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As we prepare for the new millennium we will also see continual change in the health insurance industry. Some experts predict that within the next ten years, health insurance will migrate from being predominately an employer sponsored benefit to one in which individuals will have the freedom to select the plan of their choice in an independent and free market. Unfortunately, we're a long way from that predication becoming a reality. At present heath insurance is available in several formats:
Group Health Insurance:
Group health insurance is more often defined as employer sponsored plans. With these plans your employer selects the insurance carrier or health plan which is offered to full-time and potentially part-time employees.
In most states group insurance is written on what is called a "guaranteed issue" basis. Guaranteed issue means that the insurance company or health plan will take all enrollees regardless of health status or medical history. Even in states where guaranteed issue plans exist, many also have the ability to underwrite and determine an appropriate rate for the risk they are going to insure.
Individual Health Insurance:
Individual health insurance is available in many states to individuals and families who either do not have access to an employer sponsored plan, prefer to have their own plan with the individual carrier of their choice, or for those who wish to supplement the employer sponsored plan of a spouse for example to broaden the coverage for themselves or their dependents.
Individual insurance may be for you if the employer sponsored plan that is offered to you is more expensive than what you can obtain in the individual market. For example, if your employer's plan has high rates, or if the dependant cost for that insurance exceeds what you can obtain individual insurance for, this may be an option you should give serious consideration to.
In the individual insurance market in many states carriers have the ability to evaluate the insured's risk factors through medical underwriting. With full medical underwriting a carrier may be able to accept an applicant and their dependents, or potential decline the applicant and/or their dependents. Further, in some states the ability to rider or waiver medical conditions does exist. When a carrier rider's or waiver's a medical condition, what they are saying is we will insure you or your dependent for insurance, except for certain medical conditions which may present adverse risk for the insurance company. Without having to get into the ethicality of this, medical underwriting or individual insurance is not necessarily readily available for those who suffer from chronic or ongoing health issues such as asthma, depression, heart or circulatory issues. In Texas, for example if an individual is unable to obtain individual insurance and if no group insurance is available the State of Texas Department of Insurance has created a health insurance risk pool to provide health insurance to these individuals. Texas is not alone in this as many states offer similar options for their residents as well.
Short Term or Temporary Health Insurance
Temporary or short term insurance is for those individuals who may be between jobs or who may have a longer than average waiting period for coverage at a new employer. If you are between jobs, and if your former employer is required to offer COBRA to you, this may be a better option since short term or temporary coverage does not typically offer coverage for any pre-existing conditions. As such, temporary insurance should be viewed more as a limited benefit, used for short periods of time until a permanent insurance solution is available.
Student Health Insurance
Student insurance is typically offered in two versions. First, through a secondary school (college) for their students. Secondly, through agents such as us.
Student insurance resembles the benefit offering of short term or temporary insurance and typically has much lower lifetime maximums of coverage. While an individual plan may offer a lifetime maximum benefit of $1 million to $5 million in coverage, a student plan may only offer $100,000 in total coverage. Plans vary so please read all information thoroughly or give us a call and we'll help you evaluate your options.
Further, individual insurance has become more competitive especially for college aged students who are healthy. For example in Texas, a 22 year old college student can find coverage in the individual market with $5 million dollars in total coverage for the same price as a student plan.
Student insurance becomes an issue especially for students who attend school out of state from where their parents reside, and if the parents are enrolled in a local HMO which does not offer services in the community where the university is located.
Medicare Supplement Insurance
As the name implies, Medicare supplement plans are designed to supplement what is offered to American citizens who are age 65 or older and selected disabled individuals. If you are eligible for Medicare, you should take the time to investigate the Medicare supplement and/or alternative coverage options available to you, such as Medicare supplement plans and Medicare HMOs.
Travel or Foreign National Insurance
Thinking of traveling abroad, don't forget to double check you existing health insurance policy to see if coverage is available worldwide. If not travel insurance is definitely a worth while investment.
Another classification is Foreign National Insurance for individuals who are visiting the U.S. from a foreign country and plan to spend anywhere from 30 days to 6 months or more in the U.S. Most U.S. individual health insurance carriers require you to be a resident in the U.S. for a minimum of 6 months and have a social security card issued to you in order to obtain individual coverage. If this is not possible, foreign national health insurance is for you.
For a complete listing of travel and foreign national plans available through Southwestern Benefit Designers, click this button and get connected directly with our primary carrier for travel or foreign national coverage.
Copyright © 2005 Southwestern Benefit Designers. All rights reserved. Last revised December 08, 2005