Importance of Insurance
WHAT DOES IT COST TO BE UNINSURED?
WHY INSURANCE IS IMPORTANT
THE DIFFERENCE BETWEEN GAMBLING AND INSURANCE
GOOD HEALTH IS MORE IMPORTANT THAN GOOD HEALTH INSURANCE
WHAT DOES IT COST TO BE UNINSURED?
One study concluded that the uninsured are three times likelier to die earlier than those insured. The study, by the Center for Health Policy at Georgetown University, involved 592,598 hospitalized people nationwide in 1987. It concluded, ". . . in 13 of 16 patient groups matched for age, sex, and race, researchers found the uninsured were sicker when they arrived at the hospital, as evidenced by their 44 percent to 124 percent greater likelihood of dying at that time."
Even more startling was the finding that the uninsured were ". . . 29 percent to 75 percent less likely to undergo each of five medical procedures that were costly or that allowed a wide degree of discretion in deciding whether they were needed." Doctors and hospitals hesitate to perform expensive tests or procedures if the patient can't pay.
It is definitely "healthy"' to have health insurance. No one wants to find himself or herself in a hospital unable to receive the treatment necessary because they do not have an insurance policy or because their current policy has numerous exclusions.
WHY INSURANCE IS IMPORTANT
"Well, it's not important. I'm healthy (never been sick), my wife is healthy and also my children. Insurance is a rip-off, a waste of money! I don't really need it!" If you were 100 percent sure you or your family will never get sick or injured tomorrow, next week or next month, it would be a rip off. Are you 100 percent sure? Do you know the future? If you are 100 percent sure that you will never get sick, you should "never" get insurance!
Unfortunately, no one is brilliant enough to see what tomorrow holds. But you say, "I will take my chances." Okay, but if you or your family gets ill or is injured, who will pay for it? Do you have $50,000 or $100,000 set aside for such emergencies? It could take $25,000 just to med-evac an injured family member to your home country. And what if the care was life long? What if a family member developed Crone's disease or diabetes, etc.? Now you need tens of thousands of dollars for life-long care.
I have a friend in Phoenix who, as a young college student, made a simple jump from a hillside and broke his back. He has been in tremendous pain for years. His medications are now costing him $2,000 a month. (By the way, he strongly believes in insurance.) Now, if you don't have money set aside for medical expenses, you will have to turn to your friends and family, or to your donor base if you are a volunteer worker. How will they feel? Will they consider you a good steward? And will they be able to finance your medical needs for years to come? Won't their charity eventually be exhausted? These are all very real questions of real situations that happen every day. The very existence of insurance companies is proof that insurance is meeting very real needs. It is important that all of us, especially overseas workers, have good health insurance.
THE DIFFERENCE BETWEEN GAMBLING AND INSURANCE
Risk is the possibility (uncertainty) that a loss might occur, and it is the reason people buy insurance. Some people think the risk you take with insurance is the same as the risk involved with gambling.
The risk in gambling is "speculative" risk. Gambling creates a risk situation that offers an opportunity for gain as well as for loss. Insurance deals with "pure" risk. With pure risk there is the possibility that a certain event will occur, e.g., accident or sickness.
What is the difference between insurance and gambling? The purpose of insurance is to restore the insured to his original position, not to afford the injured person the possibility of making a profit. There might be gain in gambling. In insurance there is no possibility of gain.
GOOD HEALTH IS MORE IMPORTANT THAN GOOD HEALTH INSURANCE
I've always tried following a healthy life-style, but on January 1, 1998, I made a serious resolution to really focus on my health for that year. What did I do? I lost some weight, became consistent in my exercise program, started taking some anti-oxidants, got a complete medical and dental check-up, started learning a bit about naturopathic medicine and organically grown foods, applied for a better health insurance policy, and took out Long Term Care insurance.
Our most valuable asset is our health, and we are the real experts on our body. There are many things we can do to improve this "temple" that we live in. We all know that smoking, drugs, drinking, and over-eating are detrimental to good health. Why not give ourselves a Christmas gift every day by dealing with those problems.
On the positive side we know that exercise is a plus. Many books and articles tell us that taking anti-oxidants is helpful. Since childhood we have had the importance of a balanced diet drilled into our heads. What about alternative medicine? Dr. Andrew Weil of the University of Arizona publishes a regular bulletin called “Self-Healing.” Interested in how to subscribe? Write me. Then there is the matter of natural foods grown organically. In many places our fruits and vegetables are permeated with insecticides, etc. I know that in Indonesia, where I worked for over 30 years, chemicals that were banned in the USA were readily available for all farmers to use.
Health insurance is certainly important to have, but good health is even more important. Start today getting your body healthy by focusing on healthy living for the rest of your life.
Understanding Insurance
DEDUCTIBLE IS NOT A DIRTY WORD
INSURANCE WAIVERS/RIDERS, RATE-UPS, & CAPPED COVERAGE
WHAT'S A “RIDER”? WHAT'S A “WAIVER”?
PRE-EXISTING CONDITIONS
WHAT'S A “PRE-EXISTING CONDITION”?
WHAT IS CO-INSURANCE?
EXCLUSIONS
WEIGHT, WEIGHT CHARTS AND HEALTH INSURANCE
AGE AND INSURANCE PREMIUMS
UNDERWRITING - WHAT IS IT?
TRIP OR HEALTH INSURANCE -- WHAT'S THE DIFFERENCE?
AMERICAN PPOs & HMOs - WHAT'S THE DIFFERENCE?
HIPAA / PORTABILITY INSURANCE
DEDUCTIBLE IS NOT A DIRTY WORD
HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations), to say the least, are not the best of friends! One thing HMOs do in their marketing is to claim that they have "no deductibles." Of course this is a slam at PPOs that have deductibles. Yet HMOs don't mention that if a client goes into the hospital on many of their policies there is a co-pay of $250 or $500. This large co-pay in some ways is similar to and often larger than some deductibles.
Also, most people don't realize that even though you may have a $500 deductible with a PPO you still have small co-pays if you visit a doctor. Generally, the doctor's office visit, lab work, and x-rays are all covered with just the co-pay with no extra charge to the insured. This is very similar to how HMOs work.
So, when does the deductible kick in? Usually for outpatient surgery, emergency room, and in- hospital stays.
"Deductible" is not a dirty word. In many ways it is just a variation of a large co-pay.
Most international policies are "classical" PPOs, and, according to my knowledge, none have co-pays. They could all be classed as “traditional” insurance; that is insurance that works from a deductible, co-insurance, and then total coverage.
INSURANCE WAIVERS/RIDERS, RATE-UPS, & CAPPED COVERAGE
Not one of us likes a "waiver” or “rider" on our health insurance coverage. A waiver/rider is an insurance company's method of excluding certain pre-existing conditions from coverage. For example, you have had surgery on a knee due to a soccer injury. The company places a rider on the knee, which means a recurring problem to that knee will not be covered.
What about a "rate-up"? Some companies will "rate-up" the amount of premium charged for the policy instead of using a rider, but this is not a general practice with international insurance companies.
The other method of covering pre-existing conditions is "capped coverage." In this situation the company does not cover the pre-existing condition for the first 24 months, and then limits coverage for the condition to $5,000 a year for the next ten years. This is better than no coverage on a pre-existing condition.
The best option is to accept a "temporary" rider. Often a company will remove a rider after 24 months if you have had no recurring problems with the pre-existing condition. Overall, a rider is preferable to capped coverage if there is a possibility the rider can be lifted at a later date.
WHAT'S A “RIDER”? WHAT'S A “WAIVER”?
These are terms insurance companies use to explain special exceptions to coverage in their insurance plans. For example, you may have injured your knee playing tennis and needed some minor surgery. Six months later you applied for insurance. On the application you mentioned your knee surgery. The underwriters at the insurance company decided that since the surgery was recent there was a notable risk of recurrence. Otherwise you were healthy, and they wanted to offer insurance, but they felt they could possibly lose money due to your knee problem. What do they do? They put a “rider” (“waiver”) on the knee, which simply means they will insure you but waive covering anything that happens to the knee. In other words they will insure your whole body except your knee. They will exclude covering anything that happens to the knee.
Sometimes these “riders/waivers” are permanent. Other times the company will issue a two-year, three-year or five-year rider. If the condition does not deteriorate or recur over a period of time, often they will “lift” the rider and give you full coverage. The option of using “riders” is good for the insurance companies and for the general public because it enables the companies to insure people whom they would otherwise decline to cover.
When purchasing insurance read the fine print relating to "Pre-Existing Conditions." This may determine whether or not the insurance will meet your needs.
Each company has their own definition of a pre-existing condition. Here is the definition of "Pre-Existing Conditions" taken from a policy that gives medical coverage for foreign nationals visiting the USA:
A pre-existing condition is defined as an injury or illness which was contracted or which first manifested itself; or for which manifestations of symptoms would have caused a prudent person to seek medical advice or treatment; or for which a licensed physician was consulted; or for which treatment or medication was prescribed within the five years prior to the effective date of the insured person's coverage."
The following is a “Pre-Existing Conditions” definition for a domestic policy offered in the USA:
Any injury or sickness, or any complications there from which is present or manifest itself, or for which medical care, treatment, advice or consultation was rendered to a Covered Person with the 12 months period prior to the Effective Date of Coverage. Any injury or sickness shall be considered to be present or manifest if the condition or symptoms exist prior to the Effective Date of coverage, even though no diagnosis, care or treatment were sought or received.
Different companies put a time limit on what is considered a pre-existing condition. The first company above gives a five-year look-back as the time span for determining a pre-existing condition. Among the various policies we handle the following time limits are given: 6 months, 12 months, 24 months, 5 years, 24 months, 60 months, etc.
Having pre-existing conditions does not mean that your insurance rates will be higher. But, if the pre-existing conditions fits into a company's definition for such, it may mean that those conditions will not be covered by your insurance.
Before you buy insurance get information on the "Pre-Existing Condition” clause. Otherwise, you may think some medical problem will be taken care of even though it is clearly excluded from coverage because it is a pre-existing condition.
WHAT'S A “PRE-EXISTING CONDITION”?
Technically, any medical condition that you have had prior to your application for health insurance with a given company can be considered a pre-existing condition. If you have been to a doctor about a sore elbow, even though it was four years ago and even though you received no treatment whatsoever, an insurance company could consider that a pre-existing condition.
Maybe you never went to a doctor, but had been aware for some time of a pain in your elbow. It didn't bother you continually, but every once in a while you took an aspirin to alleviate the pain. The pain in the elbow could also be considered a pre-existing condition.
Insurance companies vary on coverage for pre-existing conditions. Some will cover pre-existing conditions that were treated three years ago, others four years ago, still some even five years ago. You can generally find a statement about how an insurance company will handle a pre-existing condition by going to the “Exclusion” page in the insurance brochure.
Most of us, when we look at an insurance policy, ask, "What is covered?" That's a good question. Another good question is, "What is excluded from coverage?" Sometimes by studying the “Exclusion” section you will quickly determine that the policy will not work for you.
I have listed a few of the 34 items on one company's “Exclusion” list that say a lot about the policy: Pre-existing conditions; dental examinations; expenses of normal pregnancy; care of a new born child; treatment of acne; treatment for mental, nervous or emotional conditions or sickness; and treatment of Substance Abuse.
Often the "Exclusion” list is printed in such a way (small print, no paragraphs, etc.) that it is not easily read. Yet it is important that you check it out. Remember the old insurance adage: “The large print giveth and the small print taketh away.” The originator of the adage must have been thinking about the “Exclusion” list.
Often a person will take for granted that a condition is covered, only to find out that the condition was specifically excluded in the "Exclusion” list.
Most of us, when we look at an insurance policy, ask, "What is covered?" That's a good question. Another good question is, "What is excluded from coverage?" Sometimes by studying the “Exclusion” section you will quickly determine that the policy will not work for you.
I have listed a few of the 34 items on one company's “Exclusion” list that say a lot about the policy: Pre-existing conditions; dental examinations; expenses of normal pregnancy; care of a new born child; treatment of acne; treatment for mental, nervous or emotional conditions or sickness; and treatment of Substance Abuse.
Often the "Exclusion” list is printed in such a way (small print, no paragraphs, etc.) that it is not easily read. Yet it is important that you check it out. Remember the old insurance adage: “The large print giveth and the small print taketh away.” The originator of the adage must have been thinking about the “Exclusion” list.
WEIGHT, WEIGHT CHARTS AND HEALTH INSURANCE
As insurance brokers, the first thing we do after asking a person for their age, is to ask for their weight. Most of us don't enjoy divulging that information, but in order to suggest an insurance plan for you, it is absolutely necessary.
Insurance companies know that a person's weight has a great bearing on their overall health. Therefore, they have all generated “Weight Charts.” The charts are similar but not identical. According to the chart of one company you might be considered uninsurable, whereas another company would consider your weight within their guidelines. So don't be discouraged if one company declines you for coverage due to weight--just contact another company.
Sometimes companies will not give weight charts to brokers, therefore, in some cases we can only guess if the company will consider you overweight. And by the way, they also have minimal weight guidelines. You can actually be declined if you are underweight.
A few companies will accept you for coverage if you are overweight, but they will rate up your premium by 15 or 20 percent. That is certainly better than being declined coverage. What happens if you lose weight? If you have a doctor's report that you have lost weight, you may be able to get the company to discontinue the rate up on your premium after you have been on the plan for a year.
Sometimes if your weight is still acceptable, but you have high blood pressure and cholesterol problems, you will still be declined. The correlation between weight and certain diseases may make an insurance company cautious about offering coverage.
The good news is that we have some three-year plans that are “guarantee issue” plans and never ask concerning your weight. If you feel you may be overweight for health insurance coverage, contact us, and we will help you sort through the weight charts and options for health insurance coverage.
Often we receive requests for a health insurance quote with no age given. It is not possible to give a quote without knowing a person's age. Why is age so important? Because your medical needs vary depending on your age. For example, women ages 22-40 will be charged a higher premium because these are childbearing years. Young men in their twenties will pay lower premiums because they tend to demand less medical care. Men over 55 will begin paying higher premiums than women of the same age because of men's tendency toward high blood pressure, stroke, etc. Insurance companies have done very detailed studies over the years, and know which ages will demand more medical care. They adjust the premium charged to make sure they do not lose money on any age group.
Some insurance companies increase the rates they charge each year you advance in age. Others only increase rates every five years or ten years. For example, one company breaks down the various age levels as follows: 14 days-18 years, 19-29, 30-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74.
As long as you get your application in and ask for an effective date, even a day before your birthday, you will get the rate for your requested age. Thus if a person is turning 60 on January 1, and he get his application in and asks for a Dec. 31 effective date, he will get the rates for a 55-59 year old. According to one of my plans, that would save a person who is 59 years old approximately $1,200.
Underwriting is no more than a process to determine if you are an insurable risk. The people who do the research and make the decisions about your insurability are called underwriters. In a sense all of us do underwriting every day, for it is no more than an evaluation of risk. Every time you cross a street, you underwrite the situation first by determining if you can get across without being struck by a car. In other words, you determine if there is any risk involved.
Insurance is a business with a bottom line. When a person applies for insurance, and has a medical condition, i.e., bone cancer in his left foot that the medical profession has been treating for ten years at a cost of $3,000 a month, will an insurance company insure him with a premium of $100? The underwriter will look at the records, and if good reason indicates that medical treatment will continue at $3,000 a month, the insurance company would be foolish to insure the individual. By so doing they would lose at least $35,000 a year. If they insured many cases like that, they would go bankrupt or have sky-high premiums.
As a rule the companies with the tightest underwriting guidelines have the best rates and are the best companies to insure you. Because they are careful who they insure, they will remain stable and be able to keep their rates lower than average.
The underwriter has one task--to determine risk, to determine what possible financial outlay may be necessary to care for a person's medical condition. If they calculate the possible outlay as excessive, the applicant is declined medical coverage. You wouldn't insure a burning building; likewise, underwriters make sure that their companies do not insure us if it is certain that we have a medical condition that might cause the company to lose money.
When they do insure us, and we then develop medical problems, they are required by law to cover our expenses. But the underwriters made a decision before the medical condition arose (or with the knowledge of a present medical condition), that we were an insurable risk.
TRIP OR HEALTH INSURANCE -- WHAT'S THE DIFFERENCE?
"Short-term Health Insurance" can be very similar to "Trip Insurance." Here is the main difference: "Trip Insurance" focuses on insuring the cost of your trip, e.g. airline tickets, hotel reservations, etc. It may include minimal health insurance and medical evacuation coverage, but first and foremost the goal is to make sure you are reimbursed money you will lose if your trip is cancelled.
"Short-term Health Insurance" focuses on insuring you in case of illness or injury. It usually has good medical evacuation coverage and maximum medical coverage up to $1,000,000. Sometimes Short-term Health Insurance also includes minimal trip cancellation coverage, lost baggage coverage, etc. If you want to see a "Trip Insurance" policy, please go to <www.onlinetripinsurance.com>.
AMERICAN PPOs & HMOs - WHAT'S THE DIFFERENCE?
In an HMO (Health Management Organization) you must choose a PCP (Primary
Care Physician). This physician will be your "Care Manager" in the health care system. Your PCP, if he finds it necessary, will generally refer you to a specialist working within the HMO. He directs all of your medical care, making sure you don't receive unnecessary services. Sometimes the PCP is referred to as the "Gate Keeper" because he opens the gate and directs you to other providers within your HMO system.
A PPO (Preferred Provider Organization) is a network of medical and health care providers who agree to provide services for a specific amount and adhere to medical utilization guidelines. In a PPO you do not have a Primary Care Physician (although you may choose to have a physician function in that way). Instead you are given a list of physicians that work within a network. You can choose any physician you like and a different physician every time you have a medical need as long as you choose them from the list of doctors provided by the PPO, that is, as long as the physician is in the PPO network. Some PPOs have thousands of physicians in their network.
Some people feel HMOs are better than PPOs because they generally hold down the cost of premiums. They do this because the physician controls the extent of the care given. Others feel PPOs are better because the patient has more freedom and say in the choice of physicians and treatment.
Several years ago the Federal Government in the USA passed the Kennedy/Kassenbaum Law. This law required insurance companies to offer health insurance coverage to US Citizens that met several conditions. If the individual had been on group health insurance for 18 months, did not have a gap of more than 63 days in coverage between the end of his group coverage and his application for HIPPA coverage, insurance companies were required to offer him coverage.
This is a wonderful benefit for a person who has major health problems and would not otherwise be insurable. Without this option many Americans would not be able to get insurance at all.
But there are a few caveats. The companies that offered HIPAA (Health Insurance Portability and Accountability Act) were allowed to rate up the HIPAA plans by 400 percent compared to their regular plans. Also, if the person had not been on group insurance, they did not have to offer coverage.
We have found that sometimes insurance companies will offer the HIPAA coverage even if the person has not been on group coverage. We have also found that international health insurance companies will provide COIs (Certificates of Insurance) explaining the dates a person started and discontinued group or individual insurance. We have found that individuals seeking to go on HIPAA coverage have had little difficulty apart from the rates.
I should also mention that companies seldom rate up their plans by 400 percent. Usually the increase is about 200 percent over standard plans.
Always get a “Certificate of Insurance” when you discontinue a job or lose your insurance. And make sure you apply for further coverage right away. If you exceed the 63-day window, they can refuse you coverage.
Choosing an Insurance Plan
CHOOSING A HEALTH INSURANCE PLAN-- WHAT TO LOOK FOR
CHOOSING A HEALTH PLAN
AVOID BEING DECLINED FOR HEALTH INSURANCE
CONTROLLING UNBEARABLE INSURANCE RATES
SPLITTING POLICIES--A WAY TO SAVE MONEY
HOW LARGE A DEDUCTIBLE SHOULD I CHOOSE?
HIGH OR LOW DEDUCTIBLES--WHAT'S BEST?
WANT TO SAVE MONEY? CHOOSE A HIGH DEDUCTIBLE
HOW MUCH SHOULD I REVEAL ON MY APPLICATION?
AUTOMATIC CREDIT CARD DEDUCTIONS
CHOOSING A HEALTH INSURANCE PLAN-- WHAT TO LOOK FOR
(1) You want to make sure it is really "health insurance" and not a "caring" or "sharing" plan. These plans have worked for some, but many participants have been disillusioned.
(2) Check out the A.A. Best Rating for the company that underwrites the plan. This is not hard to obtain. An A+ rating is good, but a B+ is often
acceptable for health insurance companies.
(3) Check out the company administering the plan. These companies are called "Third Party Administrators" (TPAs). Some TPAs that have been around for a while and have grown large give poor service, while younger and smaller TPAs give good service. So don't turn a TPA down just
because it is small.
(4) Read the plan carefully to make sure the benefits match your needs, e.g., does the plan have maternity, medical evacuation, preventive care, etc? What is the policy regarding pre-existing conditions? Do they rider/waiver them or give limited coverage?
(5) Have their annual price increases been reasonable? At the present time "reasonable" would be somewhere in the 8 percent to 15 percent range.
(6) Do they offer the deductible you desire? Remember, the most cost-effective deductible is generally $1,000.
(7) How do they handle co-insurance? Do you pay co-insurance overseas
or only in the USA?
(8) What is excluded from coverage? All insurance brochures have an "exclusion" section. Read that section carefully. Remember this key proverb when purchasing health insurance: THE LARGE PRINT GIVETH AND THE SMALL PRINT TAKETH AWAY!
(9) How good is the company at paying claims? Ask your broker this question. If he has represented the company for a year, he will have a pretty good idea of the speed with which claims are paid. Remember, the bottom line is that insurance is only as good as the claims-paying ability of the company.
(10) Finally, it is best to work through a broker who represents several
companies. An agent technically represents just one company. If so, he only puts bread on his table if he sells you his product. A broker is different. He helps you search for a policy that will work for you, and is not dependent on selling you a specific plan. The good news is that Good Neighbor Insurance is a brokerage that represents seven major international health insurance companies. Thus we have a wide array of health plans from which you may chose.
How do people choose health plans? The Kaiser Family Foundation and Agency for Health Care Policy and Research did a telephone survey of 2,006 adults designed to find out what they are concerned with when it comes to health.
In choosing a health plan, people say quality of care is the biggest concern (42%), over low cost (18%), a wide choice of doctors (17%), and a range of benefits (14%). However, what most people say ultimately sways their decision is a personal recommendation from their doctors (59%) and family members and friends (57%).
Seven out of ten people regard their family and friends as "good" sources of information about health plans because they share common concerns. Employers, on the other hand, are seen less favorably. Nearly six out of ten say employers are not a good resource because they cannot be trusted to provide reliable information about the quality of different health plans "because the employer's main concern is saving money on health benefits."
AVOID BEING DECLINED FOR HEALTH INSURANCE
Many insurance applications ask: Have you ever been declined when applying for health insurance? It is good to avoid being declined so that you will never have to say “Yes” to that question. The best way to avoid a declination is to “Pre-qualify.” Good Neighbor Insurance provides an electronic “Pre-qualifying Medical Questionnaire” that you can fill out and return to us. We then run this by the various insurance companies to see how they will handle your application. If one company says that you might or would probably be declined if you applied, you can avoid applying for insurance with that company and thus avoid being declined.
It is always best to fill out the “Pre-qualifying Medical Questionnaire” for it aids us in giving you appropriate advice about what plans will give you the best coverage. If you are interested in seeing if you qualify for career health insurance plans, let us know. Of course, you never have to pre-qualify for short-term plans. They are “guarantee issue” plans that ask no medical questions. You are automatically covered once you submit your application to the insurance company.
CONTROLLING UNBEARABLE INSURANCE RATES
This is an annual problem for those who have international health insurance. Let me give several suggestions:
(1) Choose a high deductible of at least $1,000. A deductible of $2,500 or $5,000 is better yet if you have some reserve money in savings. This will have a definite impact on your insurance premium.
(2) Choose a policy with "capped" coverages. Instead of guaranteeing an unlimited amount of money for a normal childbirth, they limit the coverage to $4,000. That is enough to cover the delivery of a baby almost anywhere in the world.
(3) Choose a plan with less maximum coverage. Instead of getting $1,000,000 or $5,000,000 in coverage, settle for $500,000.
(4) Select a short-term plan. Some short-term plans can be renewed up to three years.
(5) Choose a career plan that will not cover you in the USA. Then, when coming on furlough, take out a short-term plan that will cover you during your visit.
(6) If you need maternity, put your wife on a maternity plan and yourself and children on a non-maternity plan. This will often save $40 a month or more.
None of these are "ideal" solutions, but if you start with one of these and after a year your financial situation improves, you can then upgrade your insurance coverage. If you are putting out $200 a month now for insurance, in a couple of years bumping that up to $300 for a better plan will be easier than going from $0 for no insurance to $300 now.
SPLITTING POLICIES--A WAY TO SAVE MONEY
We generally like to have Dad and Mom and the kids all on the same health insurance policy. But sometimes you can save a lot of money by splitting the family up and putting different members on different policies. For example: A couple in their thirties with two children ages 10 and 12 would pay a monthly premium of $363 on an international policy that offered maternity. By putting dad and the two children on a non-maternity plan and leaving mom on a maternity plan, the total monthly premium would drop to $231. This would give a monthly saving of $132. There are variables involved here, e.g., deductibles and total coverage. And of course you will need insurance cards from two different companies. But the inconvenience would mean $132 extra every month in your pocket. That will add up to $1,584 in a year, and would easily pay for Christmas presents or some plane tickets!
HOW LARGE A DEDUCTIBLE SHOULD I CHOOSE?
Deductibles run all the way from $100 to $10,000 depending on the plan. Usually the rates drop dramatically between $500 and $1,000. Thus we seldom encourage a person to take out a $500 deductible. I think the best buy is the $1,000 deductible.
Generally speaking, if we are pressed, we can find $1,000 to cover the deductible in a medical emergency. And the money saved in lower monthly premiums will in a very few months add up to that $1,000.
Co-insurance is another matter to keep in mind. Most companies run a 20/80 plan in the USA with no co-insurance when outside the USA. What does this mean? It means that if you have a medical situation in the USA, you will need to pay your deductible plus 20 percent of the next $5,000. In a worse case scenario, you will be out $2,000 ($1,000 for the deductible and 20 percent of $5,000 which is another $1,000). Overseas some companies waive the co-insurance and only require you to meet the deductible.
HIGH OR LOW DEDUCTIBLES--WHAT'S BEST?
High deductible plans are more cost-effective, thus they are better if you are basically a healthy person. I am in my early 60s, and have not been in a hospital for over 30 years. If the difference in the premium between a $500 and $5,000 deductible was only $100 (and usually it is more), a $5,000 deductible would have saved me $36,000 over that 30-year period. That money could have been put in a personal medical savings account in order to meet a deductible if I ever needed surgery. If surgery was not needed, I would have a substantial savings account. And this is only calculating the premium I would have saved on my own personal insurance. I have not calculated in the savings for my whole family. And what about interest income on $36,000? And all of that time I would have been protected from the cost of a major medical catastrophe, e.g., a major operation.
WANT TO SAVE MONEY? CHOOSE A HIGH DEDUCTIBLE
More and more, even in domestic insurance, people are looking for a high
deductible. That simply means the amount of money the client pays before the insurance starts to cover medical costs. Many people used to ask for a $100 or $250 deductible. We are advising clients to consider a $1,000 deductible. That sounds unreasonably high to many people. Yet the premium savings are so significant that generally the money saved in one year from lower premiums (the higher the deductible the lower the premiums) will more than make up for the higher deductible if a person had to use insurance for hospitalization.
Most of us, in a crunch, could find $5,000. It is the $50,000 and $100,000 bill that scares us. We do have clients asking for $5,000 deductibles. And we do have plans that offer $10,000 and $20,000 deductibles. One way to look at this is to ask yourself, “How many years since I have been hospitalized or had a health insurance bill over $5,000?” If it has been a long time, and you are in relatively good health, maybe a $5,000 deductible would work for you.
HOW MUCH SHOULD I REVEAL ON MY APPLICATION?
As little as possible? Everything? Neither answer is correct. If you don't answer all the questions correctly and fail to give important details concerning the state of your health, the company holds the right to rescind your coverage. I know of a case where an individual failed to reveal a skeletal problem because he did not consider it significant. He was accepted for coverage, and later had an abdominal operation. Before paying the claims for the operation the insurance company discovered the failure to report the skeletal injury. They rescinded his coverage, and would not pay for the stomach surgery.
We have had several cases where the insurance company, after the fact, discovered medical conditions not revealed on the application. They rescinded coverage and returned all premiums. So you need to be forthright about your medical conditions.
But often applications will put a time limit on the questions, e.g., asking you to reveal medical conditions in the last five or ten years. If that is the case, don't reveal what happened 15 years ago. And you do not need to reveal all minute details concerning your condition. If the insurance company feels they need more details, they will contact you for medical records.
Generally, if an applicant errs in this matter, he/she errs in not giving enough information. Remember, it is much better to give too much information. That way you won't be shocked by a letter from the insurance company saying that the claims are not going to be paid and your insurance is rescinded (cancelled by the insurance company) just when you need it!
AUTOMATIC CREDIT CARD DEDUCTIONS
Most insurance companies are seeking to cut their administrative costs. One way they do that is by encouraging automatic credit card deductions for your premium payments. Very few international companies will bill a client on a monthly basis or permit a monthly payment to be sent in. And if they do, the insurance is generally more expensive.
One of the major benefits of the credit card deduction is it insures that your policy will not lapse. As an insurance broker, I have seen this happen several times where a good client, because of a busy schedule or forgetfulness, failed to mail in the monthly premium. In one case, my client had to wait almost two years to find someone to insure her.
So the automatic credit card deduction is your "insurance" against losing your insurance. When applying for long-term (career) health insurance, ask about this option.
Managing Your Insurance
KEEP YOUR INSURANCE ACCOUNT CURRENT
GETTING THE MOST MILEAGE OUT OF YOUR INSURANCE
PREVENTIVE CARE
PRE-CERTIFICATION
RENEW YOUR CAREER PLAN OUTSIDE THE USA
CLAIMS REIMBURSEMENT--WHY IS IT SUCH A PAIN?
KEEP THOSE MEDICAL RECEIPTS
INSURANCE CLAIMS
HOW DO I GET MY NEWBORN ON MY INSURANCE PLAN?
RENEWED POLICIES MORE EXPENSIVE THAN NEW POLICIES!
APPLYING FOR HEALTH INSURANCE ONLINE
KEEP YOUR INSURANCE ACCOUNT CURRENT
Keep your insurance account current! Two of our insured friends, for various reasons, failed to pay their insurance premiums; therefore, their insurance policies were terminated. I understand this problem. Sometimes I have a hard time coming up with my premium, too. The problem is that you don't know when sickness will strike, and if your insurance is terminated because of lack of payment, there will be no coverage.
One person told me that he paid his insurance faithfully for years, forgot to pay the premium, was terminated, and two months later became quite sick and ran up huge medical bills. He had to pay for everything himself, just as if he had never had insurance.
Another sound reason for keeping your account current is that a company is not obligated to reinstate you if you developed some sickness during your coverage and then you were terminated. For example, if you had coverage, developed high-blood pressure, forgot to pay your premium and then terminated, the insurance company could then consider the high-blood pressure as a pre-existing condition and not reinstate you. So, to get the most mileage out of your insurance, keep your account current!
GETTING THE MOST MILEAGE OUT OF YOUR INSURANCE
Here are some rules that help us when we have domestic insurance coverage. They are also practical for those insured with international coverage.
[1] Pre-certify -- Make sure the insurance company approves the medical care you are requesting.
[2] Be familiar with and use all "Preventive Care" benefits included in your policy.
[3] Keep your account current by mailing your premium in on time or using automatic payment options.
[4] Remember which, if any, of your pre-existing conditions are not covered by your insurance.
[5] Keep detailed records of all medical procedures, receipts for payments, etc. in a file that you up-grade annually.
[6] Only patronize health care providers/services that are listed in your network/provider directory or approved by your carrier.
We look at health insurance for the needs of today. With the information that we have at our fingertips, we have learned that preventive care is very important for our health and also for our pocketbooks. Fortunately, health insurance companies feel the same way. Some USA domestic companies have special "Healthy Babies Program for Baby and Mom" with no co-pays for pre- and post-natal visits, a nurse advice line, health information library messages on over 25 topics, and a free baby monitor for new mothers who receive routine pre-natal care. Others give a huge range of discounts in chiropractic care, massage therapy, health and fitness, vitamins, herbs, and supplements, eye care, and rebates on car seats and sport helmets. For a doctor's co-pay, some allow physical exams, GYN exams, pap tests, mammograms, and PSA blood tests to be done.
Unfortunately, at the present time, international plans do not have such generous preventive care benefits. Here is what is offered by the three major career plans that Good Neighbor carries:
Plan 1 - $150 wellness per Certificate Period (after 24 months of continuous coverage) for Members age 35 or older. Not subject to deductible.
Plan 2 - $50 policy period maximum for checkups and routine visits. Well childcare: usual, reasonable and customary charges for policy maximum are covered, limited to three visits per policy period (after deductible).
Plan 3 - One health check-up per policy year, maximum all-inclusive, not more than $110.
Pre-certification means that the insurance company and medical foundation must approve the medical care you are requesting. Sometimes this is called "utilization review." You are given a phone number to verify that the medical treatment you are requesting will be paid for by your insurance. This is how insurance companies make sure that no undue operations or medical procedures take place. By so doing they are able to keep insurance premiums lower for each of us. The real question pre-certification seeks to answer is: "Is the care being requested by the client 'medically necessary?'"
Companies have different policies as to when pre-certification takes place. Some say you must pre-certify seven days before an operation, others two weeks. Some say only 48 hours. Of course emergencies are a different matter, but even those must be reported to the company within a specific time limit. Read your policy to determine pre-certification requirements. Of course pre-certification is not necessary for ordinary visits to your physician. But for major care, MRIs, x-rays, lab work, in-patient and outpatient surgery, ALWAYS call the pre-certification number on your insurance card. The rule of thumb: If in doubt whether your insurance will cover a medical expense, phone your pre-certification number first and find out.
Also remember that your insurance may not cover what your doctor insists is "medically necessary" care. For example, a person may have an alcohol problem, and the doctor suggests treatment for substance abuse. The treatment may be "medically necessary," but the insurance policy may exclude coverage for "substance abuse." Carefully read the "exclusion" page of your policy. Remember the rule: When you are considering any major medical care or expense, always pre-certify.
RENEW YOUR CAREER PLAN OUTSIDE THE USA
REMEMBER, with most international health plans, if you renew while in the USA you will need to leave the USA in 30 days. The international insurance companies require this in order to satisfy the Department of Insurance (DOI) guidelines in the various states. The DOI is concerned about protecting domestic insurance companies; therefore, by requiring a person who applies for and/or renews his policy to leave the USA in 30 days is one way they do it.
The insured under an international policy should make sure that he/she is outside the USA at the time of renewal, or, if in the USA, he/she will be leaving for overseas within 30 days. If you do not follow these guidelines, your policy will not be renewed.
For a pregnancy, this could be a real concern. With all international career policies you get at least six months of furlough coverage in each policy year. Try to work it out that your renewal period does not happen during your furlough when you may be waiting for the delivery of a baby. If it does, and you live near the Canadian or Mexican border, that will be no problem. You can just drive across the border and spend a night to satisfy the “leaving the USA” requirement. But if you are a distance from the border, that would be difficult.
CLAIMS REIMBURSEMENT--WHY IS IT SUCH A PAIN?
I have never met an insured person who enjoyed dealing with claims. It always is difficult and often a nightmare. Why is that so? Well, if you are covered with a short-term plan, medical underwriting is always done after the injury or illness. The insurance company needs to be double sure that the claim is not related to a pre-existing condition. Pre-existing conditions are not covered in short-term plans. If your claim is valid, you may wonder why they won't accept your initial explanation as an honest explanation. Well, lying is endemic in our world, and insurance companies lose millions of dollars every year due to fraudulent claims. If they want to stay in business, they must check out every claim before they pay it.
If you are on a long-term plan, paying claims moves a little faster. The company already asked you many medical questions when you applied. Nevertheless, they will still research your claim to make sure your injury or illness was not related to a pre-existing condition you failed to reveal on your application.
Another problem is that clients often forget to calculate their deductibles and co-insurance when requesting a claims reimbursement. As a result, the reimbursement does not match their expectations. If the client has a $1,000 deductible and an 80/20 co-insurance plan with a medical bill of $10,000, he can only expect to be reimbursed $8,000. The client must pay the $1,000 deductible plus 20 percent of the first $5,000 (e.g., $1,000). Even though many international plans waive the co-insurance while overseas, co-insurance must be paid in the USA.
In a related matter, remember that you must pay your medical bills first and then be reimbursed by the insurance company. This is because American insurance companies do not have direct business relationships with medical providers outside the USA.
In order to have a happier experience when dealing with claims, keep copies of all medical bills/expenses you pay out in a special folder. Update this folder yearly. When making a claim, use your company's claim form and send along copies of all your bills. Keep a detailed history of all your contacts with the insurance company: when you wrote them, who you talked with, what they said, etc. Be ready to wait at least six months to have your claims reimbursed. Remember that the claims department handles hundreds of claims every day. And their way of calculating your claims may be very different than yours. Ask them for an explanation when you are disappointed with the outcome. Overall, we have found the companies we work with to be fair although very careful when handling claims.
Make sure you keep copies of all letters, invoices, etc. from your insurance company and doctor's office. Also note carefully all medical procedures and the dates they were performed. Having all this information close at hand will come in handy if you have insurance claims. We suggest that you start a new medical folder at the beginning of each policy year. Keep records of all medical bills, charges, procedures, etc. for that year in this folder. This way you will be able to know how close you are to reaching your deductible. When you submit a claim also send copies of all receipts. Keep the originals for your files. Remember--sloppy record keeping can affect your payback on claims and also cause a great waste of time.
The wait for reimbursement of an insurance claim always frustrates us. Why does it take so long? In this matter we need to remember that if we take out a "guaranteed issue" policy, a policy where they ask you four or five simple questions before you are accepted for coverage, claims will take longer. The company does the underwriting after you post the claim. They need to make sure your claim has nothing to do with a pre-existing condition.
PPO plans take more time for claims reimbursement because they want to double check to make sure the claim is not based on a pre-existing condition that was not stated in the application.
It's probably good to remember that if an insurance company takes time to research the validity of claims, in the end they are saving you money. Insurance fraud costs insurance companies millions of dollars every year, and we, the insured, pay for those lost dollars through higher premiums. Every time an insurance company can avoid paying an unjustified claim, we are the winners because it helps the company control our monthly premiums. Although that may make us feel better, patience while waiting for a claim to be paid is still a difficult art to master.
HOW DO I GET MY NEWBORN ON MY INSURANCE PLAN?
Even though a couple may have a very good insurance plan, a newborn is not automatically covered on their family plan. In the USA, all parents have the option of putting their newborn on their family policy during the first month of life. International policies don't always work that way. You will need to submit an application for the baby in order to get coverage. The insurance company will then send the application through underwriting and make a decision on coverage based on the baby's health.
On most of the career plans the two youngest children under nine are covered free of charge; so if you have only two children, adding your new baby to your policy will not require any extra premium.
Also keep in mind that most international health insurance companies want you to notify them within the first three months of pregnancy. Failing to do this could cost you some benefits.
RENEWED POLICIES MORE EXPENSIVE THAN NEW POLICIES!
Many who have had an insurance policy become upset when they see that the premium they are paying at renewal is more than they would pay if they reapplied for the same policy. Why is that so? Here is one reason: If 100 people, ages 20-29, buy the “Select Health” plan of ABC Company in 2001, this is considered a “Book of Business.” The insurance company then monitors this “Book of Business” to make sure there is no loss--that is the premiums received at least equal claims. If claims are greater than premiums received, then the company raises the rates to compensate. So in a given year the renewal rates on this “Book of Business” could increase while the standard rates for the “Select Health” plan stay the same. Of course, and generally every year or two, the new rates for the plan will be increased too.
So, is it good to switch plans? Sometimes! But if you are on a plan that will not cover pre-existing conditions before you have been on the plan for 24 months, if you switch plans you will have no coverage for pre-existing conditions for another 24 months. Also, some companies will not permit you to cancel an old policy and re-purchase. But if you feel you will save money, you always have the option of switching companies. Another reason to be careful would be due to pre-existing conditions. If one company accepted you without a rider on a pre-existing, that does not mean the next company will. If you have pre-existing conditions covered, it might be good to stay where you are.
APPLYING FOR HEALTH INSURANCE ONLINE
Ninety percent of the plans offered by Good Neighbor Insurance can now be purchased online.
Below are a few things to be aware of when applying online:
Do not apply online if you are not sure what you are getting. Study the health insurance plan you are purchasing, especially the benefit page and the exclusion page. If you cannot find an exclusion page on the web site, do not purchase online.
Before you purchase online, check to see if there is a telephone number for an agent somewhere on the site. Write the number down and have it handy if you run into a problem. Be sure to also record the web site address so you can find it again if necessary. As a general rule, the larger your investment the more careful you want to be when purchasing international health insurance online.
What are the advantages with an online purchase? First, it is often quicker. Second, in most cases, you receive an immediate confirmation of coverage. Generally, an online purchase for short-term health insurance can speed up delivery of your medical ID cards and policy by two-three days. Third, an important advantage is that you can apply while outside the USA, away from contact with an agent or insurance personnel. You can purchase via a friend's computer or in a computer kiosk and at any time. So applying online and knowing how to apply online for international short-term health insurance gives you much flexibility.
Insurance for Special Situations
INSURANCE FOR HOME COUNTRY VISITS
COVERAGE ON BOTH SIDES OF THE OCEAN
FINALLY! CAREER HEALTH INSURANCE FOR SINGLE WOMEN
INTERNATIONAL HEALTH PLAN WITH PERMANENT USA COVERAGE
COVERAGE IN WAR ZONES
OVERSEAS COVERAGE FOR AMERICAN MEDICARE RECIPIENTS
RETIRING IN THE USA, BUT CAN'T GET ON MEDICARE?
INTERNATIONAL PERSONAL LIABILITY INSURANCE
FURLOUGH INSURANCE
GET UP TO TWO YEARS OF HEALTH COVERAGE WHEN RETURNING TO THE USA
HIGH LIMIT ACCIDENT / TERRORISM INSURANCE
MED-EVAC -- DO YOU NEED IT? IS IT WORTH IT?
HEALTH COVERAGE FOR THE FREQUENT INTERNATIONAL TRAVELER
INSURANCE FOR HOME COUNTRY VISITS
The problem with many (most?) international (non-American) health insurance plans is that they will not cover Americans when furloughing in the USA. We have solutions for that problem. One of our plans permits you to use your non-USA address as your residence and then take out short-term insurance as a foreign national visiting the USA. This plan is only for those who are planning to return overseas. Thus you can get coverage for one year of furlough. If you are returning to the USA after several years abroad and need insurance to cover you while settling in, we have another plan for you. It is a plan that can be used for immigrants or Americans that are returning permanently to the USA. If one of these scenarios describes your situation, please contact us so we can help you find such home country coverage.
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COVERAGE ON BOTH SIDES OF THE OCEAN
One of the most frequent questions asked is, "Will this plan cover me in the USA too?" We do have plans that cover you on both sides of the ocean, but there are limitations. Several of the career insurance plans will cover you for six months in the USA, as long as you are outside the USA six months in any given year. These plans will also cover you for one month before you leave the USA for your initial overseas assignment.
There are some folks who prefer a 12-month furlough. We have one plan that will cover you in the USA for a 12-month stretch, as long as you have been outside the USA for 12 months. Short-term plans will cover you in the USA too. Some have furlough riders; others give you two weeks of coverage in the USA. One plan grants five days of coverage in the USA for every month overseas, with a maximum of two months of coverage in the USA in a policy year.
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FINALLY! CAREER HEALTH INSURANCE FOR SINGLE WOMEN
Often we hear the question, "Why do young single women pay such high rates for health insurance?" Because they are paying for maternity coverage. Even if they are single? Yes! Some companies are finally providing career health insurance coverage for single women that does not include maternity. This means it is less expensive, cutting health insurance costs in some cases by as much as 35 percent.
If you are a single woman, you no longer need to buy career insurance that covers maternity. Now you can save a good deal of money and have the highest quality, long-term career medical insurance. If you would like a health insurance quote for yourself on these unique plans, please contact us.
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INTERNATIONAL HEALTH PLAN WITH PERMANENT USA COVERAGE
Some workers continue to ask for plans with high deductibles that will give them ongoing coverage if they relocate back into the USA. Almost all international health plans require that you spend at least half of your time outside the USA. Thus, if you return permanently to the USA, you are forced to find a domestic health plan. This is generally not difficult if you have not developed some chronic health problem. If you have, it is very difficult to get adequate domestic health insurance. We have a plan with deductibles from $500 to $20,000 that will give you ongoing coverage in the USA without a stipulation that you spend time outside the USA in any given year. By choosing a high deductible with this plan, you can also minimize the monthly premium. If this is something that interests you, please let us know. We will be happy to send you the information.
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COVERAGE IN WAR ZONES
Almost all international policies have a line in their "Exclusion" section something like: This medical plan does not cover.... any consequence, whether directly or indirectly, proximately or remotely occasioned by, contributed to by, or traceable to, or arising in connection with: (a) war, invasion, act of foreign enemy hostilities, warlike operations (whether war be declared or not), or civil war; (b) Any act of any person acting on behalf of or in connection with any organization with activities directed towards the overthrow by force of the Government de jure or de facto or to the influencing of it by terrorism or violence . . . .
I think you get the picture. So, if you are caught in the cross fire, you are not covered. But what if you are walking down the street, trip and break you ankle? In that case you are covered for it had nothing to do with a "war." So we can write insurance for people in war zones, but with the exclusion as listed above.
OVERSEAS COVERAGE FOR AMERICAN MEDICARE RECIPIENTS
If you are an American on Medicare, you are probably aware that Medicare does not cover Americans traveling abroad. Some Medicare recipients have contacted us about coverage for short-term trips.
Instead of getting separate international coverage you may want to purchase a Medicare supplement plan (C through J) from a local agent. This supplement will cover you for the first 60 days of a trip outside of the USA. There is a $250 deductible. Then the insurance will cover 80 percent of all billed charges up to a lifetime maximum of $50,000. The premium will be between $100 and $150 depending on your age. This "Foreign Travel Emergency" benefit is just one of the benefits in the supplement package. If you want information about Medicare supplement insurance or about an agent that can help you select a Medicare supplement, check out www.mutualofomaha.com , or find an agent in your local phone book. (If you already have a Medicare supplement, you may only need to add $9.00 for overseas coverage.)
If you are not interested in taking out Medicare Supplement insurance, then you will need a good short-term plan that you can apply for online at www.overseashealthinsurance.com.
RETIRING IN THE USA, BUT CAN'T GET ON MEDICARE?
Sometimes international workers cannot get Medicare coverage for various reasons. Sometimes it is because they opted out of Social Security as a young person working overseas, or they married an American and never did sign up for Social Security, or maybe they just want to retire in the USA because of family and friends here. Now at age 65 and no Medicare coverage, what is one to do?
We now have a company that will give year-to-year coverage in the USA for those over 65. It is a major medical plan that will cover your medical needs and can be renewed for years. Also, we have several other international plans that will cover those over 65 for several years in the USA. Finally, we have an international insurance plan, if taken out while you are outside the USA, will cover you for the rest of your life in the USA.
All of these plans should be considered "catastrophic" plans, as they do not have all the bells and whistles of standard plans such as co-pays, preventive care check-ups, and prescription cards. If you are interested in retirement age medical coverage in the USA, please contact us.
INTERNATIONAL PERSONAL LIABILITY INSURANCE
For several years international workers have asked for personal liability insurance. The concern has been protection in case you injure or inadvertently kill someone in a traffic accident while overseas. Now, to protect yourself from such a misfortune, you can purchase insurance that will cover you up to $100,000. The coverage can be taken out for 3, 6, or 12 months at a time. There are single, couple, and family rates. Three months of liability coverage for a couple on this plan would be $85. If you are interested in getting a copy of the brochure and application, please contact us. We will be happy to e-mail it to you.
FURLOUGH INSURANCE
Some international workers choose the socialized health care offered in their country of residence. Others have plans that will cover them anywhere in the world except in the USA. Others have no health insurance at all, feeling that medical costs are so inexpensive in their country of residence that health insurance is not necessary. Yet, all of the above are concerned about having insurance when they come home on furlough. Is there such a thing as furlough insurance?
The best option is to have an international health insurance plan that provides insurance coverage in the USA. We have several plans that will give coverage in the USA as long as a person is outside the USA six months in every policy year. We have one company that permits a one-year furlough.
But for those who do not want a career international health insurance plan, there are still several options. If they intend to return to their field of service, there are several companies that will let them apply for similar coverage that a non-American would purchase when visiting the USA.
Also, in every state a person can purchase short-term major medical insurance for two weeks up to one year. These short-term plans do not cover pre-existing conditions, nor do they offer co-pays or wellness check-ups, but they do protect a person from a catastrophe. Short-term health insurance rates are relatively inexpensive, being around 40 percent less expensive than a traditional long-term health insurance plan.
GET UP TO TWO YEARS OF HEALTH COVERAGE WHEN RETURNING TO THE USA
You have been overseas for two years or longer, and planned to stay as a career worker. Now, due to family reasons, you have to return to the USA. Can you get health insurance immediately? Yes!
We now have a policy that will cover you for your first two years while you are re-establishing yourself in the USA. The only qualifications are that you had a residence outside the USA and that you apply for this plan within 12 months of your return. So, if you have been overseas and are planning to settle back into the USA for an indefinite period, please write or call. We will be happy to help you find good, quick, inexpensive, and suitable health insurance for your first two years at home.
HIGH LIMIT ACCIDENT / TERRORISM INSURANCE
We have discovered a new product that provides permanent year-round protection for sudden and unexpected effects of an accident. This coverage includes the following options: All-risk 24 hour coverage, common carrier (all conveyances that are certified to carrier passengers), air travel only, war or act of war, acts of terrorism, medical evacuation, and repatriation of remains.
Groups or individuals can purchase this coverage. Groups of four or more will receive substantial discounts according to the size of the group. Recent terrorist acts against volunteer organizations throughout the world indicate the wisdom of purchasing such high-limit accident insurance.
MED-EVAC -- DO YOU NEED IT? IS IT WORTH IT?
One missionary tells of a child who fell out of a tree in Cambodia in 1994. The parents thought the injury was serious and medical evacuated him to Singapore for a cost of $25,000. The family did not have that kind of money. How did they pay for it? They appealed to their supporters!
What's another solution? Be covered with Medical Evacuation Insurance. For a reasonable sum a family can have insurance that provides medical evacuation services at their disposal. These companies offer round-the-clock services all over the world. The client is given a call-collect number with which to contact them.
Many international insurance plans include medical evacuation in their coverage. But you can also purchase a stand-alone medical evacuation policy.
Do you need it? That's the problem with insurance. Once you have it you hope you never need it. And you may never need it. As a foreign worker for 30 years I always thought I must have insurance--first of all, as health security for my family and second, as an act of responsibility to my supporters who acted so sacrificially to keep us involved in overseas work. I felt that they had a "right" to expect us to use part of their financial support to purchase international health insurance.
HEALTH COVERAGE FOR THE FREQUENT INTERNATIONAL TRAVELER
Instead of filling out a short-term insurance application for every trip outside the USA, you can now apply for one plan that will cover multiple trips. For a USA citizen the rate is $240 a year plus $110 for a spouse and up to two dependents. This plan offers $1,000,000 in medical protection, medical evacuation, trip cancellation, $25,000 Accidental Death and Dismemberment, emergency dental, emergency reunion, and repatriation of mortal remains. Like all plans of this type, pre-existing conditions are not covered. If you are interested in this type of plan, please contact Good Neighbor Insurance.
Short-term Health Insurance
THE COST OF NOT HAVING SHORT-TERM TEAM INSURANCE -- A TRUE STORY
SHORT-TERM VS. LONG-TERM MAJOR MEDICAL COVERAGE
WHAT TO LOOK FOR IN SHORT-TERM HEALTH INSURANCE
SHORT-TERM PLAN THAT COVERS PRE-EXISTING CONDITIONS
THE COST OF NOT HAVING SHORT-TERM TEAM INSURANCE -- A TRUE STORY
Don Jenkins, on his third mission trip to Central America, spent the day laying blocks for a church camp in La Fortuna, Costa Rica. That night he tripped on a concrete asphalt trench and hit his head. Jenkins suffered a subdura hematoma, and was in a coma for 30 days. He underwent two brain surgeries and was hospitalized for 90 days--6 in San Jose, Costa Rica, and 74 in his hometown. While still in a coma, he was flown home.
The fall would wind up costing his family more than $90,000. Because the accident occurred outside the United States, Jenkins' domestic health insurance wouldn't pay. Family members did not have the money, so his daughter mortgaged her house to get the $30,000 needed for an air ambulance to return Jenkins to Kentucky. The hospital in Costa Rica wouldn't release Jenkins until the hospital bill was paid. His son used his corporate credit to pay the $22,000 bill, which the family is now repaying in installments. The doctors and surgeons in Costa Rica agreed to accept monthly payments. With donations from churches, friends, family members, and the Kentucky United Methodist Conference, about half of the $90,0000 has been paid.
Now Mr. Jenkins' family is on their own mission--to tell everyone to check their domestic health insurance before leaving the United States. Some policies cover health care in another country. Some don't. Even if a policy will pay for treatment, generally it doesn't include medical evacuation. (By Alberta Lindsey, Times-Dispatch Staff Writer, May 5, 2001, (condensed by J. Gulleson)
SHORT-TERM VS. LONG-TERM MAJOR MEDICAL COVERAGE
If you are going to be involved in overseas work for longer than three years, we would advise you to get long-term major medical insurance. Here is the problem: Short-term major medical can cover you up to three years, but then the plan will have to be re-written. If, during those first three years, you become sick, e.g., hepatitis, diabetes, urinary tract infection, back problem, etc. these will all be considered "pre-conditions" and will not be covered when you apply for the next short-term plan.
That is not the case with the long-term policies. The long-term policies will cover you for the rest of your life as long as you meet the residency conditions and keep your account current. Some folks opt for the short-term major medical coverage because it is less expensive, but this is taking a major risk if you are a career worker. Also, with a career plan you get at least six months of coverage in your home country in any given year. That is a good time to get medical needs taken care of. Short-term plans do not give you a similar benefit. If you have questions about the wisdom of choosing a long-term or short-term plan, please contact us.
WHAT TO LOOK FOR IN SHORT-TERM HEALTH INSURANCE
With a casual glance all short-term plans look the same, but there are important differences. Varying rates (premiums) are not the only thing to keep in mind. First, when comparing premiums on different plans make sure the maximum coverage and deductible you are considering are the same amounts for each plan. For example, compare the rates for a maximum coverage of $50,000 with a $250 deductible.
After that is done, you need to ask yourself the following questions: Is home country coverage offered? How much time is allowed in the home country? Is home country coverage built into the rates or is it surcharged? What is the maximum medical evacuation amount? Is the medical coverage only for accidents or for both accidents and sickness? What is the benefit period (the length of coverage from the time the person requires medical care)? The best companies give at least a six-month benefit period. Is hazardous sports coverage offered? And if so, what is the surcharge? Although short-term plans do not cover pre-existing conditions, is there any coverage for an “unexpected recurrence” of a former medical condition? What is the optional length of the policy: one year, two years, three years? The longer a short-term policy can be in effect, the better.
SHORT-TERM PLAN THAT COVERS PRE-EXISTING CONDITIONS
Good Neighbor Insurance now offers a short-term health insurance plan for international workers that will provide $2,500 in coverage for pre-existing conditions if the care is received outside the USA. You may be aware that short-term plans traditionally give absolutely no coverage for pre-existing conditions. This plan, although short-term, is renewable up to three years. What's more, it offers $100,000 of medical evacuation insurance, and overall the rates are lower than all the other short-term international health insurance plans. If you are interested in a short-term plan that at least gives limited coverage for pre-existing conditions, please let us know. We will be happy to e-mail and/or mail it to you. You can also apply for this plan (Liaison International) online at www.overseashealthinsurance.com.
Short-term "TEAM" Insurance
SHORT-TERM TEAM INSURANCE
SHORT-TERM TEAMS NEED HEALTH INSURANCE COVERAGE
MORE ABOUT SHORT-TERM TRIP INSURANCE FOR TEAMS
ONLINE SHORT-TERM TEAM HEALTH INSURANCE
How many short-term teams go outside their home countries every year? One USA mission in 1996 sent at least 75,000 short-termers. Many sending churches and missions want coverage for these teams, coverage that includes medical evacuation insurance and catastrophic protection.
Several insurance companies are set up to cover teams, especially if there are a good number of teams being sent out in any given year. We have been able to write short-term team coverage for as low as $1.10 a day per person. The variables of course determine the rate, e.g., average age of the team member, length of the trip, number in each team, number of teams sent in a year, maximum coverage, and deductible. One of the reasons missions and churches want coverage is because they don't want to be libel for any injuries. Also, all are aware of the great cost of medical evacuation. The cost of medical evacuating someone back to their home country or to good medical care is generally somewhere between $25,000 to $75,000. If you send one or more teams and would like a quote on how much it would cost to cover your team, please contact us. You can also apply for short-term team coverage online at www.overseashealthinsurance.com
SHORT-TERM TEAMS NEED HEALTH INSURANCE COVERAGE
Will your American health insurance policy cover you during a short work trip outside the USA? Maybe partially, but generally not to the extent you expect or need. The small print on many policies excludes coverage outside the USA. And almost no domestic policies offer coverage for medical evacuation.
The good news is that there are several companies offering short-term team coverage for as low as $1.10 per day. When the cost for an individual's trip for a two-week work program outside the USA is often $1,500, it is good financial planning to add $20 to that cost to provide good health insurance coverage. Many groups, in the light of recent happenings, are making it mandatory that all team members have short-term health insurance before leaving for an overseas trip.
There are plans available that charge the same rate per day per participant. Other plans charge a per-day rate based on age. Good Neighbor Insurance would be happy to send you materials about health insurance coverage for short-term teams. If you are sending out more than ten teams a year, we can get you a per-day, per-participant quote which will provide the same rate for all ages. Please call or e-mail us for further information.
MORE ABOUT SHORT-TERM TRIP INSURANCE FOR TEAMS
Hundreds of thousands of people go overseas every year for a term
of two weeks to two months. Many of these go in teams. How do you
insure a team going overseas?
Here are several options:
(1) You can give each team member an application and let them take care of their own insurance.
(2) If you are sending out ten or more teams annually, just give us the numbers of teams you are sending, the average age of your team members, the average number of members on each team, and the average number of days they will be overseas. We can give you a "cost-per-day" insurance quote. Usually the cost per-day runs from $1.20 to $2.00 per member.
(3) Request from us the "Day Tripper" application for teams. In this plan you pay so much per day based on the age of each team member. This plan is excellent if you have from one to six teams going overseas during the year. If you desire more information about each type of coverage, please contact us.
ONLINE SHORT-TERM TEAM HEALTH INSURANCE
Now you can apply for health insurance for your whole short-term team online. You will receive a confirmation of your coverage almost immediately. To apply, simply go to the home page on www.overseashealthinsurance.com or www.missionaryinsurance.info and find "Day Tripper." You can study the plan or apply. To apply, you will need the name, date of birth, and passport number of each team member. You will also need the date the team leaves and returns, and, of course, a credit card. This is a secure site for credit card applications.
If you run into problems while going through the application process, please call us toll free at 866/636-9100. We try to always have an agent near the phone to help you.
Group Insurance
WHY GET LONG-TERM GROUP INSURANCE FOR OVERSEAS STAFF?
AFFORDABLE GROUP TERM INSURANCE FOR FIELD STAFF
GROUP COVERAGE -- COMPLETE TAKEOVER
WHY GET LONG-TERM GROUP INSURANCE FOR OVERSEAS STAFF?
In 1996 the federal government in the USA passed the HIPAA (Health Insurance Portability and Accountability Act). In essence, this act says that if a person is insured by group insurance for at least 18 months and then goes on "COBRA" (state continuance insurance once you go off company insurance) for 18 months (if COBRA is available), they cannot be denied health insurance by any health insurance company in America.
Thus, group insurance makes it possible for all of your workers to have guaranteed health insurance for the rest of their lives. How does this work? Here is an example: John and Mary work with your organization for 15 years. John develops a bad case of melanoma, a very serious form of skin cancer. He has international insurance, an individual plan, but now wants to return to live in the USA. Thus, he will drop his international insurance because he is not living outside the USA. His problem now is that no company in the USA will insure him with individual health insurance. His melanoma makes him an "automatic decline" as far as health insurance goes.
But if John and Mary are covered under "group insurance" through your organization, once they come home they can immediately apply for COBRA insurance for the next 18 months; and, if they then immediately apply for HIPAA insurance, no insurance company in America can decline to cover them. The fact that they were on group insurance while overseas assures them of the option of lifelong individual health insurance coverage once they return to the USA.
AFFORDABLE GROUP TERM INSURANCE FOR FIELD STAFF
Often an organization wants to take out just $5,000 or $10,000 term insurance on each field member. Generally, it is difficult to find a company that will provide such low levels of group term insurance for international staff working outside the USA. Now we have a company that is willing to do this. If your field staff has no term insurance and you want to provide "just" term insurance for all members and families, please contact us. The rates are also very reasonable.
GROUP COVERAGE -- COMPLETE TAKEOVER
One of the major problems career groups have is finding group coverage that will cover all pre-existing conditions. This is called a "complete takeover."
Group rates go up like all insurance rates, and when they do, we like to look around for other options. The general problem is now your group has aged and have probably developed some medical problems, so now you need to find a company that will do a "take over," thereby covering all of those existing medical problems. If your group is experiencing unbearable insurance premiums and you are interested in investigating lower rates with a company that will provide insurance with a "complete takeover," please call us. In many cases we can help.
Term-Life Insurance
WHAT IS TERM INSURANCE?
TERM INSURANCE – SOME OF THE OPTIONS
HOW TO APPLY FOR TERM LIFE INSURANCE ONLINE
WHAT IS TERM INSURANCE?
Generally it has been difficult to write good term insurance for Americans living outside the USA and others living outside their home countries. Now we have several companies that are willing to provide this insurance. We can write term insurance for almost any country in the world.
What is term insurance? It is protection for your spouse and children if you pass away. It is different from "life" insurance because there is no reimbursement to you if you live past the term of the policy.
Here is how it works: If you take out $100,000 of 20-year-level term insurance, and then died before the 20 years were up, your beneficiary would receive $100,000. If you lived past the 20-year life of the term policy, you would receive nothing. Most people purchase term insurance because it is much less expensive than life insurance and because they don't want to leave their family destitute if they die.
TERM INSURANCE – SOME OF THE OPTIONS
It is becoming more difficult to get term insurance in some areas of the world, specifically Africa and the Middle East. What are some solutions? Let me list a few:
(1) The surest way to get term insurance is to take out a health insurance policy that offers optional life insurance. If you are accepted for the medical coverage you, will also be accepted for the life insurance.
(2) Lloyds of London provides life insurance in many countries. You can find out if coverage is available in your country by going to www.gninsurance.com. Double click on the <buy online> button on the upper right hand corner of the home page. Then double click on the <life> box and work through the questions. It will take you just a few minutes to find out if Lloyds offers coverage in your country of residence.
(3) We also offer “High Limit Accident Insurance.” This is also available in areas of war, and works as terrorism insurance. This is available in all countries of the world, but is rather expensive.
(4) If you are still in the USA and live in or will be visiting Arizona, contact us several months before you go overseas. We have several American companies that offer international insurance at standard rates plus sometimes a surcharge depending on your country of residence. Coverage with an American company is best because you have the option of purchasing 20-year or 30-year-level terms. The plans above, at most, offer ten-year level term.
(5) Sometimes we can get coverage in unique situations by putting in a request to Lloyds of London. Contact us with your country of residence, age, and any medical conditions you have. We will be happy to discuss this option with you.
HOW TO APPLY FOR TERM LIFE INSURANCE ONLINE
Often new international workers inquire about purchasing life insurance a few months before leaving for the field. However, since they are planning to go overseas soon, very few life insurance companies will cover them. We have one American company that will cover "volunteer workers" in about 50 percent of the countries of the world and a European company that provides life insurance in another 25 percent, so we can provide term life insurance for 75 percent of the countries in the world.
If you are interested in getting a quote and/or applying for life insurance, you can go to our web site <gninsurance.com>. On the front page double click on the "buy on-line" button. You will then see three yellow boxes, the third being about "life" insurance. Double click on that box. The page that comes up is set for the default "International Term Life." Double click on "proceed" to get a quote. If the program will not give you a quote, that means you are in one of the countries where you cannot get life insurance. If you have questions or need help, please contact us.
Understanding Rising Insurance Costs
TRYING TO MAKE SENSE OUT OF RISING HEALTH INSURANCE COSTS
RISING HEALTH CARE COSTS
RISING INSURANCE RATES
RATE COMPARISON OF INTERNATIONAL AND DOMESTIC HEALTH INSURANCE
THE REAL DRIVER BEHIND HEALTH CARE COSTS
INSURANCE RATES WILL INCREASE
TRYING TO MAKE SENSE OUT OF RISING HEALTH INSURANCE COSTS
Are you bewildered and angry at rising premiums? Why are the rates
going up? Over the past three months I have read numerous articles in newspapers and trade magazines regarding this matter. Here are some reasons all industry experts agree on:
(1) Rising medical care costs in the USA
(2) Rising cost of drugs
(3) Increased use of drugs by medical practitioners
(4) Government mandates requiring conditions like alcoholism to be covered.
One domestic company experienced health care cost increases at an annualized rate of about 22 percent and prescription drug costs at nearly 40 percent. Besides helping international clients, Good Neighbor Insurance also provides coverage for people living in Arizona. We write insurance for many of the large carriers like Cigna, Blue Cross, Fortis, and HealthNet. These companies have raised their rates as much as 50 percent in recent years.
People on international insurance plans know that international health insurance is different from, and less expensive than, domestic insurance, so they feel increases should not be the same for international insurance. That would be so if all the people that had international insurance got their health care outside the USA. The fact is that 80 percent of the healthcare for those on international insurance is received in the USA. Thus, the increase in international health insurance rates is also tied to the vagaries of American domestic health care costs.
Sometimes rising health care costs outside of the USA are influenced by rates inside the USA. Here is some information on this matter gleaned from the Wall Street Journal on March 12, 2001: After a period of moderate increases a study by the Health Care Financing Administration found that spending on health care is rising fast. Spending rose 8.3 percent in 2000 and is expected to grow 8.6 percent this year. By comparison, it rose 5.6 percent in 1999. In 1999 spending on prescription drugs jumped 17 percent. During the next four years drug costs are expected to rise about 15 percent annually.
Joe Manning, a correspondent for the Milwaukee Journal Sentinel, on Sept. 25, 2000, adds to the above by listing specific reasons for the increases as follows: Prescription drugs are being promoted with mass marketing; people are also going to the doctor more, often unnecessarily; diagnostic tests such as magnetic resonance imaging scans (MRIS) are being used more routinely; people are demanding more health care; an aging population demanding access to expensive new technologies and medicines; and premiums have been held down artificially.
It may not sound reasonable, but international insurance rates are influenced by domestic rates in the USA. Also, many Americans who work overseas still get most of their medical work done in the USA while they are on furlough.
Rising insurance rates always trouble us, especially if we are locked into a set income. Most of us can live with inflationary increases, but those large increases really make us burn. I tend to feel an increase of six percent to eight percent a year is acceptable (am I being too generous?). If the increase is more than that, we should consider looking for another company.
But, even if the inflationary increases are moderate, why do we sometimes see large increases? There are several reasons. If you sign up with a company just before they have a rate increase, you won't feel that rate increase for a year. You are locked in for one year to the initial premium. If the company has two rate increases, one a few weeks after you sign up and another a few weeks before you have been on the policy for a year, you will get two increases on the anniversary date of your policy. Then, if you move into a new age rate bracket during that year, you will get an increase from that too. So you could possibly get two 8 percent increases and an age increase of 4 percent and end up with an increase of 20 percent. On a policy of $300 that would increase your premium to $360, and that would be only if the increases were limited to 8 percent plus 8 percent plus 4 percent.
Whatever the case, please contact us when you have questions about premium increases. We will try to get a specific calculation from the company, and if you feel their explanation is unacceptable, then we would like to give you quotes on various other companies to see if we can find a comparable plan at better rates.
Another way to beat increased rates is to go for a higher deductible. Some people start with a low deductible, and every couple of years they move up to a higher deductible. Thus, they keep their rates stable. I, for one, understand the problem of high rates. I'm a relatively healthy man in my early 60s, and even though I have insurance with a $2,000 deductible, I'm still paying over $200 a month. I wish I could find a plan that would give me comparable coverage with a lower rate, but so far I have not been successful.
RATE COMPARISON OF INTERNATIONAL AND DOMESTIC HEALTH INSURANCE
All agree that insurance rates are rising too fast and are a great burden, especially for the international worker. Individuals here in the USA are also feeling the weight of ever-increasing rates. Here is a short comparison of monthly rates between a standard international career policy and a USA policy for the state of Arizona:
(1) Family of four: husband 35, wife 34, two children ages 3 & 8: Arizona is $479, international is $271
(2) Single woman age 28: Arizona is $118, international is $81
(3) Single male age 61: Arizona is $296, international is $252
(4) Couple between 50-54: Arizona is $418, international is $318
THE REAL DRIVER BEHIND HEALTH CARE COSTS
One matter that perplexes us is why health care costs keep going up. One of the key reasons for this is "utilization." The more use (utilization) we make of something, the more it will cost us. Driving a car five miles a day will cost much less than driving it 500 miles a day. When health care is seldom used by a society, it will automatically cost less; when used more, it will cost more.
Many of the social ills today result in harmful health conditions for individuals. This means that health care will be used more, and the cost to society will be greater. Health insurance companies share the increased cost of health care with their policyholders via increased premiums. So the cost of social ills and their resulting harmful health conditions fall on all of us. Just consider the health costs incurred by drug abuse, alcoholism, tobacco, violent crime, pollution, obesity, sedentary lifestyles, and accidents that are compounded for not wearing seat belts or helmets. Then there are babies born crack-addicted, fetal alcohol syndrome, HIV, etc. When people that are insured develop health problems because of such things, we all pay for their care through our monthly insurance premiums.
There are, of course, other social factors that cannot be avoided, like the cost of caring for the health needs of an aging population, plus the fact that people live longer.
I would almost like to add to Will Rogers' statement that there are two things certain in life: death and taxes—and also increases in insurance rates! The minute you take out insurance just remind yourself that next year the rates WILL INCREASE.
Rates on individual plans always increase when you move into a new age bracket. Usually the brackets are from 20-24, 25-29, 30-34, etc., but not always. So if you move from age 34 to 35 be assured that your premium will be increased. Also rates go up due to inflation. When we speak of inflation, we are not just talking about general inflation but inflation of medical costs. General inflation may be running at three percent per year, whereas medical inflation is nine percent. If that is the case, you will get the nine percent increase.
Then there may be an added increase in premium because the plan you are on was priced too low and the company is now losing money on that “Book of Business.” The claims of all the people on the plan you took out were so great that the company had a losing year on that plan; therefore, they increase the rates on everyone on the plan to get out of the red.
But, in spite of the above, do remember that your rates will not increase because of your individual medical condition or your claims alone.
Miscellaneous Articles About Insurance
INSURANCE FRAUD AND VOLUNTEER WORKERS
THE CURSE OF BEING DECLINED FOR HEALTH INSURANCE
REAPPLYING FOR AN INSURANCE PLAN--WHY SO DIFFICULT?
GENERIC DRUGS--HOW SAFE ARE THEY?
DANGEROUS LIAISONS--MIXING DRUGS
WEB SITE FOR PREGNANT TRAVELERS
MEDICAL GUIDELINES FOR INTERNATIONAL WORKERS
INSURANCE FRAUD AND VOLUNTEER WORKERS
It may be hard to believe, but insurance companies that serve volunteer workers also lose money due to fraud.
Often people ask me if they should reveal all of their medical problems when they fill out an application. Some feel that since they had a major medical problem some time ago and it is not bothering them now, they need not list it. Yet such misstatements can cost an insurance company thousands of dollars. And remember, whenever an insurance company pays an "undeserved claim," someone pays for it. Who? The healthy people on the insurance plan pay. Unmerited claims always cause insurance rates to increase.
We had one experience where a senior worker failed to explain a certain pre-existing medical condition. If she had been honest, the company would have declined her insurance. Due to her pre-existing condition she ended up having major surgery. Before the insurance company discovered she had lied on her application, they had paid her claims of over $100,000.
In another group insurance plan, a worker in the USA falsely claimed membership of a volunteer organization. Her insurance claims of $80,000 were paid before the insurance company realized she was not a volunteer worker in the organization.
It is very difficult to win the confidence of secular people in these companies when volunteer people are dishonest in insurance matters. The good news is that almost all volunteer workers are scrupulous in telling the truth when completing a health application!