Never before has navigating the healthcare market been so complex, especially with recent rumors of increasing premiums and slashes to government funding for healthcare.
Understanding insurance benefits is like speaking a new language. What’s a subsidy? What’s cost-sharing? What does a small-group broker do? Not all of us are equally primed to learn this kind of terminology.
Amongst all the hype, there is also the glaring issue of separating truth from falsehood. Can you still qualify for health insurance if you have preexisting conditions? Are government-backed plans like Health Insurance Marketplace or Obamacare your only choices if you don’t have employer-sponsored health insurance? What if your spouse has a health issue but you carry the family’s health insurance and have been laid off?
Insurance benefits is one area where going to an expert makes sense. It can make the difference between high premiums or low ones, and large networks of doctors (PPO) to choose from or limited ones (HMO).
Your personal circumstances, including your type of work and health history, can determine your choices when it comes to insurance policies.
“Most people don’t realize they have options,” states Cherie Jones, Your Local Health Insurance Agent, who offers medically underwritten plans year-round. “What if your care is tied up with your current doctor, but that doctor won’t be participating in your network next year? Or you need to travel for work, or even relocate, and need your insurance benefits to extend nationally? There are just so many ways this can play out.”
Deconstructing the complexities of insurance jargon is one thing; purchasing an appropriate insurance plan is another.
“For example, the good news is that individuals can certainly obtain health insurance with preexisting conditions. Oftentimes, dental and accidental coverages may be added on. The main disadvantage here is that with marketplace options, you have to wait until open enrollment season (which occurs typically during November-December) or for a life-changing event like marriage, divorce, birth of a child, loss of coverage or a move,” she explains.
Educating consumers on misleading insurance offerings, which are abundant, is another piece of the puzzle.
“Companies have bought domain names to generate leads, then reach out to vulnerable populations through cold calling. They confuse people on what’s legit and what’s not. My hope is that I can get to people before they get scammed. ‘Zero deductible’ and ‘plan pays first’ are words that should raise red flags. Anybody can be an imposter and ‘sell’ you policies.”
“Unfortunately, there are a lot of people who care more about a commission than about you. That’s where I try not to be that person and surround myself with resources who can help when I can’t. When you’re a local agent, you can be held accountable; but if you’re on the phone with a stranger in a distant state, you can’t,” she continues.
This is why fact-checking is crucial in the insurance universe. For example, pinpointing the origin of an error in your billing statement can take hours of research, not to mention chasing down the culprit (was it the doctor’s office or the insurance company?). Another widely held rumor that deserves clarification is that currently there is no such thing as “Trumpcare”—it’s just spam to grab your attention and your personal information.
Yet another misconception in people’s minds revolves around company-provided continuing benefits like COBRA or state continuation and whether or not it extends to your family. In most cases, it does. While COBRA may be more expensive for older people than younger folks, the exact wording of your policy is what will ultimately dictate your costs and benefits.
Inspired by her parents, both former health insurance agents, Cherie has been helping the community understand industry trends and subsequent adjustments in insurance costs for over 10 years. In these changing times, it’s good to know that peace of mind is still accessible.
For more information, contact Cherie at 972.872.0247 or CHERIE.JONES@ushadvisors.com, or visit ushagent.com/cheriejones.
Unfortunately, there are a lot of people who care more about a commission than about you.