.healthfair.com/" target="_Blank" >HealthFair.com</a>


Be well!

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