Health Care Plans that Don’t Cut It

The self-employed and un-insured have a difficult time finding affordable health care coverage these days. The pitfall that they often fall into is in looking for a plan based on price alone. Then, once they have to use the plan, they discover that it does not have near the coverage that they need. With that in mind, here are some ways that you can identify a health care plan that is less than acceptable.

Affordable? There is sometimes a difference between the use of the word ‘affordable’ and the reality of that term. Taking a closer look at the plans that are offered, there is no discernable difference in coverage over some other plans.

Unlimited costs. If there is no ceiling placed on out-of-pocket costs in the plan offered, you could be hit with unending charges. You might also encounter policies that do not have a co-payment for doctor’s visits or prescription drugs that apply to the maximum. If you find yourself with a condition that requires constant office visits to monitor your progress, these costs will mount up quickly.

Category limitations. The opposite of the above would be limits on certain types of treatments that leave you with higher costs. For example, hospital and outpatient medical procedures, and imaging type of tests. If you must accept some limitations, make sure that they are on things like rehabilitation, medical equipment and mental health care.

Left out for a reason. Looking through the offerings of a given policy tells what is covered and what is not. But you also need to ask about things that are not listed. They might not be listed for a reason: they are not covered. And, unfortunately, it might be that way by design. Bring it up before you sign up.

Red flag words. Advertisements that use the words “not major medical insurance” or “limited benefits” are cautionary terms that should cause you to avoid the policy. If you are expecting full coverage, then you will find that these policies are less than adequate and at best are only appropriate as a supplemental plan.

Coverage Limits. Limits in coverage of $100,000 or less should be avoided. Major medical operations can easily surpass these caps. Heart attacks, strokes and even cancer which requires major surgery are the top medical procedures and will exceed these limits quite easily.

Low premiums with a price. These so called “affordable” premiums come from companies that require you to be healthy while they provide coverage that is thin from the start The better approach is to begin your search from the best polices available and then move down to the more affordable ones. With this method, you will be able to avoid coverage that is inadequate.

Small details. Sometimes the small details can be just as dangerous as the large. Be on the watch for things like policies that do not begin coverage until the second day of your hospital stay. Consider that your most expensive charges usually happen on the first day (surgeries and procedures). If you have a policy like this, then you will not be covered for those amounts.

Examine health insurance policies very carefully before signing up. You would do well to consult with an independent insurance agent who knows health policies and can direct you to a policy that fits your circumstances.