The numbers are daunting. Only 60% of businesses are now offering health insurance benefits to their workers – that’s down from 69% in 2000 and decreasing annually. With small businesses, the numbers are under 50%. Plus, premiums for medical insurance continue to increase in double digit percentages every year. The big question then becomes how can you find affordable individual health insurance?
The task may seem impossible, but if you follow a few simple steps, you should be able to find a health insurance possible that you can afford.
- Know the rules in your state – Each state has different guidelines about health insurance policies. For example, the way pre-existing conditions are defined varies from state to state. Before you begin looking at policies, you should become familiar with these rules so you’ll be able to make educated decisions about your coverage.
- Know what type of coverage you need – Once you start looking, you’ll find a wide array of choices. For example, if you are between jobs, you may only need short term health insurance. Or if you are thinking about starting a family or already have one, then you may need to find a plan that includes maternity coverage and/or that covers more than just an individual.
- Know what you can afford – Sit down and create a health insurance budget. When you buy individual health insurance, you won’t only be paying the premiums, but also co-payments, deductibles, and sometimes even co-insurance so all of these elements need to be considered when deciding what to spend on a policy.
- Compare all of your options – To find an affordable individual health insurance plan, you need to know what’s available. Just looking at one particular company’s offerings won’t tell you much. Instead, you need to look at a wide variety of plans so you can compare what is being offered and what it costs.
Action Steps
To find affordable individual health insurance, here are some resources that can be useful.
Check your state’s insurance rules
Remember you need to know your rights before signing up for any insurance policy, particularly if you looking for a good deal. Pay attention particularly to rules about pre-existing conditions (so you’ll know what will and won’t be covered in a plan) and about what has to be covered (often coverage of immunizations and other routine procedures is mandatory).
Find an insurance broker
Comparing health insurance plans can be tricky. That’s why it’s a good idea to work with an insurance broker who is familiar with the rules and policies available in your state. Because they do not work with any single company, they can give you information about many of the policies available and can even help you make comparisons.
Do your homework
To make the right choice, you need to understand some basic industry jargon. For example, do you know the difference between a PPO, HMO, and a HSA? They are all options to consider when thinking about your health insurance options. Take a little time to do some research about the options that are out there, so you’ll have the knowledge necessary to make a wise choice.
Tips & Tricks
Once you find an affordable individual health insurance policy you should be very careful when completing all of your paperwork. Do not be tempted to lie or misrepresent anything about yourself or your health. Insurance companies do thorough checks on all of the information and will refuse to pay your claims even over the smallest discrepancies.
Forty-two states are planning to increase coverage for their uninsured adults and children according a report by the Kaiser Commission on Medicaid and the Uninsured. More U. S. states are realizing the need to take action now that 47 million Americans, including 9 million children, lack any type of health insurance. This is also the first time in half a decade that none of the states are planning to cut Medicaid benefits in order trim their budgets.
Much of the state’s plans revolve around extending the State Children’s Health Insurance Program (SCHIP) and/or Medicaid. The bad news is that a budget increase for SCHIP was vetoed earlier this month by President Bush and there are limitations on how much both programs can be used to insure all adults.
Several states are also hoping to pay more to medical providers, increase income level eligibility for programs such as SCHIP, and find ways to link the quality of service with the payments made for that service. Many states are also encouraging Medicaid health plans to release information about their performance.
When the fiscal year for Medicaid ended on June 30th, directors were surprised to see a drop in enrollment for the first time in almost 10 years. In conjunction with that drop was the smallest spending increase – of just 2.9% – for the program during the same time period.
Seventy-five percent of the states cited the reason for the decreased enrollment as tighter citizenship documentation requirements. The 0.5% decline resulted from a change last year that required Medicaid applicants to submit documentation – a driver’s license or birth certificate, for example – proving they are legal citizens of the United States. Before this change, applicants merely had to check a box.
However, the director of the Center for Medicaid and State Operations disputed that information. Instead, they claim a strong economy kept the numbers of people needing to enroll to a minimum.
The spending increase was caused primarily by an increase in reimbursements to care providers in a number of the states, including Connecticut. Officials from Kansas also complained that the documentation changes increased their administrative costs.
Michigan Govenor Jennifer Granholm wants the state’s Republican representatives to help override President Bush’s veto of a bill to extend the State Children’s Health Insurance Program (SCHIP) budget by another $35 billion. The override vote is expected to take place on October 18th.
Granholm contends that vetoing the bill, which would allow an additional 80,000 Michigan children to have health insurance, “is a travesty.” Three of the state’s republican representatives already voted for the bill prior to the veto.
Republican Representative Tim Walberg co-sponsored a bill that would extend the current SCHIP budget for 18 months but he released a statement saying the bill isn’t doing enough to prevent that money from going to people who don’t need it, such as illegal animals and middle class family who can afford private coverage. Mike Rogers, another representative targeted by Granholm, said “The governor ought to be helping us negotiate a bill that focuses on providing for the critical health needs of Michigan’s poor children.”
A study published last week in the New England Journal of Medicine found children – even those who are well-insured and from middle class families – are often not receiving the health care they require. The research was based on reviews of the medical records of more than 1,500 children from 12 metropolitan areas in the United States and was conducted by the Rand Group, the University of Washington, and Seattle Children’s Hospital.
Some of the discrepancies found in the children’s medical records included a failure to measure their height and weight at yearly checkups among over 40% of 3 to 6 year olds while only 15% of adolescents had their height and weight recorded. Over half of the children suffering from asthma did receive recommended treatment and 38% did not receive appropriate treatment for diarrhea. The study also found a failure of doctors to check for anemia in children less than two years of age even though such tests are recommended and a failure to provide recommended care for diabetes and other serious medical problems. Pediatricians, according to the study, only spend about 10 minutes with their patients.
These noted failures occurred even among children who were insured. More than 82% of the children were covered by private health insurance. Experts believe the statistics are even worse for children who have no health insurance.
Potential Republican presidential nominee John McCain released details of his own plan to address the problems of the U. S. health care system while he was campaigning in Iowa on October 11th. According to McCain’s plan, Americans would be given a tax credit as an incentive to purchase private health insurance. That credit would be $2,500 for single people and $5,000 for families.
McCain admitted that changes were needed because of the vast number of problems plaguing the system which could lead to an implosion if not addressed. Besides the tax credits, McCain also wants to open up health care markets nationwide so for-profit insurance companies would not be restricted to offering their policies in only specific regional areas. Families and individuals would have more health insurance policy options and more competition among policies would be available.
McCain’s plan is quite different than the plans proposed by other potential presidential nominees. Democratic hopeful Hilary Clinton, for example, has announced a plan that would require providing health insurance to all Americans.
Massachusetts may have successfully covered a large portion of the state’s uninsured, but their plan is facing real challenges which could help other states, such as California, as they work towards universal health insurance coverage in their states. In 2006, Governor Mitt Romney and the state’s legislature passed a plan that would require all state residents to carry health insurance. The law would also provide subsidies to help low-income families pay for those costs and would charge employers who did not offer health insurance.
Currently, the state has enrolled about one-third of its uninsured residents, roughly 200,000 people. The majority of those enrolled have been low-income residents who qualify for subsidies. Unfortunately, those who do not qualify for subsidies may be facing major challenges. Because the law did not include cost negotiations, nothing is being done in the state to keep health insurance costs affordable. Plus, those who do not secure their own health insurance will face fines starting at $216 and increasing yearly into the thousands.
With the costs of health insurance expected to continue rising, the state may also find funding the subsidies for low-income individuals difficult to maintain in the coming years.
