Consumer’s Health Insurance Blog

Health Insurance Book Author on Buying Health Insurance and Health Insurance Ripoffs

Marrying for Health Insurance

February 4th, 2010 by jpletzke
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People will marry for health insurance, not only in California. But how many will go on national TV?

http://www.cnn.com/video/#/video/bestoftv/2010/02/03/hln.behar.andrew.young.intv.cnn?hpt=T2

 

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

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Harvard’s Jeff Miron on the Obama Health Insurance Proposal

June 15th, 2009 by Jonathan Pletzke
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Here is an article worth reading about the nature of health care expenses, how we make the decisions about what to spend and how much, and why having your own health insurance policy may mean that you are a better cost risk than someone on a government or employer’s plan:

http://www.cnn.com/2009/POLITICS/06/15/miron.health.costs/index.html

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

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Health Insurance Q&A for Small Business

March 28th, 2009 by Jonathan Pletzke
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This health insurance question came to me recently and I thought it worth sharing:

We are meeting with our health insurance broker tomorrow to review and select options in providing our employees HMO/PPO health insurance benefits.  We have many options, and many rates in front of us between two insurers.  Would you be able to suggest a few key critical review questions we should be asking our broker both from the perspectives of 1) lowest cost options to the company and 2) acceptable employee options?  We have under 50 employees now, and are going to contribute 50% to the plan for the employees.  None of us are experts in benefits, so we want to be sure we are making the choices in both the best interest of the company and to our employees which range in age from 22 to 75, half of which are over 50. 

From a benefits perspective, you certainly know more about what it takes to attract and retain employees in your industry. My recommendation is to make sure you get all the numbers to make your health insurance spreadsheet for comparison and know how high a health insurance deductible your group will be able to tolerate (the higher the health insurance deductible, the lower the monthly health insurance rate). Depending on the group of employees and creative strategies allowed in your state, some companies are able to create reimbursement packages for employees such that they buy their own health insurance and/or receive HSA contributions from the employer.

Buying health insurance will be an annual exercise for your company, and of course there are other options such as employee leasing companies that can handle all of these details for you. Be sure to check out news stories (such as those from the LA Times and the Wall Street Journal) on these health insurers as well as to check them out via the free online databases in the health insurance resources center. You may also wish to make sure you are considering all of your options by looking at the insurers rated best at in the health insurance resource center and ensuring that you have health insurance quotes from them.

Best wishes on your search.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

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Can’t Get Medical Insurance? Move!

July 25th, 2008 by Jonathan Pletzke
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I know it sounds crazy, but did you know that if you move to another state you may easily get health insurance, no questions asked? The reason is because some states do not allow medical underwriting when applying for health insurance, whereas the bulk of them do. So those states that don’t allow medical underwriting are much easier to get health insurance regardless of medical status – the application forms don’t involve disclosing your detailed medical history.

Sure there’s a waiting period for pre-existing conditions (perhaps six months), but then you’ll have your health insurance – and having health insurance is an essential component of many people’s financial picture. For whatever reason you no longer have health insurance, whether it due to an illness, a family situation, a layoff, or one of the many other reasons, getting it back can be essential. Relocating to a friendlier state may be your solution, along with considering the other options available without moving, including obtaining employment that offers health insurance or buying your own (and making sure that you know all of your options – that’s why I wrote a book on health insurance!)

Moving is not to be taken lightly – there are many consequences and expenses involved with moving. However, you can move to your new state in a very lightweight way, simply by establishing a residence consisting of no more than a studio apartment or a bedroom in a shared house. As you further transition to your new state, you may begin moving more items to the new state, and continue to make your transition. Some people never move everything they own to a new state, but have a second residence elsewhere (such as the scenario that many retirees desire – with a residence in Florida and a second home elsewhere). So long as you meet the defined requirements of residency in your new location, you’ll still continue to be able to travel and visit anywhere that you wish.

So which are the states that offer guaranteed issue health insurance without medical underwriting? Presently the short list of states includes:

A few more states that I’ve found have special programs that really help people in need of guaranteed issue health insurance (check with your state department of insurance as well as others before you make a move):

If you don’t wish to move, then you may find that your state offers guaranteed issue health insurance, subsidized rates for certain income levels, and special programs and special times of year when health insurance is not medically underwritten. There may also be specific special programs for those that have lost employment due to jobs moving overseas, or certain other industry and natural events. The best place to start finding out about these programs is with your state department of insurance. You can find contact information for your state department of insurance at State Health Insurance Resources at http://www.besthealthinsurancebook.com/state-health-insurance-resources/

As always, consult your team of financial and medical professionals before making a move. With these ideas and their advice, you may be better off.

This post originally appeared at HealthCentral.com at http://www.healthcentral.com/caregiver/c/76590/31355/insurance-move

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

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Cavalcade of Risk Blog Carnival

July 17th, 2008 by Jonathan Pletzke
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Cato Institute’s Michael Cannon hosts this compendium of insurance/risk related posts

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

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Medicare: What’s Covered and What’s Not

July 7th, 2008 by Jonathan Pletzke
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Medicare - What's Covered and What's NotPuzzle Image

Medicare can be confusing. There are a number of pieces to the Medicare puzzle, and understanding how they fit together and where the gaps are is important to knowing where Medicare coverage begins and ends. For the official U.S. Government perspective on Medicare, visit the Medicare Options Compare website. Remember that Medicare is a financial tool and should be used with your own common sense to determine things you may also want above and beyond Medicare.

Pieces of the Medicare Puzzle

Medicare comes in four parts, with variations, and can be supplemented with other health insurance options purchased privately or from an employer retirement plan. The four parts of Medicare have evolved over time, and names have changed, too. They are now known as Part A (Hospitalization), Part B (Medical), Part C (Medicare Advantage), and Part D (Prescription). The other popularly known piece of the puzzle is Medigap, which is private insurance that supplements the other parts.

Puzzle ImagePart A: Hospitalization 

If you end up in the hospital, you're likely to have significant medical bills. Medicare Part A, hospitalization insurance, is intended to help you reduce your liability for those charges that occur when you are in a hospital, a skilled nursing facility, or hospice, along with some home health care expenses.

Medicare Part A DiagramView an Instructive Diagram of Medicare Part A Coverage

  • Premium: Varies based on your eligibility. Can range from nothing to several thousand dollars depending on whether you've worked the minimum 10 years to qualify.
  • Out of pocket: You must pay an annual deductible that is close to $1000 for the first 60 days of hospitalization. For 61-90 days in the hospital, you must pay about $250 a day. For 91-150 days in the hospital, you're on the hook for about $500 a day. Go over 150 days and you pay it all.
  • Providers: Anyone who takes Medicare Hospitalization.

Puzzle ImagePart B: Medical (Doctor) 

Unpredictable medical expenses can make your financial life a mess. Medicare Part B, Medical Insurance, is intended to balance out the financial ups and downs to help you stay financially sound in the face of medical needs, including outpatient services, doctor visits, and some home health care. It specifically does not include vision, dental, routine foot care, hearing aids, and routine doctor visits.

Medicare Part B DiagramView an Instructive Diagram of Medicare Part B Coverage

  • Premium: about $100 a month or more
  • Out of pocket: You pay 20% of the total allowable charges, Medicare picks up 80%.
  • Providers: Anyone who takes Medicare Medical.

Puzzle ImagePart A + B Supplement: Medigap 

The Medigap supplement reduces the difference between what is paid by Medicare and what is charged by the healthcare providers. This can really make a difference once you look at the out of pocket costs of Medicare Part A and Medicare Part B. Since it is purchased from private insurers, the quality of the insurance company should be foremost.

  • Premium: Varies. For a 65+ in excellent health, insurers in my county are charging from $60 to $250 a month per person.
  • Out of Pocket: Varies
  • Providers: Anyone who takes Medicare Hospital & Medical

Puzzle ImagePart C: Medicare Advantage from a private insurer 

When managed care was introduced for Medicare recipients, many insurers entered the market only to withdraw after a few years, leaving their policyholders unable to get coverage at the same rates. While this market has settled down, there is still a slight risk that this might happen again. Medicare Advantage Policies cover parts of A (hospitalization), B (medical), and D (prescription) and may cover other things, such as vision or dental. These are purchased from a private insurer and feature a "network" of authorized medical providers, much like an HMO or PPO, that restrict which providers you may see in order to be covered.

  • Premium: Varies, perhaps slightly more than A+B+D together
  • Out of pocket: Varies
  • Providers: Restricted to a network of providers. Utilization outside of network may result in higher costs or denial of coverage.

Puzzle ImagePart D: Prescription 

Anyone who is taking significant prescriptions or who may take significant prescriptions may want this coverage. While the premium may exceed the cost of prescriptions while healthy, you may find that it works well if you need medication due to an illness. This is a particularly tricky one to figure out the point at which you break-even on the premiums due to the complex nature of the way it pays for medication.

Medicare Part D DiagramView an Instructive Diagram of Medicare Part D

  • Premium: Varies, less than $100 a month
  • Out of Pocket: Varies. An example, after a deductible near $250 a year, you pay 25% until you've paid over $500, and then you pay about another $1500 before you get benefits again: where you pay 5% of prescriptions. Confusing? Yes!
  • Providers: Most pharmacies

Your Medicare Mileage will vary...

It may take some work to figure out the best Medicare options for you and your spouse. There are a few other things to keep in mind before jumping in:

  • Get a good insurer - if you're selecting Medigap or Medicare Advantage, you'll be working with a private insurer - and there is variance in satisfaction.
  • Make sure you play by the rules - ask first, don't assume, make sure it is necessary or covered when possible.
  • Know when to appeal - to the insurer, to the government.
  • Never miss a payment - if you do, you may not be able to get back into the plan, and if you can you may have to wait or pay a higher rate.

What is and is not payable under the plan is always changing - new items are added regularly, and things that you might have had last year may no longer be covered. You should check with your provider to determine what they believe is covered - and hold them to it. If in doubt about coverage of specific items, check with the Medicare Coverage website.

 

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com.

 This post originally appeared at HealthCentral.com at http://www.healthcentral.com/caregiver/c/76590/29443/medicare-covered

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10 Must-Have Investing and Insurance Books

May 10th, 2008 by Jonathan Pletzke
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PhillyBurbs.com 10 must-have investing and insurance books

Get a Good Deal on Your Health Insurance Without Getting Ripped-Off named to "10 Must-have Investing and Insurance books"

"Dummies and Idiot’s guides may get you started in investing and help you understand the intricacies of your insurance policies, but these books are must-haves if you want to be an intelligent investor and consumer."    -     writes Dave Ralis of PhillyBurbs.com, the online version of the Bucks County Courier Times, who placed Get a Good Deal on Your Health Insurance Without Getting Ripped-Off on his list of "10 Must-have Investing and Insurance Books". 

Health Insurance Book listed in 10 must have investing and insurance books

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

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Five Star Book Review: Health Insurance Book at Retire Early Home Page

April 22nd, 2008 by Jonathan Pletzke
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Retire Early Homepage Health Insurance Book Review Another 5 Star Review for "Get a Good Deal on Your Health Insurance Without Getting Ripped-Off" was posted recently at the Retire Early Home Page, one of the most interesting and useful sites for people interested in what it really takes to retire early. John P. Greaney, who successfully retired early at a young age, has very useful information covering all aspects of early retirement.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

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FM Talk 101 Audio Clip

February 13th, 2008 by Jonathan Pletzke
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FM Talk 101 Radio Listen to a brief audio clip from an appearance on FM Talk 101 with Brad and Britt in the morning. The format of the program was an introduction of Jonathan and the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, followed by discussion with the hosts about the health insurance book, and then to the callers, who provided questions that Jonathan was able to answer well.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

 
icon for podpress  Health Insurance Book Appearance on FM Talk 101: Play Now | Play in Popup | Download

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Cavalcade of Risk #45: Is love a risk?

February 13th, 2008 by jpletzke
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Health Insurance blog postings at Paid Twice

The latest Cavalcade of Risk blog carnival is lovely. It is hosted this time by I’ve Paid For This Twice Already and includes some excellent reads on risk (health insurance being my favorite). My blog posting on health insurance copayments is included.

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

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