• Work with an agent

One of the most important things you need to know is to always work with a health insurance agent. No matter how much you read online, you won’t understand everything you should know about health insurance. A good agent has worked with health insurance for many years, and will know much more, and how it will apply to you. This will allow them to help you get a better plan than if you just did it on your own.

• Understand your plan

The second tip you need to know is making sure you understand your health insurance plan. The aspects that you should understand are things like deductibles you will have to pay, max out of pocket, which doctors will be in-network, etc. These are all important things to know, and you should ask your health insurance agent so that you understand what you have in your policy, how it works, and how to go about using it if needed.

• Use in-network providers

If you want to limit the expenses you will have to pay, then make sure to always stick with in-network doctors and other medical providers. If you don’t, then you may be responsible for a much bigger portion of the medical bills.

• Use your insurance once your deductible is maxed

Once you have hit your deductible and out of pocket maximum, your insurance policy will cover everything else! This is a good time to schedule appointments that you may need, and you should do these before your policy deductible restarts.

• Use the benefits

Many health insurance plans offer many benefits. This can be things like gym memberships, fitness trackers, health classes, etc. If your plan includes these types of benefits then you should always take advantage of these! You are paying for them and should get as much value out of your policy as possible.

These are five tips that should help you get the most from your health insurance and make the entire process go smoothly. Again, talk to me or your health insurance agent if you don’t understand your policy or think that you need a better policy. Remember that unless you fall under certain special qualifications, you can only sign up for and make changes to your health insurance during the open enrollment period. This is one of the reasons it is so important to make sure you get a policy that will fit your needs!

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• Out-of-pocket maximums

When you hear the term above, it is referring to the maximum amount of money that you will have to pay in one year for medical care covered by your policy. This may seem simple and obvious, but around 40% of Americans don’t know what the term means. For example, if you have an out-of-pocket maximum of $5,000, you will never pay more in a year than that $5,000 for the care your policy covers. Once you hit this amount, you are done paying for covered medical care. You need to remember that this only includes services that the insurance company will cover. If you need something that insurance won’t cover, then you would still have to pay for this out of your own pocket. The monthly premium you pay does not go towards this out-of-pocket maximum. The good news is that your deductible does count! Be aware that the out-of-pocket max may be higher than your deductible.

• Coinsurance

The majority of Americans understand terms such as deductible and premium, but many don’t know what coinsurance is. Coinsurance is the amount you will have to pay after your deductible is met. Make sense? If not, here is an example. In this scenario you have already covered your deductible, and you still have a $1,000 medical bill. Your coinsurance is 20%, which means that your insurance company will pay $800 of that $1,000, and you will be responsible for the remaining $200.  This might seem scary if you have a huge medical bill, since you most likely won’t have tens of thousands of dollars laying around. But you don’t need to worry, because as covered in the last point, your policy will have a maximum amount you have to pay in a year. So once you hit this, you no longer will have any coinsurance costs.

• In-network vs out-of-network

If at all possible, you should always use in-network doctors or other health care providers. It is much more expensive to use out-of-network providers. There are a few different reasons for this cost difference.

• Many insurance companies actually have a higher deductible if you use any health care provider that isn’t in-network.
• It is also common for the out-of-pocket max to be much higher for out-of-network. So, you could be responsible for a much larger portion of any medical bills.
• Coinsurance will likely be higher for out-of-network. In our example earlier, if you normally had 20% coinsurance, you instead might have to pay 50%.
• Health insurance companies negotiate with in-network providers to ensure that certain services are priced at set amounts. This means that if you visit an out-of-network doctor, and normally your health insurance company pays $100 for this visit, but the out-of-network doctor charged $150, you will likely have to pay the difference.

These are a few of the reasons that it is so important to understand what these different terms mean. It can change based off of the policy, and this is why it is important to talk to your health insurance agent about this topic.

Understanding these terms will help you have a better experience interacting with your health insurance and will prevent frustration. As you can see, there are many different terms and aspects to a health insurance policy that are good to know, and you probably aren’t going to learn them all. This is why you should avoid using the internet to sign up for a policy, but instead, it is suggested that you talk to a health insurance agent.  It is free and easy!

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Medicare is a government health insurance program that was created in 1965. The goal of the program is to provide health care for anyone that is 65 or older. It can also cover those who have some disabilities or certain levels of kidney failure. Medicare does provide protection for many different medical costs, but it won’t cover everything. For example, most long-term care isn’t covered.

What Medicare covers

There are multiple parts of Medicare. Part A covers expenses when you are admitted into a hospital. It can also cover skilled nursing care or home health care under certain circumstances. Once eligible to enroll in Medicare, most people can get these benefits with no extra fee because they have worked long enough to pay in the required Medicare taxes. When you sign up for Part A, you can also signup for Part B.

Part B will cover medical bills like doctor visits and other medical supplies and services. This is optional and does require an extra paid premium. However, this can get a bit more complicated, which is one of the reasons you should also talk to a local agent knowledgeable about Medicare.

When Do I enroll?

It is a great idea to contact an agent around 3 months before you turn 65. It is important to not put this off. Again, it is free to work with an agent, so this is the recommended route you should take.

What doesn’t Medicare cover?

There are certain expenses that Medicare won’t generally cover. Here is a list of services that usually won’t be covered.

• Dental care and dentures
• Some immunizations (some are covered by Part B or by Part D)
• Prescription drugs (Part D will cover these, but this is optional)
• Routine foot care
• Medical services outside of the U.S.
• Hearing aids and glasses
• Cosmetic surgery
• Experimental Procedures

This isn’t everything that may not be covered, but these are some of the most common services that people ask about. Again, in some situations some of these would be covered, but it depends on the circumstance.

While it may seem confusing, the good news is that you don’t have to figure it all out on your own. Work with a local agent that you can trust, and you will get the plans that will cover the medical expenses you need at an affordable price!

The post Everything You Need to Know About Medicare appeared first on Michael Suhany Insurance.

If you are wondering who an international travel insurance plan is for, then here are a just a few of the types of people that one of these plans could greatly benefit!  

• Tourists and vacationers

This is the biggest group of people that need to purchase an international travel insurance policy. No matter where you are going overseas, it is important to have one of these policies. Your policy will cover anything from a sprained ankle on the beach, to medical care for a severe illness. While you are overseas you want peace-of-mind that if something should happen, you won’t have to worry about cost.

• Business travelers

If you travel internationally for business, then chances are you travel outside the country frequently. The more you travel abroad, the more likely it is that at some point you will have some type of medical mishap. You also are more likely to be alone, and your travel insurance policy can even pay for a loved one to fly out to be with you should you become ill.

• Students

An international medical policy is super important for a student that is studying abroad. Especially since they likely won’t be familiar with the country they are going to be in and won’t be familiar with the health care system of that nation. Again, if something were to happen to the student, they could be evacuated to another country for medical care if needed. If you are a parent of a student that will be studying abroad, this is something you should make sure they have.

• Missionaries

Many missionaries operate in remote parts of the world and in 3^rd world countries. This makes having a good international health insurance plan extremely important. If they fall ill, they can be moved to a country that better provides the health care needed or will cover the costs of healthcare in the country they are in.

These are just a few of the types of people that can benefit from an international travel insurance policy. If you aren’t sure if this is something you need, or if you are traveling out of the country and know you need this type of policy,  give me a call and schedule a time to talk!

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What is Health Insurance?

Health insurance is a plan that you can purchase that will provide you coverage for medical care. This can include things like surgery, doctor’s visits, hospital stays, medications, and more. The concept behind health insurance is simple: medical care can be expensive, and most people can’t pay for it out of pocket. So, people group together to each pay a set amount each month, regardless if they need it or not, and the risk of needing medical care is split amongst everyone. This is the basic principle of how health insurance works.

Do I really need it?

Yes! Even if you are an incredibly healthy person, you still run the risk of being seriously injured. Healthy people are in accidents, need stitches, or get sick all the time. There are many things you just can’t control. So, everyone needs and should have health insurance.

What if I have a health problem?

Currently health insurance companies can’t deny anyone coverage because of preexisting health conditions.  This allows everyone to get health care coverage.

Terms you should know

There are many terms that are used in conjunction with health insurance, and it is important to know these so you can better understand your coverage.

• Deductible

The deductible is the amount of money you must spend on health care before your insurance policy will cover the expense. The deductible could be anywhere from hundreds of dollars to tens of thousands. The size of your deductible will change how much your monthly payment is.

• Premium

Premium is the amount of money you spend each month for your health insurance policy

• Co-pay

Co-pay means that you pay a portion of medical costs, and the insurance company will pay the rest. Some insurance plans have co-pays, and this is something you will want to check into. So be aware that you may not have everything covered when you need medical care.

• In-network

This is an important portion of your policy, since not every health insurance policy will cover all doctors and hospitals. You will want go to doctors or hospitals that accept your health insurance. If you don’t, then you may have to cover the entire amount on your own.

There are many other terms that can be helpful, but these are some of the most important! The other important thing to do is talk to a health insurance agent! You don’t have to be an expert in health insurance! It is completely free to work with me, and you’ll find the best health insurance policy for you!

The post Health Insurance Basics appeared first on Michael Suhany Insurance.

Vision wellness

One of the most important parts of vision insurance is wellness benefits. Usually must vision plans will cover preventive care, and will cover most of these costs. This is important since having regular eye checkups is the best way to prevent serious problems from arising, or at least catching any eye diseases before they progress. Glaucoma, cataracts, macular degeneration and other eye diseases are more treatable when caught early.

Overall health

Most people think that eye care only is beneficial for their eyes, but eye doctors often catch serious medical problems during eye exams. For example high blood pressure, diabetes, thyroid issues, and even some cancers. These are all possible to be found by a regular eye exam. Your eyes are an important part of your health!

Cost savings

Before deciding which vision insurance plan to choose, you should sit down and think about what eye care you are going to need during the upcoming year. This is important since not every plan will offer the same benefits. Some plans will cover only eye exams, and give you discounts on some glasses or contacts. This type of plan may be best if you need minimal vision care. You can purchase a bigger vision insurance plan that will cover things like glasses, and other serious eye care.

As a insurance agent I will be able lay out the different vision insurance plans available to you, and help you find a plan that will fit your budget and cover your needs.

The post Benefits of Vision Insurance appeared first on Michael Suhany Insurance.

• Young/healthy people don’t need good health insurance

Many people think that when you are young, health insurance is not important. This is a very limited view on life since no one knows what could happen tomorrow. While it is true you may be less likely to develop a disease, it is still possible. In fact, the best time to buy health insurance is when you are healthy and don’t need it! If you ever have a major medical disaster, you will never regret having good health insurance.

• Health insurance starts the day I purchase it

This is another misconception health insurance agents hear. Many people think that if they go buy health insurance when they need it, they can turn around and use it. The fact is that health insurance can only be purchased at specific times of the year and only becomes effective on the first day of the following month.

• Go cheapest

While it isn’t a bad idea to try to save money, it isn’t always a good plan when it comes to health insurance. Many people don’t plan on using their policy, so they go with the cheapest plan they can.  However, this means that you will have a massive deductible and if something were to happen, you may not be able to cover this amount. It also may reduce the amount of benefits you receive, which can also cost you more long term.

• Insurance will pay for all medical costs

While this may seem like the purpose of insurance, it isn’t actually true. There are many different plans, and not all of them will cover everything. For example, if you have a copay, then that means you’ll have to pay a portion of all expenses. Or, you may have to pay for medicine out of your own pocket. The plan you have will change how much you have to pay out of pocket. You should talk to a health insurance agent to determine what plan is best for you.

• I should just buy health insurance online

It can seem easier and cheaper to purchase internet online, but this isn’t true at all. Using a health insurance agent will cost you nothing. Plus, you can talk face to face with a person, and they can answer all of your questions. This will ensure you understand your policy. Instead of going online and looking for the cheapest health insurance policy you can find, we would suggest talking to a local health insurance agent!

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Marco Rubio’s Healthcare Reform Proposals

Marco Rubio states that his healthcare reform proposal will “Expand access to affordable, quality health coverage by providing every American with an advanceable, refundable tax credit that can be used to purchase insurance.”  Such a proposal recognizes that everyone having health insurance is a social good, but that people can sometimes lack motivation to obtain or be unable to afford coverage.  This proposal attempts to use the tax code to address this problem.  Presumably, someone who refuses to obtain coverage would forfeit their tax credit and would thus be motivated to purchase insurance.  The tax credit would also make coverage affordable for those who could not otherwise be able to pay for coverage.

Further, Marco Rubio states that his plan will “Reduce health care costs, promote innovation, and ensure access for the most vulnerable by expanding access to consumer-centered health plans, reforming insurance regulations, and putting protections in place to ensure those with pre-existing health conditions can get access to affordable coverage.”  This proposal covers quite a bit of territory.  The most significant element concerns those with pre-existing health conditions and the desire to ensure that those who have these conditions can get affordable health insurance.  This requires that insurance companies accept these people who are at higher risk of incurring claims and that they spread this risk out to healthy people in the form of increased premiums.

Third, Marco Rubio says that his plan will “Promote innovation in the Medicaid program by giving states a per-capita block grant, which preserves funding for Medicaid’s unique populations while freeing states from Washington mandates.”  This proposal recognizes that being on Medicaid can be a miserable experience of bureaucrats making eligibility determinations, administrators making coverage decisions, and difficulty in finding providers who will take Medicaid’s diminished reimbursements.

Barack Obama’s Healthcare Reform Accomplishments

How do the proposals that Marco Rubio has made compare with the current state of healthcare under the Affordable Care Act?  One of the central features of the Affordable Care Act is an “advanceable, refundable tax credit that can be used to purchase insurance” called the Advanced Premium Tax Credit.  This tax credit is administered through the Health Insurance Marketplace.  The Affordable Care Act also provides for Cost Sharing Subsidies that further lowers Out-of-Pocket Costs for lower-income individuals and families.  The Affordable Care Act is doing just what Marcio Rubio proposes and it does more to make health insurance and healthcare costs affordable.

Marco Rubio wants healthcare reform that protects people with pre-existing conditions so they can purchase affordable coverage.  This is precisely what the Affordable Care Act did in phases, beginning in 2010 and completely beginning on January 1, 2014.  The Affordable Care Act does this by requiring insurance companies to take people without medical underwriting and without charging them a higher premium because of their medical condition.  The Affordable Care Act is already doing just what Marcio Rubio is proposing.

Finally, Marco Rubio wants the states to run Medicaid so that innovation free from Washington mandates can prevail.  Well, he needs to come to Indiana and talk with Governor Pence about the Healthy Indiana Plan like I have because this is exactly what the Pence and Obama Administrations were able to accomplish under the Affordable Care Act.  The public officials in the State of Indiana who had the experience of an innovative program to provide healthcare to those with lower incomes worked with federal officials to implement that program as an expansion of Medicaid much to the benefit of lower-income Hoosiers.

Conclusion

Maybe the next President and Congress will repeal the Affordable Care Act.  If Marco Rubio becomes President, he will be trying to replace it with something that looks quite similar.

The post Marco Rubio Likes Barack Obama’s Ideas on Healthcare appeared first on Michael Suhany Insurance.

Donald Trump has released his healthcare reform plan on his campaign web site.  He calls on Congress to make seven specific changes in the laws that he will presumably sign if he is elected the next President.  What are the proposals?  What do they really mean for the marketplace and the consumer?  Will his healthcare reform plan work?

1. Completely Repeal Obamacare Including the Individual Mandate

Donald Trump calls for the repeal of Obamacare in general and specifically the Individual Mandate.  The Individual Mandate is the requirement under the Affordable Care Act that almost everyone must either demonstrate that they have health insurance or face a penalty when they file their taxes.  The Individual Mandate is certainly one of the least popular features of the Affordable Care Act, but what else would happen if the Individual Mandate went away?

If the Affordable Care Act were to be repealed and the Individual Mandate as well, the insurance market would have to return to much the same state it was before the implementation of the law.  Insurance companies would once again ask medical questions of their applicants.  People could be denied coverage or charged higher premiums because of their medical conditions.  Pre-existing conditions could be excluded.  Affordability would once again be a major concern as insurance premiums would be no lower than 2013 levels and the tax credits under the Affordable Care Act would go away.

If most of the Affordable Care Act were to remain intact but the Individual Mandate were to be removed, then insurance companies would be faced with leaving the market altogether for inability to stay solvent or further increase premiums to make up for the fact that healthy people formerly purchasing insurance and paying premiums would no longer keep their policies.

2. Modify Existing Law that Inhibits the Sale of Insurance Across State Lines

Donald Trump wants laws modified that interfere with selling insurance across multiple states.  The theory that gives rise to this suggestion is that state regulation of insurance interferes with competition in the marketplace resulting in fewer choices for the consumer and higher prices.  If insurance companies do not have to deal with each state department of insurance, the belief is that there will be greater competition, more choices, and lower premiums.

There are two problems with this specific proposal by Donald Trump.  The first is that the laws that regulate the sale of insurance within a state are state laws.  Congress and the President can’t rewrite state laws.  If he is proposing federal law that overrides state regulation, then he is proposing a system that will either lack the consumer protections that the states have enacted or an even bigger federal role in health insurance than even the Affordable Care Act represents.

The second problem with this specific proposal is that it is contradictory.  The proposal states “As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state.”  Do we want state regulation or not?  And how is this second part of the proposal any different from the current state of affairs where the states set requirements and any company who wishes to comply can compete in the state?

3. Allow individuals to fully deduct health insurance premium payments from their tax returns.

Donald Trump wants individual health insurance premiums to be a tax deduction just like group health insurance premiums are for employers.  Under the current tax code, employees who receive their health insurance through an employer are receiving a tax advantage that is not available to employees who have to purchase their own health insurance.  Under a group health plan, the employee contribution can be made with dollars that are not taxed.  The employer contribution is not taxable income to the employee and it is a business expense to the employer.  Making individual health insurance premiums a tax deduction would level that playing field.  The only negative would be the loss of tax revenue to the government.

4. Allow individuals to use Health Savings Accounts (HSAs).

Donald Trump wants to encourage the use of Health Savings Accounts.  Health Savings Accounts have been around for years and are a valuable tool in helping people make the best use of their healthcare dollars.  For most people, it makes sense to purchase a less expensive policy where office visits and prescriptions are paid by the policy owner and credited toward the policy deductible.  The policy owner can then open up a tax-favored savings account that allows them to pay their out-of-pocket expenses with dollars on which they do not have to pay income tax.  The only new wrinkle that this proposal seems to add is that the accounts would not be subject to inheritance tax which would benefit very few people.

5. Require price transparency from all healthcare providers

Donald Trump wants doctors, clinics, and hospitals to disclose their pricing.  This is presumably to allow people to price shop for their medical care.  The first question is just how much of a person’s healthcare are they either willing or able to access based on price.  If someone needs to schedule a lab test or some diagnostic imaging that they will pay for out of pocket, it is certainly possible to imagine calling multiple providers for prices.  If someone is ill and needs to see a physician, are they price-shopping for the cost of an office visit or are they trying to get an appointment with their primary care physician?  If you need open-heart surgery, are you price-shopping to save the insurance company money or are you trying to find the most skilled surgeon possible?

The second question is why a physician’s or hospital’s pricing should be any more public than the provider chooses to make them.  Shouldn’t a provider be free to negotiate pricing as they choose?  Shouldn’t a provider be free to negotiate a better price and keep their reimbursements private from an insurance company that brings them a high volume of patients and pays promptly in preference over another insurance company with fewer patients to offer and slow reimbursements?

6. Block-grant Medicaid to the states.

Donald Trump wants states to manage Medicaid to provide better care and to reduce fraud, waste, and abuse.  The states already do manage Medicaid with most of the money coming from the federal government.

7. Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products.

Donald Trump wants American consumers to have “access to imported, safe and dependable drugs from overseas.”  The first question is who it is that will determine whether the drugs from another country are safe and reliable.  Does this proposal mean that drugs from other countries still have to meet the standards of the Food and Drug Administration?  Does a drug just have to be approved for use in some country somewhere for it to be legal to import into the United States?

The second question has to do with how it is that a drug from another country is less expensive than a drug in the United States.  Certainly, a pharmaceutical company in another country may simply have a competitive advantage over a U.S. company and be able to produce the medicine for less.  What about cases where the government in another country is subsidizing the drug maker and creating an unfair advantage for the U.S. company?

Conclusion

Is this the type of plan for Healthcare Reform that will make America great again?  I’ll let the reader draw their own conclusion.  I do hope that I have provided some helpful perspective on these proposals.  Let me know if you have any questions.

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