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Michael J. Malasnik
Impaired Risk Specialist Independent Insurance Broker This email address is being protected from spam bots, you need Javascript enabled to view it Phone 623-535-8299 Business hrs M-F 9-5 |
FAQs
A – Because they have 2 completely different motives and goals. Your Dr. is mainly concerned with improving your health and wellbeing. Your insurance company is mainly concerned with keeping your claims amount under your premium amount. Not exactly in sync are they? Here is a great example of a frustrating situation. You may have a rather minor condition such as chronic allergies or elevated cholesterol, but if your treatment is a $150 a month drug, and your premium is only $179 a month…....do you see where this is going? Something will have to give. This situation would likely end up with an exclusion rider for allergies and a rate up for cholesterol on a PPO and a decline from an HMO.
A – You may have a couple of options. But first understand that no individual insurance company will accept anyone who is pregnant or the spouse of someone who is pregnant. Would you give me your $100 bill for my $20? Well they don’t want your $3,000 minimum claim for $250 a month premium for 6 months either. And most importantly, a premature baby can easily cost them over $700,000!
Here are some options: 1 - Arizona Health Care Cost Containment System (AHCCCS) 2 - Baby Arizona - Arizona Wellness Center 3 - Healthcare Connect - Discount Medical in Maricopa County 4 - Pima Community Access program 5 – Pre Paid Maternity Packages
A – You have two options when choosing individual dental coverage: Indemnity Insurance and Prepaid Plans. If you are married* to your dentist, (*will not change dentists), you will want to consider an indemnity dental insurance policy. If you want to get the most for your money look at a “good” prepaid plan.
The best pre paid plan I have found is Savon Dental Plan. They are very straight forward and predicable every time you use them. Simply choose a dentist from their network, pay half the bill at time of service, and your done.
A – These are becoming more and more popular because of their comparatively low premiums. (I am writing a fair amount of them these days) Unfortunately, many people I find seeking them are doing so because they have severe pre-existing conditions and believe they may get approved where lower deductible plans would decline them. The truth is “deductible underwriting” is not very common, and the same underwriting criteria for low deductibles will often apply. Look at it this way, the insurance company has the same fears and concerns that you do. Meaning they aren’t overly concerned about paying a $5,000 or $10,000 claim, but tend to get real nervous when they start thinking about having to pay a $50,000 or $100,000 claim!
A - Click here
A – A Health Savings Account is actually more of a concept than a product. It combines a high deductible major medical policy with no co-pays with an interest bearing, tax exempt health savings account. The idea is this: Buy a high deductible policy and “fund” your deductible amount (tax free) in your savings account to use for all your IRS and policy eligible expenses. By doing this you are buying a lower premium policy and can save money on your income taxes. If you don’t intend to fund your policy, then don’t buy an HSA unless you like the coverage the policy provides. The trick to saving the most money is to find the carrier that has the lowest re-imbursement contracts. In other words, they pay the lowest contracted rates through their PPO network. As an example, a lab may bill you $320 for its services but will get repriced by your PPO to only $40. Big Savings for you!
A – I get paid a percentage of your monthly premium directly from the insurance company. So, every time my one of my insured’s makes their payment, I get a percentage of that premium. First year health commissions average 15% and renewals around 5%. Life pays approx 75% on the first year and little to nothing after that.
A – No and No. If you buy a policy from an insurance company, they will most often only accept business from an agent or broker, so there are no “direct” rates. HMO’s will most often market to both the consumer and through the broker. They can only have one rate and it is the same no matter how you purchase it. They are simply “blending” the cost of doing business with a broker and selling direct to arrive at an average cost. In fact, independent broker business is often far less costly to them. So by using an experienced broker you get professional guidance for no additional cost, the company keeps their expenses down and the broker can raise their family. It’s a Win Win Win situation!
A - Absolutely! I would say that about half of my business is comprised of what you call “Healthy People”.
A – Although I am licensed for all lines of insurance, I currently only underwrite/broker health and life.
Q - My employer dropped our group plan and made everyone get less
expensive individual plans that I can’t qualify for. What can I do?
A – It depends on your condition and situation. First of all, you may be able to qualify for individual insurance but just haven’t applied to the right company yet. If that is not the case, and you have had a total of 18 months of credible coverage including your most recent group policy, you may qualify for a guaranteed issue HIPAA Portability policy with no pre-existing condition waiting periods or exclusions. Contact me.
A – In short, Buyer Beware! This is a situation where the logic behind them is sound, but in practice they usually end falling far short of expectations. In theory – The insurance companies use PPO networks that have agreed to accept much lower reimbursements, and in return they will send these providers a large number of patients that keeps their waiting rooms full. In reality – You are not an insurance company. Yes you are self insuring by paying for your own claims. However the problem most often appears in two forms. First – Many Dr.s and hospital’s feel like they are being insulted when someone asks or even demands that they “discount” their professional services and often will refuse to accept the cards. Second – Of those who will accept them, payment will be due paid in full at the time of service. So can you write a check for $15,000 to cover an otherwise $60,000 hospital bill? Not everyone can. They can, however, work quite well for diagnostic services such as MRI’s and blood or urine lab tests. My recommendation is to save the $30 to $70 these cards charge and try to negotiate for yourself. TIP - Try asking if your provider will accept the AZ Foundation PPO reimbursements. You may be surprised.
A – Healthcare Group of AZ has been around since 1985. I administered this plan for APIPA/United HealthGroup from 1996 through 2000. It is an effort by our government to help reduce Arizona’s uninsured population. Being a true small group health plan, it is limited to covering the self-employed and small businesses with less than 50 employees. The state recognized that there were two main barriers to securing healthcare. One was that many people couldn’t AFFORD the premiums being offered by the commercial market. The other is that for even those who could afford the premiums, coverage wasn’t made AVAILABLE to them by the commercial markets. Click here for more information
A – Most often yes! Keep in mind that there is only 1 claim you can make against a life insurance policy. So they don’t care as much about your medications, Dr. visits, prior surgeries and etc. like the health insurance companies will. Often you can expect to pay from 25% to 100% more than the standard rates for pre-existing condition(s) that affect your life expectancy. Not too bad! Click here see one of the brokerages I use.
A - In short, because group insurance is so expensive. You are just now seeing the same amount your employer was being billed for you less their premium contribution. Often there will be a 2% admin fee added to your premium. If you are reasonably healthy, you should look into FAR CHEAPER short term major medical plans for coverage between permanent plans or secure permanent individual coverage.
A - If you are healthy enough to qualify for an individual plan then do so. However, if you are not so fortunate, or are in the middle of treatment, you may apply for HIPAA Portability. This is part of a federal reform from Hillary Clinton in 1996 that basically and briefly says that after 18 month’s of continuous credible group coverage (group and/or cobra) you can apply to anyone you want and they have to accept you with no waiting periods or exclusion riders. Now realizing that that these policies are only enrolling those people who have current and/or substantial medical costs, they must collect enough premiums to pay those claims. These premiums can be very high If these premiums are unaffordable, please contact me to see if a much lower cost Hospital & Surgical policy might be a better option for you.
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