Frequently Asked Questions
Do I really need Insurance?
A: Short answer is, yes you really should have it to minimize the risk of having to shoulder the burden of sometimes hefty medical bills. The best way to do that is with an insurance policy that essentially lets you share risk with other policy holders. Here’s how it works: you pay your Premium in exchange for the Insurance Company's promise to pay a predetermined amount of money for any or all problems, which are referred to as Claims.
I’ve heard about Coinsurance what is that?
A: The term coinsurance is simply the portion of your medical bills that are shared by you AND the Insurance company. Here’s an example, if you have an 80% to $5,000 coinsurance;
- Your insurance company will pay for 80% of the next $5,000 in covered medical expenses.
- You would have to pay for 20% of that amount as long as the expenses are covered under your plan.
- So you would end up paying 20% of $5,000 or $1,000 and the Insurance company would pay the other 80% or $4,000 of the medical bill charges.
How much is my Deductible?
A: It depends on your policy. There are many different types of policies and many different deductibles. But they basically all work the same way. For most deductibles, there is a predetermined amount of money that you are responsible for which has to be paid before the Insurance Company becomes responsible for any benefit payments.
The main reason insurance works this way is so that people only go to seek treatment when the have a genuine need for medical attention. Another reason is that it helps Insurance Companies keep premium lower for policy holders.
Do I have to pay my deductible before "Office Visits" are covered by co-pays?
A: Usually no. But you may find some companies that do have that stipulation in their policies, but it’s very rare.
Can you explain the term “preexisting condition”?
A: This simply means that you had a physical or mental condition that required medical attention, was diagnosed or that a previous doctor or health professional recommended treatment to you before you activated an insurance policy. Basically, you may have had some injury or illness before applying for insurance and the company would want to know that. Coverage for these types of conditions often have different terms.
If I have a “pre-existing condition” could I be denied coverage?
A: That is possible. An insurance company can deny any applicant coverage. Reasons run the gamut, but they can deny you for almost anything. The good news is that, once you are accepted, your policy can’t be canceled for any reason, except for nonpayment of premium.
Is it possible for my policy to be cancelled for health problems?
A: No. Once your policy is accepted, your policy cannot be canceled. Although, if you exhaust your benefits by having covered expenses paid beyond your lifetime maximums, your coverage will end.
Will my insurance cost more if I’m a smoker?
A: Being a smoker doesn’t affect the premium you will pay. However an insurance companies can decide to reject your application.
Is there any benefit to dealing directly with the Insurance Company instead of the agent?
A: There is no cost benefit or otherwise to dealing directly with the insurance company. When you deal with a agent, you are, in fact, dealing with a part of the insurance company. The agents you’ll deal with through this site are selected and approved by insurance companies and are committed to providing good service and to fairly and accurately represent the companies they work for. You don’t pay anything extra to work with an agent.
How does Group Insurance work?
A: Typically, Group Insurance is a policy between an employer provides coverage to its employees via their Insurance Company. In most cases, the employer pays a percentage of your premium as long as you work a specified minimum number of hours per week. Some states consider Group Insurance as "Guaranteed Issue" insurance, which means that coverage cannot be denied to anyone who applies.
How much is a typical "Doctor's Office Visit Copay"?
A: Usually the amount of money that you would have to pay as an insured patient would be around $20 (some are less, some are a bit more). But most often, any charges you incur after that initial amount are covered between 75% and 100%.
So do all my co-payments add count toward my annual deductible?
A: Unfortunately not. Insurance companies treat office visits payments and hospital stays separately from the deductible. If you should have to be admitted to the hospital, those costs would be covered by the "Major Medical" part of the policy.
Do I have to pay a fee if I use a health insurance agent?
A: No. By using the services of a health insurance agent, you don’t need to pay any extra cost. The agent gets a commission from his or her health insurance company for selling you a policy. That’s how they are paid.
I don’t have the best health, so what happens if my application for health insurance coverage is denied?
A: If you happen to be declined, you can simply apply to another health insurance company. Each health insurance company uses a different set of criteria. Using their criteria, you could be approved and get coverage through that company. Although, the approval will be based on your current health conditions at the time of your application.
Can my health insurance coverage ever be canceled? And what are reasons it would be?
A: It depends on the state, but as a rule of thumb, your insurance company cannot cancel your policy UNLESS you: (1) do not make your premium payment, (2) misstate or leave out something on your health insurance application, or (3) your insurance company decides not to provide insurance in your state simply closes up its business there.
I don’t understand short-term health insurance. What is it?
A: In a nutshell, short-term health insurance is a policy that helps fill temporary, or “short-term” gaps in your ongoing "permanent" health insurance coverage. The nice thing about “short-term” policies are that they are very affordable and can be activated rather quickly. The typical term for a policy like this is usually about six months.
If I go with a new insurance plan, can I still keep my regular doctor?
A: It really depends on your plan and how much out-of-pocket expenses you can tolerate. It’s best to carefully review the details of any health insurance plan and specifically the physician network. Your agent should be able to help you determine whether your doctor is “in network” or not before applying to the plan. And even if he’s not, you might just have to pay a bit more for your deductible if you want to continue to use him.
Is a physical exam required before I can get my health insurance?
A: Most of the companies you’ll deal with through BestHealthInsuranceInc.com will not ask you to take a physical exam. The only exceptions they might make are for folks who are a bit older and have not see a doctor or had any medical attention in the previous five years or so.
How do I pay for my health insurance premium payment?
A: Most companies will set up a payment schedule that requires a payment once a month. You can send in a personal check or money order. Many companies will also let you pay over the phone using a credit or debit card.
Can I still get health insurance if I’m pregnant?
A: Unfortunately, insurance companies will not write a new policy for you while you are pregnant. A good option is to look into a group health insurance plan. They will take new applicants who are pregnant at the time of the application.
Are my premiums fixed? Or do they go up over time?
A: It’s a fact that the older you are, the more health care expenses you have. So to keep pace with those increasing expense, health insurance companies will charge you higher rates the older you get.
I’m a bit overweight. Will that affect my health insurance rates?
A: Yes it does. Health insurance companies refer to standard height/weight tables to determine what your health risks might be. If you fall outside standard height/weight ratios you could be charged a higher rate or even denied coverage. If that happens, you can apply for health insurance from another health insurance company. Because height/weight tables can vary from company to company.
