• Successful Claim
  • Creditable Covera..
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Successful Claim

Guaranteed Health Insurance-your checklist for a successful claim

All over the US, many people fail to get their medical bills reimbursed by their medical insurance companies despite being enrolled under the Guaranteed Issue Health Insurance. Cases of medical fraud are also reported where a person has to bear about 70-80% of the medical cost while the insurance company pays the rest. Ideally, it should have been just the reverse.
In case you too are unaware of what the requirements are for filing a successful claim, here’s your checklist:
·         Know what your plan covers: Usually, most of your healthcare requirements will be covered by a guaranteed health insurance plan. This includes hospital care, physician visits, as well as outpatient and in-patient care. However, read through the fine print to find if any specific disease is outside your plan’s purview, and to note the waiting period for pre-existing conditions like AIDS, diabetes, cancer, heart disease etc. If you fail to note what diseases are covered and the ones that have an initial waiting period (which could be up to a year), your insurance company may turn down your claim for medical bill reimbursement in case you fail to fulfill the predetermined medical plan requirement.
·         Ask if discounts for medical care are available: Some guaranteed health insurance plans offer as much as 50% discount on medical expenses.  So, ask if your chosen insurance company offers such discounts, and if yes, whether there’s any limit on the usage of your card as laid down by the medical plan requirements.  
·         Check legal requirements: Guaranteed health insurance laws vary widely among states. Some states offer more protection for consumers than their counterparts in other states. Again, some states need insurers to sell coverage on a guaranteed issue basis, while others have requirements related to limited guaranteed access (for example, only for those with prior continuous coverage, or who are HIPAA eligible individuals). Some states even have open enrollment periods, during which coverage due to a medical condition may not be denied by the insurers. So, make sure to know your legal rights so that you can claim medical expense reimbursement without any problem.
 Knowing about other factors like maximum deductible on the guaranteed health insurance, lifetime maximum vs. per occurrence benefits  are also important for a hassle free claim reimbursement.

Creditable Coverage

Guaranteed Health Insurance – Some tips for choosing a creditable coverage

Given that health insurance itself is often a last priority for most, a lack of coverage results in more money being spent towards medical bills than saving it. Under these circumstances, opting for guaranteed health insurance is advisable and preferred for those with such conditions. However, it is important to choose an insurance policy that is creditable and affordable. Here are some basic factors that you should consider when choosing such creditable coverage.

  • Shop before you finalize: more often than not, we tend to buy the first policy that comes our way, if it looks a little attractive. We often ignore to look into the finer points of the policy, and are not aware of the limited indemnity offered, which results in us paying through our nose during emergencies. The best way to avoid such situations is to shop extensively for guaranteed health insurance, before choosing the best one with creditable coverage.
  • Understand the finer points of the policy: remember that an attractive and affordable guaranteed health insurance may not really cover all pre-existing conditions. In order to ensure that you buy the best policy, it is important to learn more and understand about the exact creditable coverage on offer.
  • Legal and real plans: when choosing plans that offer you creditable coverage, it is important to choose ones that are regulated by the laws of the land as well as contractual obligations that exist between different stakeholders, especially pharmacies and medical providers.
  • Affordable and incentive based plans: when looking for good plans, ensure that you choose ones that do not have limited indemnity. In other words, make sure that your plans offer enough coverage and also allows for discounts on medical expenses and supplies etc.

Keeping these factors in mind while searching for guaranteed health insurance will ensure that you are not saddled with a plan that promises the moon but doesn’t deliver.

 

Health care reform for pre

Health care reform for pre-existing conditions

The U.S. Health and Human Services Department reports that up to 50 percent of Americans have a pre-existing health condition, such as asthma, cancer, diabetes, high blood pressure or heart disease. What’s more, nearly 25 million of these individuals do not have health insurance. In addition, somewhere between 45 and 85 percent of individuals between the age of 55 and 64 have a pre-existing health condition.

Promises for new health care reform are slow in coming at best. It sometimes feels that we are caught in a tug of war between the insurance companies, our doctors and the federal government. Although talks about good reform for those with pre-existing conditions are a hot topic, the reality of what such changes might mean are very vague. It seems that congress is planning on "doing away" with pre-existing conditions. Americans with long standing medical history are awaiting the day in 2014 when they will be freely accepted into major medical policies despite their long history of pre-existing conditions. Unfortunately, what has not been so widely spoken about is what these changes will ultimately mean for the consumer.

   Taken from the vantage point of the insurance companies, outlawing denial of health insurance is akin to demanding that car insurance companies pay for an already crashed car. In order to make such a federally mandated change a reality, insurance companies will have to hike up insurance premiums for those with health conditions upwards of 200-400%. This will mean that many Americans will be asked to pay more than half their monthly income in insurance payments. This of course, does not include the additional deductibles, and co-payments that Americans will be asked to pay before ANY insurance benefits will begin to pay out benefits. Sadly, Americans awaiting these types of reform will still find themselves at a loss on how to treat pre-existing health conditions in a cheap and affordable manner. 

At Health Insurance Guaranteed, we demand more for our customers. We take health seriously and have gone out of our way to find alternatives for those with a previous medical history. We represent the client, not the insurance companies, and have made relationships with over 45 insurance companies, many of those that do accept those with a medical history. These plans are affordable and range from $95-$300 for the individual to $250-$800 for the entire family. The range in price is just a factor of how much coverage you need. For the first time, you can feel that you are in charge of your premiums.

The reality is that despite the supposed government changes, these changes will not take full effect for years. During that time, many Americans will have to go without insurance, risk paying out of pocket for expensive medical coverage and in many cases be denied from receiving much needed medical services because the inability to provide proof of coverage. Private doctors today are continuously refusing to see clients who cannot provide proof of insurance coverage. They are afraid that after the much needed surgery, hospital visit or in-patient procedure, the client will refuse to pay the remaining balance.

Affordable Care Act

According to HealthCare.gov, the pre-existing condition problem is addressed by the Affordable Care Act, passed by President Barack Obama, which prohibits insurance companies from denying coverage to those with a pre-existing condition. In addition, the act prohibits charging higher premiums or setting benefit limits for those with a pre-existing condition.

While some aspects of the Affordable Care Act are already active, such as a prohibition against denying insurance coverage to a child with a pre-existing condition, many of the policies of the Affordable Care Act will not go into effect until 2014.

Insurance Plans

For most people with a pre-existing medical condition, waiting for 2014 when the Affordable Care Act is to go into effect is not a realistic possibility because of mounting bills from continuing medical care. If this is the case for you, consider some alternative insurance policy plans.

Limited Indemnity

A limited indemnity plan offers guaranteed acceptance into an insurance plan if certain eligibility criteria is met and covers costs such as doctor’s office visits, hospital costs, surgery fees, anesthesia, emergency room costs, diagnostic tests and procedures and other treatments.

The plan will cover a certain percentage of medical costs, at which point the individual must pay for the remainder of the fees. However, there are no co-pays for visits to the doctor, urgent care or ER and there are no deductibles. This means you will have first-dollar coverage in the case of an emergency.

A limited indemnity plan does not limit patients to a certain network of providers and does not require an initial medical exam or questions. Some preventative care is not included under the plan but many other necessary doctor visits, treatments and tests are covered with a co-insurance payment by the insured.

There is typically a wait for acceptance into the plan before the insurance will cover medical costs, including a delay for treatment for those with pre-existing medical conditions.

For more information about our limited indemnity plan when it comes to pre-existing conditions, please contact us.

Guaranteed Issue


Consider a guaranteed issue insurance plan, which essentially means automatic approval for a health insurance plan that covers costs of doctor’s visits, medical tests and treatments.

While there is a typical waiting period before the insurance policy becomes effective after acceptance into the plan, a guaranteed issue plan can be the answer to individuals who have a pre-existing medical condition and have been struggling to pay for medical costs on their own. The cost of a guaranteed issue plan may cost more than traditional insurance policies but as you probably know, the cost of paying for every medical bill with no insurance is far higher.

Our guaranteed issue plans are PPOs. A preferred provider organization health insurance plan, or PPO, does not limit members to a certain care provider network. Instead, members can select their own primary care physician, see specialists, and use various hospitals without needing a referral.

Contact us for more information about PPO guaranteed issue medical insurance plans and whether or not a PPO plan is viable if you have a pre-existing medical condition.

 

While the government’s Affordable Care Act may prove to be beneficial to the millions of individuals in America with a pre-existing condition, the plan will not go into effect until 2014.
If you do not have health insurance and have a pre-existing medical condition, why wait? Call us today to discuss our insurance health care options.

Successful Claim

Guaranteed Health Insurance-your checklist for a successful claim

All over the US, many people fail to get their medical bills reimbursed by their medical insurance companies despite being enrolled under the Guaranteed Issue Health Insurance. Cases of medical fraud are also reported where a person has to bear about 70-80% of the medical cost while the insurance company pays the rest. Ideally, it should have been just the reverse.
In case you too are unaware of what the requirements are for filing a successful claim, here’s your checklist:
·         Know what your plan covers: Usually, most of your healthcare requirements will be covered by a guaranteed health insurance plan. This includes hospital care, physician visits, as well as outpatient and in-patient care. However, read through the fine print to find if any specific disease is outside your plan’s purview, and to note the waiting period for pre-existing conditions like AIDS, diabetes, cancer, heart disease etc. If you fail to note what diseases are covered and the ones that have an initial waiting period (which could be up to a year), your insurance company may turn down your claim for medical bill reimbursement in case you fail to fulfill the predetermined medical plan requirement.
·         Ask if discounts for medical care are available: Some guaranteed health insurance plans offer as much as 50% discount on medical expenses.  So, ask if your chosen insurance company offers such discounts, and if yes, whether there’s any limit on the usage of your card as laid down by the medical plan requirements.  
·         Check legal requirements: Guaranteed health insurance laws vary widely among states. Some states offer more protection for consumers than their counterparts in other states. Again, some states need insurers to sell coverage on a guaranteed issue basis, while others have requirements related to limited guaranteed access (for example, only for those with prior continuous coverage, or who are HIPAA eligible individuals). Some states even have open enrollment periods, during which coverage due to a medical condition may not be denied by the insurers. So, make sure to know your legal rights so that you can claim medical expense reimbursement without any problem.
 Knowing about other factors like maximum deductible on the guaranteed health insurance, lifetime maximum vs. per occurrence benefits  are also important for a hassle free claim reimbursement.

Creditable Coverage

Guaranteed Health Insurance – Some tips for choosing a creditable coverage

Given that health insurance itself is often a last priority for most, a lack of coverage results in more money being spent towards medical bills than saving it. Under these circumstances, opting for guaranteed health insurance is advisable and preferred for those with such conditions. However, it is important to choose an insurance policy that is creditable and affordable. Here are some basic factors that you should consider when choosing such creditable coverage.

  • Shop before you finalize: more often than not, we tend to buy the first policy that comes our way, if it looks a little attractive. We often ignore to look into the finer points of the policy, and are not aware of the limited indemnity offered, which results in us paying through our nose during emergencies. The best way to avoid such situations is to shop extensively for guaranteed health insurance, before choosing the best one with creditable coverage.
  • Understand the finer points of the policy: remember that an attractive and affordable guaranteed health insurance may not really cover all pre-existing conditions. In order to ensure that you buy the best policy, it is important to learn more and understand about the exact creditable coverage on offer.
  • Legal and real plans: when choosing plans that offer you creditable coverage, it is important to choose ones that are regulated by the laws of the land as well as contractual obligations that exist between different stakeholders, especially pharmacies and medical providers.
  • Affordable and incentive based plans: when looking for good plans, ensure that you choose ones that do not have limited indemnity. In other words, make sure that your plans offer enough coverage and also allows for discounts on medical expenses and supplies etc.

Keeping these factors in mind while searching for guaranteed health insurance will ensure that you are not saddled with a plan that promises the moon but doesn’t deliver.

 

Health care reform for pre

Health care reform for pre-existing conditions

The U.S. Health and Human Services Department reports that up to 50 percent of Americans have a pre-existing health condition, such as asthma, cancer, diabetes, high blood pressure or heart disease. What’s more, nearly 25 million of these individuals do not have health insurance. In addition, somewhere between 45 and 85 percent of individuals between the age of 55 and 64 have a pre-existing health condition.

Promises for new health care reform are slow in coming at best. It sometimes feels that we are caught in a tug of war between the insurance companies, our doctors and the federal government. Although talks about good reform for those with pre-existing conditions are a hot topic, the reality of what such changes might mean are very vague. It seems that congress is planning on "doing away" with pre-existing conditions. Americans with long standing medical history are awaiting the day in 2014 when they will be freely accepted into major medical policies despite their long history of pre-existing conditions. Unfortunately, what has not been so widely spoken about is what these changes will ultimately mean for the consumer.

   Taken from the vantage point of the insurance companies, outlawing denial of health insurance is akin to demanding that car insurance companies pay for an already crashed car. In order to make such a federally mandated change a reality, insurance companies will have to hike up insurance premiums for those with health conditions upwards of 200-400%. This will mean that many Americans will be asked to pay more than half their monthly income in insurance payments. This of course, does not include the additional deductibles, and co-payments that Americans will be asked to pay before ANY insurance benefits will begin to pay out benefits. Sadly, Americans awaiting these types of reform will still find themselves at a loss on how to treat pre-existing health conditions in a cheap and affordable manner. 

At Health Insurance Guaranteed, we demand more for our customers. We take health seriously and have gone out of our way to find alternatives for those with a previous medical history. We represent the client, not the insurance companies, and have made relationships with over 45 insurance companies, many of those that do accept those with a medical history. These plans are affordable and range from $95-$300 for the individual to $250-$800 for the entire family. The range in price is just a factor of how much coverage you need. For the first time, you can feel that you are in charge of your premiums.

The reality is that despite the supposed government changes, these changes will not take full effect for years. During that time, many Americans will have to go without insurance, risk paying out of pocket for expensive medical coverage and in many cases be denied from receiving much needed medical services because the inability to provide proof of coverage. Private doctors today are continuously refusing to see clients who cannot provide proof of insurance coverage. They are afraid that after the much needed surgery, hospital visit or in-patient procedure, the client will refuse to pay the remaining balance.

Affordable Care Act

According to HealthCare.gov, the pre-existing condition problem is addressed by the Affordable Care Act, passed by President Barack Obama, which prohibits insurance companies from denying coverage to those with a pre-existing condition. In addition, the act prohibits charging higher premiums or setting benefit limits for those with a pre-existing condition.

While some aspects of the Affordable Care Act are already active, such as a prohibition against denying insurance coverage to a child with a pre-existing condition, many of the policies of the Affordable Care Act will not go into effect until 2014.

Insurance Plans

For most people with a pre-existing medical condition, waiting for 2014 when the Affordable Care Act is to go into effect is not a realistic possibility because of mounting bills from continuing medical care. If this is the case for you, consider some alternative insurance policy plans.

Limited Indemnity

A limited indemnity plan offers guaranteed acceptance into an insurance plan if certain eligibility criteria is met and covers costs such as doctor’s office visits, hospital costs, surgery fees, anesthesia, emergency room costs, diagnostic tests and procedures and other treatments.

The plan will cover a certain percentage of medical costs, at which point the individual must pay for the remainder of the fees. However, there are no co-pays for visits to the doctor, urgent care or ER and there are no deductibles. This means you will have first-dollar coverage in the case of an emergency.

A limited indemnity plan does not limit patients to a certain network of providers and does not require an initial medical exam or questions. Some preventative care is not included under the plan but many other necessary doctor visits, treatments and tests are covered with a co-insurance payment by the insured.

There is typically a wait for acceptance into the plan before the insurance will cover medical costs, including a delay for treatment for those with pre-existing medical conditions.

For more information about our limited indemnity plan when it comes to pre-existing conditions, please contact us.

Guaranteed Issue


Consider a guaranteed issue insurance plan, which essentially means automatic approval for a health insurance plan that covers costs of doctor’s visits, medical tests and treatments.

While there is a typical waiting period before the insurance policy becomes effective after acceptance into the plan, a guaranteed issue plan can be the answer to individuals who have a pre-existing medical condition and have been struggling to pay for medical costs on their own. The cost of a guaranteed issue plan may cost more than traditional insurance policies but as you probably know, the cost of paying for every medical bill with no insurance is far higher.

Our guaranteed issue plans are PPOs. A preferred provider organization health insurance plan, or PPO, does not limit members to a certain care provider network. Instead, members can select their own primary care physician, see specialists, and use various hospitals without needing a referral.

Contact us for more information about PPO guaranteed issue medical insurance plans and whether or not a PPO plan is viable if you have a pre-existing medical condition.

 

While the government’s Affordable Care Act may prove to be beneficial to the millions of individuals in America with a pre-existing condition, the plan will not go into effect until 2014.
If you do not have health insurance and have a pre-existing medical condition, why wait? Call us today to discuss our insurance health care options.