What Everyone Should Know About the Health Insurance Deductible

The deductible is the dollar amount an insured individual must pay for covered expenses during a calendar year before the plan begins paying co-insurance benefits.  Simply put, this is how much you will have to pay before the insurance carrier will start paying part of your bill (copay), or covering all costs.

However, this may not apply to preventative care services. Think about it. The insurance company doesn’t want you to put off doing an annual checkups or other routine preventative exams in the risk that they may not catch something early, and later on down the line after it becomes worse and more costly to perform treatment. For this reason, your insurance will immediately start covering some of these costs without the need to hit your deductible. Speak to your broker or agent to be sure what your plan covers.

Health Insurance should not be for routine stuff. Rather, it’s meant to protect you and your family from catastrophic financial loss.

If you’re healthy and hardly ever go to the doctor then it’s probably best just to have the higher deductible. Let’s take the two extremes for example. We’ll compare Kaiser Permanente’s 20/500 plan at $467*/mo. and the 40/3000 at $257*/mo. If you get the plan with the higher deductible, with the difference of pricing, you’ll be saving $210/mo. Which calculates out to $2520/year. So hypothetically, if you did hit your deductible because you were hospitalized, you’ll have that money you’ll be saving every month to offset the cost and pay for it. If you don’t hit your deductible… which if you are healthy you most likely will not, you’ll be saving all that money.
See Plans and Pricing

Think of a cell phone plan. If you hardly use 450 minutes, then there’s no need to pay more for a plan that allows for 1000 minutes. You most likely won’t even hit the $500 deductible for the insurance to kick in differently than it would with the $3000 deductible.

Remember, you can change your plan at anytime and there is a 30 day free look period to see if the plan is right for you. I had someone this month just go from the 20/500 plan to the 40/3000 since they are healthy and hardly ever go to the doctor.

If you like the security of only having to pay $500 then that plan would be something to consider. However, there is the higher premium that goes along with it. If you want, meet somewhere in the middle with the 30/1500 plan and re-evaluate after a year.

Be sure to download the Kaiser Permanente Deductible Plans Brochure to see all available health plans (CA Only). I hope that all makes sense. If there is anything else just let me know. My email is wrholt@walterrayholt.com and may be reached by phone (310) 853-0782.

*Pricing shown for a 35 year old non-smoking female in Oakland, CA.

How to Get Health Insurance if You Don’t Have a Job

If you have found yourself recently unemployed, there are many options for obtaining health insurance for those who currently do not have a job. It is important that you do not have a gap in your coverage in this type of situation because many people think the Health Insurance Portability and Accountability Act (HIPAA) requires health insurance companies to offer coverage to those with pre-existing conditions.  This is simply not true; rather it protects you from being denied coverage when switching employers who offer health insurance. It will provide you no such protection in the open market when purchasing individual health insurance.

1. COBRA – Which stands for the Consolidated Omnibus Budget Reconciliation Act, requires your previous employer to keep you (the employee) on the company health insurance plan for up to 18 months after you were laid off.  However, this may be costly considering that the employer is no longer contributing to the cost.  So you’ll be responsible to 100% of the premium… which may be around $350 for just you, or $1000 for an entire family*.  This may be your best option if you have a pre-existing condition, which would jeopardized you being accepted when applying for an individual health plan on your own. Contact your employer within 30 days of leaving to enroll if they haven’t already provided you with the information to do so.

Questions about some of the terminology? See Health Insurance Terms for definitions.

2. Short-Term Health Insurance – If you are just in between employment, or you have a waiting period at your new company before their employer sponsored plan kicks in, you should consider short-term health insurance. This coverage will keep you protected in case of emergencies. The rates are affordable and provide the coverage you’ll most likely need during transition. Short-term plans are generally month-to-month, so you can cancel the plan at anytime.

3. Individual & Family Health Insurance – There are plenty of benefits in having an individual plan, even if your next employer offers health insurance.  You can continue with this plan no matter what your employment status and offers the best portability. Depending on how much you pay and how often you use your health plan, this may be your best option.  Just compare rates against what you would pay with your employer-sponsored plan/CORBA and that of an individual plan with the same benefits (co-pay, Rx, deductible, out-of-pocket-maximum, etc.)  If you have a pre-existing condition you may have to wait 12-18 months before the new health plan will cover the costs of claims associated with the condition(s).

Other options include Medicaid and health insurance though Group Associations.

Need health insurance? Get free quotes on individual, family, or group medical plans. Call me for a quote. 310.853.0782

*Kaiser Permanente Quotes

10 Things To Ask Yourself When Looking for a Small Group Health Plan

Finding an affordable group health plan for your business isn’t as challenging as it may seem. In order to help you get an idea on what type of plan will fit your company here are 10 things to ask yourself when looking for a small group plan. Use this list of questions, and together with the support of my insurance office we will help you find a plan that fits your company and your budget.

  1. Do you want to increase or decrease benefits?
  2. When does your group medical, dental and life coverage renew?
  3. What is the contribution you are able to put towards your employees plan?
  4. What do you like and dislike about your current plan?
  5. Do you have previous service issues with any carriers?
  6. Are there any doctors or hospitals you really like and don’t want to lose?
  7. What is most important to you and your employees about your medical plan? (i.e. doctors, benefits, cost)
  8. Are there any medications or health concerns we need to know about?
  9. What type of company are you? (corporation, sole proprietorship, partnership)
  10. When did your business start and what documentation do you have to support the start date?

Send us your answers and we’ll help you find a plan that fits your small business.

W. Ray Holt

Walter Ray Holt Insurance Services CA Lic. #0G59076

5 Benefits of Offering Employee Benefits

When it comes to employee benefits, where does your company stand? Paid vacation? Tuition reimbursement? Medical insurance?  Unlimited vacation days? … wait, what?

That’s right, unlimited vacation days. This perk has become more common in today’s workplaces. Company’s like Red Frog Events have quite the attractive benefits package, which includes unlimited vacation days along with health/dental/vision insurance & a 401k plan where they match up to 10% of salary. It doesn’t stop there. They also offer $100/ month in cell phone reimbursement, one work from home day per week, sabbatical, a trip abroad, a birthday massage, free food and drinks, and much much more.

This isn’t even what caught our attention. Their 17,000-square-foot office is home to computers, desks, a tree house complete with zipline, a rock climbing wall, and a conference table made of 50,000 Legos.

A fun and creative work environment has surely has its benefits.

  1. Easier Recruiting. Simply, the more you have to offer you’ll start attracting top talent from even the most prestigious universities and company’s. Young innovative thinkers thrive for a creative work environment to express their talents.
  2. Mutual Appreciation. When employers invest in the office space it let’s employees know that they care that their work environment is comfortable, relaxing, and stimulating.
  3. Less Stress & More Happiness. Creative spaces encourage innovation, increase productivity, and inspire better performance.
  4. Free PR. Just like you’re reading about it here. Your company will draw more attention and may land yourself the spot of “Best Company’s to Work For” in your city.
  5. Enhanced Creativity. A work environment that is conducive to growth through the synergy between creative thinkers in a creative environment.

Short Term Health Insurance from Assurant

Between jobs? Waiting for employer benefits to kick in? Currently a temp or seasonal employee? Did you recently graduate from college and no longer under your parent’s health plan?

These are one of many reasons why you may need an Assurant Health short term medical insurance plan. Sudden illnesses and accidents can lead to large medical bills. Keep your financial future safe at a price you can afford with Short Term Medical temporary insurance. Coverage starts the day after you apply and you may keep your own doctors.

Between jobs? Waiting for employer benefits to kick in? Currently a temp or seasonal employee? Did you recently graduate from college and no longer under your parent’s health plan?
These are one of many reasons why you may need an Assurant Health short term medical insurance plan. Sudden illnesses and accidents can lead to large medical bills. Keep your financial future safe at a price you can afford with Short Term Medical temporary insurance. Coverage starts the day after you apply and you may keep your own doctors.

Aetna Advantage Plan for Individuals

If you live in California and are looking for a health plan that fits your needs you may want to take a look at the Aetna Advantage Plans for individuals, families, and the self-employed.

Aetna Advantage Plans offer some of the best choices and value to help meet your health coverage needs. We can help you choose an affordable health insurance coverage from Aetna. See Plans & Pricing for Aetna Advantage
Aetna Advantage Health Plans

Affordable quality & choices

Choose from a wide range of health insurance plans that offer excellent quality. Aetna Advantage plans are designed for maximum value, with lower monthly premiums, plus benefits for preventive care.You can choose how much to spend in premiums versus out-of-pocket expenses.

Robust coverage,competitive costs

Aetna offer plans with valuable featureswhich may include: An excellent combination of quality coverage and competitively priced premiums.  The freedom to see doctors whenever you need to, with no referrals needed. Coverage for preventive care, prescription drugs, doctor visits and hospitalization.  No deductible for well-women exams when you visit a network provider.  No claim forms to fill out when youuse a network provider.  Aetna’s nationwide provider network offers you a vast selection of licensed physicians and hospitals.

Family Coverage

Apply for coverage for yourself, your spouse, and children, or even just your children. Coverage can include prescription drugs, doctor visits, hospitalization and preventive care services.

Tax Advantages

Aetna also offer High Deductible plans thatare compatible with tax-advantaged Health Savings Accounts (HSAs). You can contribute money to your HSA tax-free. That money earns interest tax-free. And qualified withdrawals for medical expenses are tax-free, too.

Coverage when you travel

Like to travel? You have access to covered services from a nation wide network of doctors and hospitals that accept Aetna’s negotiated fees.