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guaranteed issue health insurance ohio Glossary & Terms

 

Q: What is open enrollment and why is it crucial?

Answer: Typically, employers set aside an open enrollment window for employees to follow-up, compare and choose from the health programs offered by the company. In most cases, open enrollment comes once a year, so it's important to take advantage of this time period to comparison-shop and ask your benefits administrator about specific questions you may have about coverage. Separately, life-changing events – like the birth of a child or loss of a loved one – may qualify you to make changes outside of the open enrollment window. Learn more about changing your insurance programs.

Question: Will I have to select a new doctor during open enrollment? And what if my employer has switched insurance carriers?

Answer: During open enrollment, you can compare health programs and make changes to your coverage. If you stay with your current insurance carrier, it's not likely that you'll be required to select new physicians – unless your provider is dropped from the programs network, retires, etc. Should you elect a new health insurance carrier – or your employer discontinues its previous plan – you may have to do some research. In any case, you'll want to double-check whether your physician falls in the policies provider network. Follow these pointers in choosing a doctor.

Q: What should I look for in a plan?

A: Good question. A insurance plan generally offers coverage for a mix of health care services ranging from traditional medical (e.g., office visits and hospital/emergency room treatment) and preventive care to rehabilitation and alternative or complementary medicine. The key is knowing the total amount you can expect to spend for care. A medical insurance broker may be able to offer money-saving tips.

Q: How do I evaluate prescription drug coverage? How do I find out if a particular prescription is covered?

A: It's important to understand your insurer's prescription drug benefits before you purchase your medication. You may pay by using in-network pharmacies, asking for generic drugs or using mail-order services that deliver to your door. Keep these prescription drug facts in mind.

Q: Are dental benefits included in my coverage?

A: Don't assume that your health insurance includes dental, vision, mental health or other services at the same level – or at all – until you review the fine print in your health services. If your coverage does not look adequate for your family's needs, you may need to consider supplemental insurance. A supplemental health plan may offer you some limited benefits to complement your primary plans.

Question: What are deductibles and co-pays? How do they work?

A: insurance deductibles and co-pays are out-of-pocket expenses for which you're generally responsible. For a listing of common expenses, review our health expense chart. You can, however, take steps to limit your costs with a tax-free account for future expenses.

Question: I have a pre-existing condition. Can I get insurance coverage? How will my pre-existing conditions impact my policies and rates?

A: As you apply for insurance – even an employer's group plans – keep in mind that pre-existing conditions may lead to higher premiums and, in some states, denial of coverage. Here's what you need to know about pre-existing conditions and insurance premiums.

Q: Will my doctor accept this plan? How do I make sure my doctor is in a specific insurance programs network? What does it mean to be in-network or out-of-network?

A: An out-of-network provider is not in your insurance company's preferred network. You may be required to pay your physician at the time of service and file a claim with your insurance company separately for reimbursement. In the end, consumers typically pay more for out-of-network services. Consult with your benefits administrator, review your services provider network booklet or website, or double-check with your provider for network status. If your plan has changed and you're shopping for a provider, search by specialty, condition, treatment or procedure.

Question: How do I know if a particular service or procedure is covered by my insurance?

Answer: Your benefits administrator or insurance carrier should be able to give you a complete breakdown of coverage for office visits, diagnostics and testing, emergency care and a host of other services. Not satisfied with your plan? Get a medical insurance quote from another carrier or consult with a insurance broker to find the best health insurance plan for your needs.

Q: What is COBRA?

Answer:COBRA is a law that may offer you some protections – and extend your health care coverage – if you lose your job or a spouse's insurance benefits. Find out about COBRA qualifications and costs.

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Republicans Keep Up Health Overhaul Repeal Pressure, Critic Questions Commitment

07/28/10 7:46 pm

Republicans continue their push to win support to repeal the health overhaul, even as parts of the legislation take effect, The Washington Times reports. “Rep. Steve King, [an] Iowa Republican, is circulating a petition that would force an up-or-down vote in the House of Representatives on repealing the …check out our ads below, they maybe of interest.

California Workers’ comp insurers lost $1.5B in 2009 in underwriting

07/28/10 7:46 pm

California’s workers’ compensation insurers lost more than $1.5 billion in their underwriting in 2009 due to a battered economy and lower workers’ compensation rates, according to a summary of recently released workers’ comp data. Workers’ comp insurance companies earned premium of $9.1 billion in 2009, a 16.5 percent decrease …and i though i was [...]

People With Diabetes Guaranteed Health Insurance Claims Rights

07/28/10 7:46 pm

The American Diabetes Association applauds the new White House rule which will help people with diabetes and other chronic diseases appeal the denials of health insurance claims. This rule comes under the new Patient Protection and Affordable Care Act. The rules will help simplify the denial process and …never miss a day, thanks for the blog

25 House Members Go To Bat For Agents On Future Health Care Role

07/28/10 7:46 pm

Twenty-five members of the House have asked federal health regulators to ensure a role for licensed insurance agents in the web portal that will be used to aid consumers in comparing coverage options. The Department of Health and Human Services unveiled the web portal July 1 on a trial …like our content consider our [...]

Insurers, Young, Uninsured All Prepare For Different Changes Under Health Reform

07/28/10 7:46 pm

Insurers, the young, the uninsured and lawmakers are just a few of the groups sorting out what the implementation of health reform means for them as details emerge on changes to the system. The New York Times: Insurers are fighting over the details of how much of the premiums …guaranteed issue health insurance ohio

Study Shows Medical Cost Shifts Onto Auto Insurers

07/25/10 11:45 pm

President Obama’s health care  package will affect auto insurers—that much is certain, though no one is quite sure how much the new law will affect them, according to the Insurance Research Council (IRC). An IRC report this year found a link between low Medicaid and Medicare reimbursement rates and …great news thought i would [...]

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