California Health Insurance – Independent Health Life Agent Verses Insurance Company In House Agent

You have just completed an online form requesting a free health insurance quote and moments later you are being inundated with phone calls from insurance agents hoping to get your business. Try not to become overwhelmed or annoyed by these “pesky sales people” because they are really not telemarketers. Most of them are well-trained state licensed professionals who can really help you make a good decision regarding which health plan is best and most affordable for your individual or group coverage needs.

You may be under the misconception that if you buy your health plan directly from the insurance company, and cut out the “middle person”, you will save money. This is absolutely not the case. In fact, insurance companies rely on agents for most of their business and that’s why they pay them commissions for bringing in customers. It does not cost a consumer one penny more to use a licensed California health insurance agent to obtain their insurance coverage.

There are many differences between California health insurance and other states including how it is applied for.

For example, while Blue Cross and Blue Shield are one company in other states, here in California, each is separate and applied to individually as Anthem Blue Cross of California and Blue Shield of California.

California health insurance law AB 1672 is an improvement over the federal HIPAA law that covers all states in that it includes the following with regard to California group coverage:

1. Individuals with pre-existing medical conditions may change over to a new group health plan without an exclusionary period.

2. It allows small businesses and professional organizations to have access to health plans providing they have between 2 and 50 full time employees.

3. It keeps insurance rates from climbing after a claim is filed.

4. Employees who have health problems may change jobs or health plans without being rated higher for having pre-existing conditions.

That said, the very best health insurance agent for your individual and business needs is an “Independent Agent.” Why? Because they represent multiple insurance carriers, not just one. An independent agent can help you select the most appropriate cost-effective plan offering the most benefits for your dollar as available from the major carriers, rather than feeding you just one company’s line of health plans which may not suit your particular needs. Many people are too complacent and settle for what their current insurance company has to offer. They could use a good independent agent to sort through the many plans available from multiple insurance carriers to find and provide the best choice of options.

Another misunderstanding you may have is that insurance agents set the premium rates for the health insurance plans they sell. Thinking if you shop around you may get a better price for the same plan. Premium rates are based on your age, zip code or county in which you reside and are controlled completely by the insurance companies. Every agent uses the exact same rate guides set by the insurance companies. The condition of your health may affect your premium, which may be rated up after the insurance company’s underwriting department has reviewed your medical records. Again, the insurance company, not the agent, determines that outcome.

Now, let’s talk about the benefits of having a good insurance agent representing you. Most consumers neither know nor understand the benefits of a health plan being offered and need the expertise of an agent to explain the benefits to them in full. For example, do you know what the difference is between an “out-of-pocket maximum” and an “annual deductible?”

An out of pocket maximum is the most you will have to pay in a given year for deductible and coinsurance for covered benefits before your insurance starts to pay 100% of most expenses until the year ends.

An annual deductible is usually the amount you pay each year before your health plan starts paying anything for covered services. Generally, the higher the deductible, the lower the premium. Certain services such as prescription drugs carry separate deductibles. Plans may vary and sometimes benefits will kick in before you have to meet the deductible.

A knowledgeable health insurance agent can be a guide through the maze and help you choose the right plan to meet your needs and budget while obtaining the most benefits for your dollars spent. An agent will also make clear how the benefits for a generic prescription may differ from the benefits for a brand prescription on a particular plan.

After you have a health plan in place, a good, caring agent will remind you to pay your premium on time so the insurance company doesn’t cancel you. Your agent can also be an enormous resource for assistance if you run into a problem with a health insurance claim. Instead of waiting on hold at the insurance company’s 800 number for thirty to forty- five minutes, call your agent and explain your problem and if you have chosen the right agent, you will get help and may save yourself lots of time and frustration, maybe even some money by having an expert in your corner where your best interests come first.

So next time you or someone you know, fills out one of those on-line forms for a health insurance quote and you get several phone calls from health insurance agents wanting your business, be grateful that a professional wants to help you for free to choose the right plan and you’ll have an important friend for life.

Online Babysitting Services: How Do They Work and How To Choose The Right One For You

So you need someone to watch your children and have decided to look into online babysitting services. However, there are so many to choose from, including Sittercity, Care, Care4Hire.com, GoNannies, AuPairCare and 4Sitters.com, that it is overwhelming. To find the best fit for you and your family, you need to check out an assortment of sites. Each one will vary in everything from their fees and services, to their applicant filtering system and reputation, to the number of caregivers in their database. Some even provide contact information for pet sitters, housekeepers, tutors and eldercare services.

There are two ways in which online babysitting services work. With the first method, parents post a job and then the sitters who are interested and nearby contact them. This may be done via email or telephone. The parents can then respond accordingly. With the other method, parents can look at the profiles of potential babysitters and then contact the best ones. When searching, you get immediate access to babysitters. Simply type in your zip code and a list of local sitters pops up. When you click on a sitter, you may get a brief bit of information or their entire profile.

Some sites will let you preview and look for sitters without registering, so you can see the options. However, if you want to get the contact information, you need to be a member. Subscriptions may be paid for on a monthly or yearly basis. The best sites will give you a free trial period, perhaps for a week, so you can try it out first. If you like it, you often have to pay an initial registration fee, in addition to the subscription costs.

Be aware that not all sites do the same things. Some may simply interview the babysitters to create a profile but do not check references. Others provide the option of doing extensive background checks. However, it may cost extra or require you to increase your membership level. The best sites will have a multi-step screening process. In addition, the online babysitting services should have comments or referrals from people the caregivers have worked for in the past.

Most online babysitting sites also have a search filter that lets the parents narrow down the candidates. For instance, if you have a child with special needs, you can locate a babysitter who has previous experience with this type of child or someone with specific medical certifications. This search filter will help you save time. They can also help you find back-up sitters at the last minute, in case the scheduled sitter gets sick or you get an unexpected dinner invitation. Some sites, like Sittercity, even offer nannycam and video monitoring options.

Obesity and Fast Foods

Before we discuss obesity and fast foods, let us have some definitions first.

o Obesity: A person is termed obese when his or her Body Mass Index exceeds 30
o Body Mass Index (BMI): A unit of measurement used to define the state of a person’s body weight. It is derived by dividing a person’s weight in kilograms by the square of his or her height in meters.

Underweight BMI = less than 20
Normal BMI = 20 to 24.9
Overweight BMI = 25 to 30
Obese BMI = greater than 30

o Fast food: there is no standard definition for it, but generally taken to mean foods that are prepared in very large quantities using standard kitchen utensils, following standardized recipes and repetitive preparation procedures and served rapidly in standard designed restaurants known as fast food restaurants. They usually advertise their services through electronic and print media and generally target children and young people. The rapid spread of such restaurants is usually made possible through the franchising system.

The key to good health through eating nutritious foods needs no explanation. As the saying “we are what we eat” goes, our physical well being is largely dependent on the type of foods we take. Cases of diet related diseases are well documented. They include the likes of diabetes, overweight, obesity, hypertension, heart diseases and certain types of cancer.

The link between obesity and fast foods has been well documented. It has been recognized that excessive consumption of fast foods is a leading cause of obesity due to the high content of fat, sugar and salt in fast foods. They are typically low in complex carbohydrates.

Another area of concern is that advertisements of fast foods are generally targeted towards children. Children, particularly the younger ones, are generally unable to discern through food and nutrition information. It is no coincidence that there are increasing incidences of the rise in obesity in the younger people.

Countries around the world are getting more and more alarmed at the rate of increase in obesity particularly in the younger people; they are well aware of the link between obesity and fast foods.

However, it is unfair to put the entire blame squarely on fast foods. Kids nowadays spent more time on computer games and television than their parents’ generation; they are less likely to part take in robust physical games.

Seeing the need to address the danger of the link between obesity and fast food, many countries around the world are taking action to enforce tighter control on television and print media advertisements, because the younger people are usually the targets of fast food companies.

Of particular concern is television advertising, an extremely influential and effect medium of advertisement for children. Among some of the restrictions adopted are:

o Prohibition of TV advertisements of fast foods during the airing of children’s programs
o Prohibition of TV sponsorship by fast food companies for children’s programs
o Prevention of misleading food information which may confuse consumers
o Fast food companies are prohibited from any form of advertisements that encourages excessive consumption
o Fast food companies are prohibited from promoting fast foods as healthy substitutes for a complete or balanced meal

The link between fast foods and obesity has prompted many governments to take affirmative action to prevent excessive consumption particularly by the younger people. It is a step in the right direction to reduce the overall burden of health care costs provided by governments around the world.

Alternative Health Treatment – 5 Questions and Answers

1. Why should I look at alternative health treatment as a realistic remedy for my ailment?

While Western medicine has advanced closely in tandem with knowledge of and experimentation with drugs as a way of treating disease and illness.

It’s not surprising, therefore, that it relies heavily on drugs and medications for treating disease. But drugs and medications are not natural to the human body, and invariably there are side-effects, often harmful.

Alternative health treatment is based wholly on natural cures not involving drugs or manufactured or processed materials. As such, it is invariably accepted by the body without resistance, so no energy is wasted in fighting it. It’s like swimming with the current rather than against it.

Besides, alternative health treatment has an excellent record in curing people of illness and disease, arguably a better record than Western medicine.

2. How does alternative health treatment differ in essentials from orthodox medical treatment?

Orthodox Western medicine depends largely on the administering of drugs and medicines, and unnatural procedures such as chemotherapy for cancer victims. It focuses largely on the symptoms rather than the underlying cause. A typical example is the taking of pain killers to cure a headache.

Alternative medicine acknowledges that the natural state of the body is one of good health, and that the body, mind and spirit are closely connected. It recognizes that all these components of the whole need to be in balance, and treats illness as a sign that they are out of balance. It therefore works to restore the natural balance and, thereby, good health. A headache would be cured by direct action on the area affected, e.g. by acupressure techniques.

3. Why don’t doctors and surgeons give more weight to alternative health treatment, and why hasn’t it made more progress in being accepted by the medical establishment?

The medical establishment consists largely of doctors and surgeons. Put yourself in the position of a doctor or surgeon. You spent seven gruelling and expensive years qualifying and passing difficult exams, and working long hours for at best mediocre pay. You now have an encyclopedic knowledge of medicines and medical drugs and procedures, and are enjoying a financially rewarding career in medicine.

Then you learn there is an alternative system of medicine based on herbs, and practices such as acupuncture that claim to be able to deal with medical conditions better than the medicine you learned at such cost in money and time. What would your feelings be towards these alternative medicines?

4. Isn’t alternative health treatment rooted in the past, and modern Western medicine with all its advanced technology the way ahead?

What matters more than anything else is what treatment will effectively cure your own particular ailment.

Just because skills such as acupuncture, acupressure and yoga have been practiced for thousands, of years in the Far East it doesn’t mean they are any less relevant today. On the contrary, it is evidence of their effectiveness.

Western medicine may have all the modern gleaming technology, but it is still a system developed and administered by humans and subject to all their faults and failings. Yes, it can and does produce some astonishing and greatly beneficial results, such as transplant surgery and artificial limbs, but in the case of common ailments and complaints, sometimes the simple methods are the best.

5. Which alternative health treatment is best – herbal, physical contact type treatment such as acupuncture or chiropractic, or supplements such as oils and enzymes?

It’s horses for courses. Different kinds of treatment best suit different kinds of illness. A general malaise, such as weight loss or gain, can often best be treated through a change in diet and the administration of herbal remedies, plus an exercise regime, whereas constant muscular pain such as back ache is best treated by someone like a chiropractor or osteopath, who can manipulate the bones and muscles so as to remove the root cause of the pain.

Don’t Put Off Researching For The Right Family Healthcare Plan

Family health care plans or insurance can be extremely beneficial to the well being of the people you care the most about. Let’s be honest, our health is very important to us and as we age it becomes vitally important that we spend some time thoroughly researching the health insurance providers in order to find a family healthcare plan that protects the interest of our family’s health without costing us a fortune in health insurance premiums or monthly rates.

There are several reasons why researching a family healthcare plan is a good idea. First and foremost as I’m sure you are aware more and more companies are downsizing or eliminating the benefits they provide their employees. Unfortunately, reducing or completely doing away with health care benefits has become the norm as opposed to an exception to the rule. For this very reason it is imperative that you spend quality time now finding an adequate family healthcare plan that will provide outstanding family health insurance to your most precious of assets.

Guess what, accidents happen and they do so with enough frequency that should you need to take a trip to the emergency room or to the doctor’s office it’s better if you go knowing that you have a family healthcare plan that has you covered and will take care of any medical or health related bills that appear as a result of the hospitalization required due to the accident.

Being financially strapped for cash is no picnic and can be very stressful for many consumers. Having a family healthcare plan allows you to put aside any financial worries you may have in the event you find yourself or a family member needing attention or treatment at a local hospital. Having proper health insurance also affords you the opportunity to save money for other needed necessities in life because you won’t have to worry about having to cover any medical expenses or bills that may come up due to receiving medical attention from a hospital or doctor.

As you do your online research in order to find a family healthcare plan that fits your needs, wants and desires you will be able to compare price quotes between several different health insurance providers or companies. Always make sure to look at deductible costs, prescription costs and of course the doctor’s that you can choose to seek future medical treatment from. The time you invest in finding the best family healthcare plan will save you money and aggravation in all of your future medical emergencies.

Fast Food Statistics – Choices Matter

Fast food statistics let us know that fast food can be an unhealthy option. A quickie burger is a popular choice among people who don’t want to cook, or who are under time pressures and don’t have time to cook. But instead of buying takeout why not make your own fast meals at home?

What’s in a Fast Meal?

Here is a quick statistic on a fast food meal. A cheeseburger, fries, and milkshake have around 1,000 calories. About 17% percent of those calories are from protein, which is not too bad. But around 39% of those calories are from saturated fat and that’s not good. And around 44% are from refined carbohydrates, which is constipating and fattening.

Too much saturated fat in the diet causes high levels of cholesterol in the blood and risk of heart disease. Children may quickly burn up calories from fat in a typical fast food meal, but for most adults those calories quickly turn to body fat and cellulite.

Nutrition of Fast Food

A regular portion of fries has about 210 calories and 10 grams of fat. A 4-ounce hamburger, without the cheese has around 420 calories and 20 grams of fat, plus a whopping 690 grams of sodium! Yikes that is a lot of sodium for a small hamburger. A medium soft drink boasts about 210 calories and 50 of those calories are from sugar.

Eating fast food is a convenient way to grab a bite, but fast food in undeniably unhealthy in many ways. Fast food does not have any fiber whatsoever, which leads to constipation that can later develop into colon cancer. The saturated fat content of fast food is not healthy for the heart. It’s never a good idea to eat fast food more than a couple of times a month, and for some people, never.

Making Your Own Fast Meal

If you enjoy eating hamburgers once in awhile, the alternative is to make your own. Mix ½ pound ground meat with ½ pound ground turkey. Add seasonings of your choice. Form into patties and broil in the oven. Take two whole potatoes and wash and scrub thoroughly. Cut potatoes into French fry wedges. Toss some olive oil, sea salt and paprika on the potatoes and bake for 45 minutes at 400-degrees.

Time Saving Tips

The rush, rush mentality of society has made many people flock to the nearest fast food joint for meals. But there are healthy eating alternatives. Here are a few tips:

If you live close to your work, simply go home for lunch. If you don’t have the luxury of working close to home, bring lunch to work with you.

If you have to eat out, choose a salad bar, soup, or light sandwich. Bring your own salad dressing with you instead of using those fattening creamy dressings.

Have a well-stocked pantry at home full of healthful foods such as beans, brown rice, pasta and other whole grains. When you cook, make more than you will need and freeze the rest in individual servings for work or when you don’t feel like cooking.

Be prepared. Make lists of what you are going to eat throughout the week. On the night before going to work do most of the prep work, so when you come home from work all you have to do is cook the food.

Cook in your crock-pot. The crock-pot does the cooking for you.

Fast Food and Traditional Food

The term “cooking” includes a wide range of methods, tools and combination of ingredients to create the flavor and digestibility of food. Cooking technique, known as culinary art, generally requires the selection, measurement and combining of ingredients in a controlled procedure in an effort to achieve the desired result. Constraints on success include the variability of ingredients, ambient conditions, tools, and the skill of the individual cooking. The diversity of cooking worldwide is a reflection of many nutritional, artistic, agricultural, economic, cultural and religious considerations that impact upon it. Cooking requires applying heat to a food which usually chemically transforms it and changing its flavor, texture, appearance, and nutritional properties. There is archaeological evidence that the primitive human being used to cook their food with fire that was the most important thing discovered by the primitive human being. Cooking food and cuisine culture vary from country to country and from one culture to another and each cuisine has its specific particularity. Nowadays, because of the modern life that changes everything around us and influence our life style and eating habits, people are less preparing their own food. Eating habits tend to unify people from different society. The food production and the process of eating obtain new characteristics. Food available around us seems to be very different from the one that we used to eat.

Eating habits and modern life

Everything is running in high speed, people do not have time for cooking, don`t has the desire and patience to stay longer in the kitchen, and they don`t have the willing to prepare their own food. Old generation still prefer to cook their own food unlike young people who prefer to eat fast food because they don’t want to spend long time cooking and the desire for the cooking. The modern life shapes our eating habits and makes us like slave following its speed. It`s not hard to find fast food restaurant they are everywhere and every corner. Fast food consumption cause damages to the social and economic life of the country and leads to many health problems such as obesity and heart diseases according to many studies. Also, many nutrition experts from different countries have already declared the epidemic character of fast food. The rapid process of globalization and modern life influence our eating habits and gives opportunity to fast food restaurants to grow and flourish. Fast food seems to become very common everywhere, though some positive aspect of the fast food in easy to prepare, available in many places, and it is a substantial meal. But in other hand, we can estimate that its negative aspects are more important and bigger. I think it is easy to understand that fast food is one of phenomenon that is going to be accepted by people. We are going to see the process of disappearance of the traditional culture with the development of fast food restaurants in all countries all over the world.

How to fight fast food addiction

The best example of the fast food success to change the modern life is the invasion of the world’s food market by the giant fast food company such as McDonald, KFC and others. According to McDonald`s web site, McDonald has about 29.000 restaurants in 120 countries all over the world, and serves nearly 54 million customers each day. As well as it indicates the fact of such changing in eating preferences and even in the way of life itself. There is no doubt that right now fast food changes the face of many nations and eating habits around the world. To sum up, unfortunately, it is hard to prevent these global changes that traditional food is going to be replaced by new foods that common for all people in all countries all over the world. But the good news is that, recently there are some people and some movements which try to contrast the process of modern life and ask people to go back to their traditional food. To solve this problem we need restaurants that offers traditional food, and able to attract large amount of faithful customers. Also parents must teach their children how to prepare and cook the traditional food. Many People figure out that traditional food is much better for our health, so they want to preserve and keep the cooking tradition from evaporating. There is enormous hope of people to preserve their food preparation customs and tradition. The major obstacles are the modern life style. Some people might say that it is difficult to preserve our traditional food because it takes a long time to prepare and people today can not spend a long time in cooking. Other people, especially older people might say that, it is unfortunate to destroy culture and tradition. Those people might be right.

Conclusion

In these days, people have more health problems that are related with the new eating habits and fast food consumption. Despite some advantages of fast food the harm caused by fast food does not outweigh its benefit. I think that people should consider the negative fact of fast food consumption and the benefits of preparing their own food at home. It`s unfair that the traditional food which arrive to us from generation to generation we are going to replace it with junk food that will harm us more than benefit us. It`s unfortunate to lose the cooking tradition and eating homemade food prepared by our mothers together around the table. I am sure that all of us must think over this problem and try to find the appropriate solution to save our cultures, our traditional foods, and more importantly our health. So we should take action immediately to preserve traditional food and encourage people to prepare their own dishes, so they can stay healthy and live longer. Even though fast food is cheap, convenient, yummy and available in every corner in our cities, but that does not mean that our health is cheaper than the fast food that we eat.

Dental Care For the Poor

We all know that dentists are highly specialized doctors who deal with all kinds of dental issues; however, his expertise does not limit to only teeth but may also cure other issues related to the mouth such as sore mouth, swollen gums etc.

It is widely believed that visiting a dentist more often for a routine check up is always better than visiting him for any dental issue. Though the fees charged by dentists are high there are some dental care services that may charge you nominal fee and help in getting treated at a low cost.

For those people who find it difficult to pay for their dental checkups, there are dental care organizations where cheap or free of cost dental checkups are done.. Even universities have offers for the poor to take care of their dental issues at a low price or for free. Often projects and camps are conducted by students who are doing the studies of dentistry to offer free or reasonable aid to people suffering from dental problems but can not afford dental care.

You may also come across numerous plans and communities established only for the welfare of poor who are not able to afford dental checkup. There are several NGOs and governmental organizations that can help in curing your dental problems for free or at a nominal cost. There are thousands of recognized dentist who participate in such charity based dental checkup events.

Those people who cannot afford regular dental checkup due to unfavorable financial conditions, it is suggested to opt for dental discount plans. Such plans may be available with most of the dentists. You may receive your membership card which you need to show to your dentist whenever you visit him.

Finding a proper dentist who offers cheap dental care service in your locality, may not be that tough. You may seek advice from your friends and relatives about cheap dental care programs. You may even check in business directories for reasonable or free dental checkup.

There are fair chances that you may find details of some good and reasonable dentist. A search on the internet for low cost dentist or free dental care can help you find affordable dental treatment service in your vicinity.

Small Business Health Insurance – The Best Policy Is A Great Agent

I have been a health insurance broker for over a decade and every day I read more and more “horror” stories that are posted on the Internet regarding health insurance companies not paying claims, refusing to cover specific illnesses and physicians not getting reimbursed for medical services. Unfortunately, insurance companies are driven by profits, not people (albeit they need people to make profits). If the insurance company can find a legal reason not to pay a claim, chances are they will find it, and you the consumer will suffer. However, what most people fail to realize is that there are very few “loopholes” in an insurance policy that give the insurance company an unfair advantage over the consumer. In fact, insurance companies go to great lengths to detail the limitations of their coverage by giving the policy holders 10-days (a 10-day free look period) to review their policy. Unfortunately, most people put their insurance cards in their wallet and place their policy in a drawer or filing cabinet during their 10-day free look and it usually isn’t until they receive a “denial” letter from the insurance company that they take their policy out to really read through it.

The majority of people, who buy their own health insurance, rely heavily on the insurance agent selling the policy to explain the plan’s coverage and benefits. This being the case, many individuals who purchase their own health insurance plan can tell you very little about their plan, other than, what they pay in premiums and how much they have to pay to satisfy their deductible.

For many consumers, purchasing a health insurance policy on their own can be an enormous undertaking. Purchasing a health insurance policy is not like buying a car, in that, the buyer knows that the engine and transmission are standard, and that power windows are optional. A health insurance plan is much more ambiguous, and it is often very difficult for the consumer to determine what type of coverage is standard and what other benefits are optional. In my opinion, this is the primary reason that most policy holders don’t realize that they do not have coverage for a specific medical treatment until they receive a large bill from the hospital stating that “benefits were denied.”

Sure, we all complain about insurance companies, but we do know that they serve a “necessary evil.” And, even though purchasing health insurance may be a frustrating, daunting and time consuming task, there are certain things that you can do as a consumer to ensure that you are purchasing the type of health insurance coverage you really need at a fair price.

Dealing with small business owners and the self-employed market, I have come to the realization that it is extremely difficult for people to distinguish between the type of health insurance coverage that they “want” and the benefits they really “need.” Recently, I have read various comments on different Blogs advocating health plans that offer 100% coverage (no deductible and no-coinsurance) and, although I agree that those types of plans have a great “curb appeal,” I can tell you from personal experience that these plans are not for everyone. Do 100% health plans offer the policy holder greater peace of mind? Probably. But is a 100% health insurance plan something that most consumers really need? Probably not! In my professional opinion, when you purchase a health insurance plan, you must achieve a balance between four important variables; wants, needs, risk and price. Just like you would do if you were purchasing options for a new car, you have to weigh all these variables before you spend your money. If you are healthy, take no medications and rarely go to the doctor, do you really need a 100% plan with a $5 co-payment for prescription drugs if it costs you $300 dollars more a month?

Is it worth $200 more a month to have a $250 deductible and a $20 brand name/$10 generic Rx co-pay versus an 80/20 plan with a $2,500 deductible that also offers a $20 brand name/$10generic co-pay after you pay a once a year $100 Rx deductible? Wouldn’t the 80/20 plan still offer you adequate coverage? Don’t you think it would be better to put that extra $200 ($2,400 per year) in your bank account, just in case you may have to pay your $2,500 deductible or buy a $12 Amoxicillin prescription? Isn’t it wiser to keep your hard-earned money rather than pay higher premiums to an insurance company?

Yes, there are many ways you can keep more of the money that you would normally give to an insurance company in the form of higher monthly premiums. For example, the federal government encourages consumers to purchase H.S.A. (Health Savings Account) qualified H.D.H.P.’s (High Deductible Health Plans) so they have more control over how their health care dollars are spent. Consumers who purchase an HSA Qualified H.D.H.P. can put extra money aside each year in an interest bearing account so they can use that money to pay for out-of-pocket medical expenses. Even procedures that are not normally covered by insurance companies, like Lasik eye surgery, orthodontics, and alternative medicines become 100% tax deductible. If there are no claims that year the money that was deposited into the tax deferred H.S.A can be rolled over to the next year earning an even higher rate of interest. If there are no significant claims for several years (as is often the case) the insured ends up building a sizeable account that enjoys similar tax benefits as a traditional I.R.A. Most H.S.A. administrators now offer thousands of no load mutual funds to transfer your H.S.A. funds into so you can potentially earn an even higher rate of interest.

In my experience, I believe that individuals who purchase their health plan based on wants rather than needs feel the most defrauded or “ripped-off” by their insurance company and/or insurance agent. In fact, I hear almost identical comments from almost every business owner that I speak to. Comments, such as, “I have to run my business, I don’t have time to be sick! “I think I have gone to the doctor 2 times in the last 5 years” and “My insurance company keeps raising my rates and I don’t even use my insurance!” As a business owner myself, I can understand their frustration. So, is there a simple formula that everyone can follow to make health insurance buying easier? Yes! Become an INFORMED consumer.

Every time I contact a prospective client or call one of my client referrals, I ask a handful of specific questions that directly relate to the policy that particular individual currently has in their filing cabinet or dresser drawer. You know the policy that they bought to protect them from having to file bankruptcy due to medical debt. That policy they purchased to cover that $500,000 life-saving organ transplant or those 40 chemotherapy treatments that they may have to undergo if they are diagnosed with cancer.

So what do you think happens almost 100% of the time when I ask these individuals “BASIC” questions about their health insurance policy? They do not know the answers! The following is a list of 10 questions that I frequently ask a prospective health insurance client. Let’s see how many YOU can answer without looking at your policy.

1. What Insurance Company are you insured with and what is the name of your health insurance plan? (e.g. Blue Cross Blue Shield-“Basic Blue”)

2. What is your calendar year deductible and would you have to pay a separate deductible for each family member if everyone in your family became ill at the same time? (e.g. The majority of health plans have a per person yearly deductible, for example, $250, $500, $1,000, or $2,500. However, some plans will only require you to pay a 2 person maximum deductible each year, even if everyone in your family needed extensive medical care.)

3. What is your coinsurance percentage and what dollar amount (stop loss) it is based on? (e.g. A good plan with 80/20 coverage means you pay 20% of some dollar amount. This dollar amount is also known as a stop loss and can vary based on the type of policy you purchase. Stop losses can be as little as $5,000 or $10,000 or as much as $20,000 or there are some policies on the market that have NO stop loss dollar amount.)

4. What is your maximum out of pocket expense per year? (e.g. All deductibles plus all coinsurance percentages plus all applicable access fees or other fees)

5. What is the Lifetime maximum benefit the insurance company will pay if you become seriously ill and does your plan have any “per illness” maximums or caps? (e.g. Some plans may have a $5 million lifetime maximum, but may have a maximum benefit cap of $100,000 per illness. This means that you would have to develop many separate and unrelated life-threatening illnesses costing $100,000 or less to qualify for $5 million of lifetime coverage.)

6. Is your plan a schedule plan, in that it only pays a certain amount for a specific list of procedures? (e.g., Mega Life & Health & Midwest National Life, endorsed by the National Association of the Self-Employed, N.A.S.E. is known for endorsing schedule plans) 7. Does your plan have doctor co-pays and are you limited to a certain number of doctor co-pay visits per year? (e.g. Many plans have a limit of how many times you go to the doctor per year for a co-pay and, quite often the limit is 2-4 visits.)

8. Does your plan offer prescription drug coverage and if it does, do you pay a co-pay for your prescriptions or do you have to meet a separate drug deductible before you receive any benefits and/or do you just have a discount prescription card only? (e.g. Some plans offer you prescription benefits right away, other plans require that you pay a separate drug deductible before you can receive prescription medication for a co-pay. Today, many plans offer no co-pay options and only provide you with a discount prescription card that gives you a 10-20% discount on all prescription medications).

9. Does your plan have any reduction in benefits for organ transplants and if so, what is the maximum your plan will pay if you need an organ transplant? (e.g. Some plans only pay a $100,000 maximum benefit for organ transplants for a procedure that actually costs $350-$500K and this $100,000 maximum may also include reimbursement for expensive anti-rejection medications that must be taken after a transplant. If this is the case, you will often have to pay for all anti-rejection medications out of pocket).

10. Do you have to pay a separate deductible or “access fee” for each hospital admission or for each emergency room visit? (e.g. Some plans, like the Assurant Health’s “CoreMed” plan have a separate $750 hospital admission fee that you pay for the first 3 days you are in the hospital. This fee is in addition to your plan deductible. Also, many plans have benefit “caps” or “access fees” for out-patient services, such as, physical therapy, speech therapy, chemotherapy, radiation therapy, etc. Benefit “caps” could be as little as $500 for each out-patient treatment, leaving you a bill for the remaining balance. Access fees are additional fees that you pay per treatment. For example, for each outpatient chemotherapy treatment, you may be required to pay a $250 “access fee” per treatment. So for 40 chemotherapy treatments, you would have to pay 40 x $250 = $10,000. Again, these fees would be charged in addition to your plan deductible).

Now that you’ve read through the list of questions that I ask a prospective health insurance client, ask yourself how many questions you were able to answer. If you couldn’t answer all ten questions don’t be discouraged. That doesn’t mean that you are not a smart consumer. It may just mean that you dealt with a “bad” insurance agent. So how could you tell if you dealt with a “bad” insurance agent? Because a “great” insurance agent would have taken the time to help you really understand your insurance benefits. A “great” agent spends time asking YOU questions so s/he can understand your insurance needs. A “great” agent recommends health plans based on all four variables; wants, needs, risk and price. A “great” agent gives you enough information to weigh all of your options so you can make an informed purchasing decision. And lastly, a “great” agent looks out for YOUR best interest and NOT the best interest of the insurance company.

So how do you know if you have a “great” agent? Easy, if you were able to answer all 10 questions without looking at your health insurance policy, you have a “great” agent. If you were able to answer the majority of questions, you may have a “good” agent. However, if you were only able to answer a few questions, chances are you have a “bad” agent. Insurance agents are no different than any other professional. There are some insurance agents that really care about the clients they work with, and there are other agents that avoid answering questions and duck client phone calls when a message is left about unpaid claims or skyrocketing health insurance rates.

Remember, your health insurance purchase is just as important as purchasing a house or a car, if not more important. So don’t be afraid to ask your insurance agent a lot of questions to make sure that you understand what your health plan does and does not cover. If you don’t feel comfortable with the type of coverage that your agent suggests or if you think the price is too high, ask your agent if s/he can select a comparable plan so you can make a side by side comparison before you purchase. And, most importantly, read all of the “fine print” in your health plan brochure and when you receive your policy, take the time to read through your policy during your 10-day free look period.

If you can’t understand something, or aren’t quite sure what the asterisk (*) next to the benefit description really means in terms of your coverage, call your agent or contact the insurance company to ask for further clarification.

Furthermore, take the time to perform your own due diligence. For example, if you research MEGA Life and Health or the Midwest National Life insurance company, endorsed by the National Association for the Self Employed (NASE), you will find that there have been 14 class action lawsuits brought against these companies since 1995. So ask yourself, “Is this a company that I would trust to pay my health insurance claims?

Additionally, find out if your agent is a “captive” agent or an insurance “broker.” “Captive” agents can only offer ONE insurance company’s products.” Independent” agents or insurance “brokers” can offer you a variety of different insurance plans from many different insurance companies. A “captive” agent may recommend a health plan that doesn’t exactly meet your needs because that is the only plan s/he can sell. An “independent” agent or insurance “broker” can usually offer you a variety of different insurance products from many quality carriers and can often customize a plan to meet your specific insurance needs and budget.

Over the years, I have developed strong, trusting relationships with my clients because of my insurance expertise and the level of personal service that I provide. This is one of the primary reasons that I do not recommend buying health insurance on the Internet. In my opinion, there are too many variables that Internet insurance buyers do not often take into consideration. I am a firm believer that a health insurance purchase requires the level of expertise and personal attention that only an insurance professional can provide. And, since it does not cost a penny more to purchase your health insurance through an agent or broker, my advice would be to use eBay and Amazon for your less important purchases and to use a knowledgeable, ethical and reputable independent agent or broker for one of the most important purchases you will ever make….your health insurance policy.

Lastly, if you have any concerns about an insurance company, contact your state’s Department of Insurance BEFORE you buy your policy. Your state’s Department of Insurance can tell you if the insurance company is registered in your state and can also tell you if there have been any complaints against that company that have been filed by policy holders. If you suspect that your agent is trying to sell you a fraudulent insurance policy, (e.g. you have to become a member of a union to qualify for coverage) or isn’t being honest with you, your state’s Department of Insurance can also check to see if your agent is licensed and whether or not there has ever been any disciplinary action previously taken against that agent.

In closing, I hope I have given you enough information so you can become an INFORMED insurance consumer. However, I remain convinced that the following words of wisdom still go along way: “If it sounds too good to be true, it probably is!” and “If you only buy on price, you get what you pay for!”

Satisfying Dental Care Needs in Raleigh

If you are relocating to Raleigh, North Carolina or the Research Triangle Park area, this information may help you find the best dentist to provide the level of care most appropriate for you and your family.

How Accessible Are Dentists in Raleigh?

In Raleigh, dental care is much more accessible than it is in many other parts of North Carolina. Raleigh is located in Wake County, which is one of eight North Carolina counties with dentist-to-patient ratios that exceed the national average. Sadly, the state of North Carolina ranks 47th in the nation in terms of dentist-to-patient ratios. While the state ranks low for dental care availability, Raleigh residents have great access compared to the rest of the United States. By combining June 2009 figures from the North Carolina Dental Board with 2008 census figures for Raleigh, one can extrapolate that there is a ratio of about one dentist per 1,350 residents.

What Kind of Quality Can I Expect?

The quality of care (as well as the number of dental providers) in Raleigh is influenced by the nearby University of North Carolina School of Dentistry in Chapel Hill, NC. Raleigh, the Research Triangle Park area, and neighboring cities and counties have exceptional access to dental care, thanks in large part to the presence of graduates of this school.

Founded in 1954, the UNC School of Dentistry has a national reputation for both research and education. Each year, the school admits about 80 students to its DDS (doctorate of Dental Surgery) program, with about 80% of those being in-state admissions. In the United States, schools of dentistry – unlike medical and law schools – have no official rankings. However, UNC is typically a top contender on unofficial lists. The nationwide respect for the UNC School of Dentistry program helps to validate the quality of dental services being provided in Raleigh by graduates of that school.

The North Carolina Dental Board is the regulating body for providers of dental services in North Carolina. Its mission is to ensure that the dental profession merit and receive the confidence of the public and that only qualified persons be permitted to practice dentistry and dental hygiene in the state of North Carolina.
What Types of Dental Providers Exist?

While the North Carolina Dental Board is the regulatory body, the North Carolina Dental Society is a professional organization that promotes the improvement of the public’s oral health and the art and science of dentistry. It encourages the maintenance of high standards of practice and competency, and represents the interests of members of the dental profession and the public that it serves. While membership in the professional organization is not mandatory, the North Carolina Dental Society provides figures that give some insight into the distribution of different types of providers of dental care in Raleigh. Raleigh members include dental providers in these commonly used categories: General Practice (142), Orthodontists (17), Oral/Maxillofacial Surgery (11), Endodontists (9), Pediatrics (8), Periodontists (7). June 2009 figures from the North Carolina Dental Board indicated that 264 dentists in Raleigh were licensed to practice General Dentistry. The combination of these two sets of numbers should provide for rough extrapolation on the number of specialized providers.

What Are the Emerging Trends in Dental Care?

In Raleigh, the provision of dental services is beginning to change, thanks to the progressive thinking of some dentists. This change involves making a broader range of dental care services available under a single roof. General dentists willing to invest in appropriate training can offer a broader range of dental care services, a concept sometimes referred to as Comprehensive Dentistry. Some also include Cosmetic Dentistry services. Having services provided under a single roof also eliminates the need to obtain consents and transfer dental records from one practice to another.

This emerging model for dental care in Raleigh has distinct advantages – one being that the dentist most familiar with the patient’s dental care and preferences can provide most, if not all, of the needed services in a familiar environment. A familiar environment can help to reduce the anxiety that some patients experience when they have to go to a (new) specialist to receive needed services. (Be assured that general dentists who provide a broader range of dental services do refer very complex cases to appropriate dental care specialists who focus on only one very specific dental care issue, and whose skills may be needed in those particular situations.)

Since specialists in Raleigh are not nearly as accessible as general dentists (see figures above), general dentists who offer a broader range of services can help provide more timely treatment for many “non-routine” dental needs (e.g., wisdom tooth extraction, periodontal treatments, orthodontics). Ask any prospective provider of dental care in Raleigh to explain the range of services the practice is making available to you, as well as the specific credentials of the dentist(s). You may also want to ask whether the practice is accredited by the state of North Carolina to perform sedation dentistry, because the state recently enacted guidelines and an accreditation process to ensure public safety in the administration of sedation in dental practices.