Health Insurance and You!

Before you finalize your health plan decisions take the time to inquire about the extra benefits that may be available. Supplemental benefits may include dental expenses, vision care, Medicare supplemental insurance, alternative medicine and other health-related expenses not covered by your health insurance.

To be adequately insured you need to assess your medical priorities. Do you think you might need extra care? If there is a particular expense you are concerned about, make sure to ask about it.

Understanding the benefits you will receive with your new policy will not only help you determine what, if any supplemental products you need, but will also help you take full advantage of the benefits to which you are entitled. Find out if you are eligible for a discount on fitness club membership, glasses or physical therapy for example, and then be sure to use it!

I found this article funny and, while exaggerated, it shines a light on the inefficiency and lack of customer service in the health care delivery system. It was written by Jonathan Rauch and published on NationalJournal.com. Happy reading!

If Air Travel Worked Like Health Care
Fasten your seat belts — it’s going to be a bumpy flight.
by Jonathan Rauch

“Hello! Thank you for calling Air Health Care, the airline that works like the health care system. My name is Cynthia. How can I give you travel care today?”

“Hi. My name is Jonathan Rauch. I need to fly from Washington, D.C., to Eugene, Oregon, on October 23.”

“Yes, I’d be happy to assist you with that. It does look like we can get you on a flight on January 23 at 1 p.m. or February 8 at 3 p.m. Which would you prefer?”

“Neither. I need to be in Eugene on October 23. As in, the 23rd of October.”

“I’m sorry, we have nothing open on that date. You might try another carrier.”

“I suppose I’d better. Who has availability?”

“I’m afraid I have no way to know that. I have no way to look into their systems.”

“Who would know?”

“You can call them individually and ask. I’m sure you can find one.”

“Look, I don’t have time to call two dozen airlines. It’s important that I get to Eugene on the 23rd. There must be something you can do.”

“Well, it looks like maybe we could squeeze you in on October 26, if you don’t mind departing Washington Dulles at 5:35 a.m.”

“Good grief. All right, I suppose it will do.”

“I’m sorry, sir, we don’t use e-mail to transmit records and other personal or secure documents. We keep our records on paper.”

“Great, thank you, I’ll be happy to make that booking for you. That’s one flight from Washington Dulles to Chicago O’Hare on October 26. Will there be anything else?”

“Wait, hold on. Chicago? I’m going to Eugene. It’s in Oregon.”

“Yes, sir. The Eugene portion of your trip will be handled by a western specialist. We’ll be glad to bring you back from Chicago to Washington, though.”

“You mean I have to call another carrier and go through all this again? Why don’t you just book the whole trip?”

“Sorry, sir, but you do need to make your own travel appointments. We would be happy to refer you to some qualified carriers. May I have your fax number, please? Before I can confirm the booking, we’ll need you to fill out your travel history and send that back to us.”

“Cynthia, I have filled out my travel history half a dozen times already this year. I’ve told six different airlines that I flew to Detroit twice and Houston once. Every time I fly, I answer the same battery of questions. At least a dozen airlines have my travel history. Why don’t you get it from them?”

“We have no way we could do that. We do not have access to other companies’ records, and our personnel have our own system for collecting travel history.”

“But 95 percent of these questions are always the same. Don’t you know that every time I fill out one of these duplicative forms I increase the chance of error? Wouldn’t it make more sense to hold my travel information centrally, so that everyone could see the same thing?”

“Sorry, sir, we have no capability for that, and we do need to have your travel history at least two weeks before you fly.”

“I don’t suppose I could fill out these forms online?”

“No, sir. The forms are only about 30 pages, though. Did you have that fax number, please?”

“I don’t have a fax machine. No one faxes anymore. Just e-mail me the forms.”

“I’m sorry, sir, we don’t use e-mail to transmit records and other personal or secure documents. We keep our records on paper.”

“What century is this? You think paper is secure?”

“We do keep all your travel records on low-acid paper and in fire-retardant file drawers. When someone needs access to your records, we make a photocopy and put them in the mail. Or fax. How many items of luggage were you wanting to bring?”

“Two.”

“OK, good. We suggest you make luggage arrangements with Rapid Air Transport, though of course you’re free to use any luggage company you like.”

“Luggage company?”

“Yes, sir. You’ll need to arrange baggage transport. Would you like a phone number for Rapid, or would you prefer to find your own baggage company? I’m sure Rapid would be pleased to work with you. All you need to do is sign the Personal Travel Records Release form. Where would you like me to mail that?”

“Release form?”

“Yes, sir. You’ll need to sign and fax or mail that back to our Travel Records Department so that we can release your travel records to Rapid. Under the privacy rules, we’re not authorized to tell them when or where you’re flying without your written permission.”

“I suppose I couldn’t just e-mail you this permission, or grant it online?”

“No. Did you want a list of luggage carriers for your Chicago-Eugene leg?”

“Let me guess. Rapid doesn’t operate out West. I have to find a separate luggage company for the second leg.”

“Yes, sir.”

“And they’ll need more copies of all the same paperwork. And they’ll ask me all the same questions. And I’ll have to arrange to get my travel records to them by mail or fax. And I’ll repeat all this nonsense five or six separate times between here and Eugene, because the providers aren’t equipped to talk to each other and my records aren’t digitized and no two providers use the same system.”

“Yes, sir, that’s right! Did you have a preferred fuelist, or did you want a reference for a company to provide jet fuel for your flight?”

“Fuelist. That would be a fuel specialist, I suppose.”

“We can make a fuel arrangement for you, but please be advised that the fuelist’s charge will be billed separately and you will be responsible for it. We’ll need to know where to have that bill sent.

“May I have your flight-insurance information, please?”

“Millennium Travel Care, group number 068832, ID number RS-3390041B.”

“I’m sorry, sir, we’re not in Millennium Travel Care’s provider network.”

“You’re listed on their website. It says you accept Millennium.”

“We did until last week. If you like, you can pay out of pocket for your ticket.”

“How much would that be?”

“Yes, sir, I’ll be happy to get that price for you. That would be $17,885.70.”

“What? For a flight to Chicago? Does anyone actually pay that?”

“I’m sorry, sir, I wouldn’t know. I can tell you that different clients and insurers pay different rates. For individuals, the rate is $17,885.70.”

“Oh.”

“In a sane system, I would call an airline and it would give me a price for the whole trip, not just for one part of it.”

“Plus tax. And fuel.”

“Is anyone else cheaper?”

“Sir, again, I couldn’t tell you that. Carriers don’t have public rate sheets. Prices are privately negotiated, so there’s really no way you could comparison shop.”

“Oh.”

“Did you want to go ahead, then?”

“No. I DO NOT WANT TO GO AHEAD. I do not want to go anywhere! I want to jump off a cliff!

“This system is insane. It is fragmented to the point of incoherence. Record-keeping is stuck in the 1960s. Communication is stuck in the 1980s. None of the systems talks to the others. Everyone reinvents the wheel at every stage of the process. There is no pricing transparency.

“In a sane, modern system, I wouldn’t have to arrange each leg of my flight myself. I wouldn’t have to fax documents around, find and juggle multiple providers, fill out again and again what are essentially the same forms every time I use a provider.

“In a sane system, I would call an airline and it would give me a price for the whole trip, not just for one part of it. It would sell me a safe round-trip journey, instead a series of separate procedures. It would have back-office personnel using modern IT systems to coordinate my journey behind the scenes. The systems and personnel would talk to each other automatically. At the press of a button, once I entered a password, they would be able to look up my travel history. We’d do most of this stuff online.

“In fact, Cynthia, I would be able to arrange a whole trip with a single phone call!”

“Sir. Please. Calm down and be realistic. I’m sure the system can be frustrating, but consumers don’t understand flight plans and landing slots. Even if they did, there are thousands of separate providers involved in moving travelers around, and hundreds of airports, and millions of trips. Getting everyone to coordinate services and exchange information just isn’t realistic in a business as complicated as travel.”

“Yes. I suppose I’m dreaming.”

“Was there anything else I could help you with?”

“No.”

“My goal today was to provide you with outstanding service. Did I accomplish that?”

[click]

When signing up for employee-sponsored health insurance, enrollees are either presented with a small number of options or no choices at all. The company selects the plan for its employees. In contrast, when buying individual insurance, the possibilities are practically endless. First, an individual has to choose the carrier. Which insurer has the best network of hospitals and health care professionals, has a good reputation for customer support, makes timely reimbursements, provides the most services and has a high rating for financial strength? Next, the customer has to determine how to allocate his or her spending among premiums, deductibles, co-insurance, out-of-network fees and out-of-pocket expenses. What about special benefits such as dental care, vision and long-term health? You get the idea.

This is where a health care exchange comes in. An exchange uses the information a person provides about his or her needs and budget to intelligently narrow down the choices to a few relevant plans. Online or on the phone, an exchange will provide a personal, helpful side-by-side comparison of available plans in a selected a price range. The exchange’s team of health insurance experts will answer questions and help the customer navigate the process through to the application. Best of all, this help is free. GetInsured.com is a premier health care exchange that offers knowledgeable service representatives, a huge variety of available plans and customer friendly online comparison-shopping. Check it out!

An estimated 26 million Americans are currently without insurance, presumably because the price is too high. Yes, health care reform will help this group of people by subsidizing a basic insurance policy. But the promise of a better deal looming on the horizon is actually causing harm. How many of those who are currently uninsured could afford at least some minimal coverage now but are deferring their purchase while waiting for reform?

We heard in President Obama’s address to Congress that federal reform may take 3-5 years to take effect. I urge everyone to not put off this decision. Individual plans aren’t necessarily more expensive than employer-based plans and can be tailored to offer benefits for an individual’s needs and exclude benefits mandated for employer-based plans. For example, there are low-cost plans available that provide catastrophic coverage. Such an inexpensive plan won’t cover preventive and non-urgent care, but it will pay for treatment in the case of an unexpected accident or serious illness while saving the individual from financial ruin.

Another possibility for those seeking minimal coverage while waiting for federal reform is a short term policy. A short term policy typically lasts six months, and the insurer is not obligated to renew it, but can be an affordable interim solution for some.

There are many people who could and should be getting more coverage than they currently have, rather than waiting for health reform legislation to pass before taking action. And, when a health reform law is passed, those who are eligible can supplement their insurance with more complete, subsidized coverage.

When an individual applies for a mortgage loan, the loan is not extended immediately upon approval. Most states require both parties to wait three days. This time, called a rescission period, is intended to allow the borrower an opportunity to consider his choice in the comfort of his own home. He is encouraged to read the small print, and make sure that he is making the right decision for himself and his family.

Buying health insurance is at least as complicated. That’s why many states have a 10-day “free-look” period for insurance policies. Just like taking out a loan, buying insurance involves a long-term financial agreement. This is an important and personal transaction and should not be made hastily or under duress. Our company, GetInsured.com works hard to design a health insurance plan suited for each customer. Then we go one step further than any other company and the mandated free-look. From the day an application is submitted, customers have 30 days to think about their new policies. If the customer changes his mind for any reason, GetInsured.com will give him or her a full refund. No questions, no pressure. I am proud of this industry-leading practice because, after all, what is insurance for if not to provide peace of mind.

This rule is very similar to rule 2 — but is very easy to miss.

Let us start with the obvious — when you buy a health insurance plan, of course you want to choose one that your local hospital accepts. But many consumers are not either thinking about getting sick or may not know what hospitals are near them.  If you do not know which hospitals are really near you, then use this tool to find out what hospitals are near you.

Next, make sure your health insurance counselor uses this information to select a plan that covers nearby hospitals.

Chini Krishnan

http://www.getinsured.com/

Telling the truth is generally always a good idea, but especially so in a health insurance application.

When you buy health insurance, you are entering into a contract. The essence of the contract is that  you pay daily amounts (called premiums) in exchange for your insurer agreeing to pay for certain (and hopefully most) of your medical expenses.

But there is a catch — if you lie or misrepresent your health status, your insurer may retroactively cancel your coverage.  This is truly a terrible situation to be in because you could be denied valuable coverage at the time your greatest need.

Don't let this happen to you.   If you have a situation, discuss it confidentially with your health insurance counselor first.  

Chini Krishnan

http://www.getinsured.com/

This one sounds so obvious and yet most people miss it.  If you are looking to buy health insurance, you fall into one of two situations:

Case 1: You do not have a family doctor or specialist. Alternatively, even if you have one, you are not particularly attached to seeing that doctor. If this is true, then you can safely ignore the rest of this post.

Case 2:  You do have a family doctor and would very much like to continue seeing that doctor.  If you fall into this category, then remember this – not all doctors accept every plan.  If you buy a health insurance plan and then find out later that it does not cover your doctor, you could lose hundreds of dollars in out-of-network costs each year.

So, if you do have a family doctor and would like to keep him or her – please do ask your health insurance counselor to choose a plan that covers that doctor!

Chini Krishnan 

John Smith (name changed) called us yesterday and needed to obtain health insurance for his family.  Unfortunately, Jane (John’s wife) is diabetic, which would disqualify her from most well branded health insurance carriers.  John’s family would be considered “split” – in that John and the children would qualify for health insurance, but Jane would not.

How did we help this family? First, we split the family into two separate applications – John and the children on one plan (as it happens, a plan from Aetna) and Jane on to an accident medical plan.

There are some who question the wisdom of this approach — because we could not find Jane a program where she would be fully covered. However, I believe it was absolutely the best decision under the circumstances. By creating two separate applications, we got John and the kids into the best plan they could possibly hope for.  As it relates to Jane – we really have only two meaningful choices – the first is to do nothing.  The second is to provide Jane protection for health expenses that may result from an accident and/or supplement it with discount programs. This type of coverage is usually inexpensive (under $30/month). The latter is what we chose to do.

Many others in Jane’s situation have taken a more expansive approach and signed up for guaranteed issue health insurance plans that cover more than an accident. We absolutely do not encourage such alternative approaches when a customer qualifies for major medical insurance and can afford it.  But when a customer does not, we believe it is a better choice to service the customer's need than give up.

The wonderful service counselors who form part of getinsured.com can provide each of you this service – at no cost.  We believe this guided approach is much better than looking at web pages with hundreds of health plans. We also believe it is better than talking to a local Life and auto broker who may just offer one health insurance plan or two and has no fundamental focus on health insurance.

This post is part of a series — where we will build a series of consumer tips for purchasing health insurance well.  Is there anything you would like to hear about? 

Chini Krishnan
www.getinsured.com
Founder and CEO

Health Insurance can be scary, confusing and unaffordable. I’d like to start by acknowledging this basic truth that millions of Americans live every day.  We talk to thousands of Americans each day and I’d like to give voice to some real issues affecting individuals and families who don’t get health insurance as part of their employer’s plan.

• Health insurance can be hard to afford – the average consumer plan that we provide each day costs about $180.00 per month – this is a significant component of the family budget.
• If you have diabetes or many other conditions, most health plans will not accept you. 
• You don’t know if you are getting a good deal – even when you can qualify for health insurance and can afford it, it is hard to know what the best value plan for you is. Most people have a hard time understanding and managing their health policies.

Welcome to my blog, whether you are a consumer, a policy maker or part of the health insurance industry.   Our goal here is to understand the many dimensions of the health insurance crisis and how technology, policy and markets can help the American consumer.

Chini Krishnan
Founder and CEO
www.getinsured.com