California Health Insurance Quotes and Blog

Of all the people I help find health insurance, some of the most grateful are people under 65 who are permanently disabled and have parts A and B of Medicare. Many disabled people believe that there is no way they’ll qualify for a health plan. A very important point I want to get across here is that there are guarantee issue health insurance plans for people who are under 65 and have parts A and B of Medicare. Both HMO and PPO, and some of the plans even include a prescription drug benefit.

When it comes to Medicare, it’s important that you know both sides of the story, and understand the advantages and disadvantages of relying solely on Medicare to provide for your health care needs. Though Medicare by itself covers many health care costs, there are many medical services that Medicare does not cover. This point is clearly made in the “Guide to Health Insurance for People with Medicare,” which is published yearly by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services. As the guidebook suggests, there are health care costs that Medicare either does not pay in full or does not pay at all. If you need or want services not covered by Medicare, you must pay the bill. To help fill the gaps in your Medicare coverage, you have the option of buying supplemental insurance policies known as “Medigap” plans. Supplement plans help pay the bills Medicare does not, and provide you with protection from the ever-increasing gaps in Medicare.
For the pre-65 Medicare beneficiary there are certain guidelines and timeframes you need to follow in order the get a health insurance policy issued. For a Medicare Supplement plan acceptance of your application is guaranteed if you are under age 65 and apply within six (6) months of your initial enrollment in Part B of Medicare. You must already be enrolled in both Parts A and B of Medicare to apply for these plans. If you have missed the enrollment period you will have to wait until November 15th and apply for a Medicare Advantage Plan.

Medicare Advantage Plans are health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered health care through that plan. This coverage can include prescription drug coverage. Medicare Advantage Plans include:

• Medicare Health Maintenance Organization (HMOs)
• Preferred Provider Organizations (PPO)
• Private Fee-for-Service Plans
• Medicare Special Needs Plans

When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your health care. In most of these plans, generally there are extra benefits and lower copayments than in the Original Medicare Plan. However, you may have to see doctors that belong to the plan or go to certain hospitals to get services.

To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer.
So, if you are under 65 and have both parts A and B of Medicare, you can get good affordable California health insurance. We just need to follow a few rules and timelines.

Most people focus on the price when they are shopping for health insurance. Price is important but a very important part of the buying decision is weighed upon how much it will cost when it’s time to go to the doctor and exercise the almighty co-pay. This seems to be the most important factor for some people who buy health insurance. Buying a high priced plan with low co-pay and the assumption it will cost you less when you go to the doctor’s office is a big mistake. Very often the higher priced plans will cost you the most when services are needed. So I’ll try my best to help you understand why this is.

I’ve been a California Health Insurance Agent since 1994. And I can’t get over the fact that so many people are so hung up on having a co-pay in order to go to talk to the doctor. They feel that a health plan is no good without one. Co-pays I think are totally overrated. First let me help you understand what a co-pay is. A co-pay, in regards to a doctor’s office visit is the dollar amount you are charged JUST TO TALK TO THE DOCTOR. Let me clarify. Let’s say you have a PPO plan with a $40 co-pay. That $40 lets go into the doctor’s office and covers only the conciliation. Once the doctor stops talking and starts any extra procedure or orders labs or any radiology, you start paying your deductible if you have one or the percentage that you are responsible for.

The amount of premium a policy holder pays in order to have a co-pay can easily be 25% higher than having a policy with no co-pay. Let’s say a 34 year old wants a policy with a co-pay and that policy is $85 a month. And this almighty $85 health plan only lets you see the doctor on a co-pay of $40 3 times per year. If a 34 year old bought health insurance without the co-pay benefits only $69 a month, and that policy covers all the same major medical bills like labs, radiology and hospital stays. It just doesn’t have the co-pay benefit. (Source www.MattsInsurance4CA.com )

At this point I sure I’ve lost a few readers because math scares them. Or because they feel that having a plan with no co-pay is absurd. Well for those of you still reading you are going to find a little secret. High deductible health plans give you the most bang for the buck. Just do the math. High deductible health plans like HSA qualified health plans cost less per month and have the least amount out of your pocket if there’s a big clam.

The average doctors’ office visit/consultation is about $58. Not far off from a $40 co-pay. And the annual savings on my health insurance policy with no co-pay is huge. What if that 34 year old co-pay type policy holder doesn’t go to the doctor all year? That’s right. You’re paying at least 25% more for something you never used. Kind of like that new treadmill/clothes rack you got at Costco.

Why are people so afraid to pay for a doctor’s visit themselves? I don’t know. Skip the co-pay plans and focus on the deductible and out of pocket max. It’s really no big deal. All it takes to save a huge amount of money is a little smarts.

You’ll thank me later. (Source: Monk)

High gas prices have inadvertently made some people, who wouldn’t have otherwise, walk or bike to work. Next time you’re out around 5:00 or quitting time, look around.  I see some people riding bikes who look like they haven’t been on a bike in years. I see more people walking around 5:00 who look like they are wearing work cloths and they have back packs on. And I think to myself “This is great!” Not only are they saving money on gas but if I’m not mistaking, their getting some exercise and it looks like their actually having a little fun.

Do higher gas prices equal a healthier America? I don’t know. But from what I see I think it may be helping by forcing some to get up and move around. Maybe it’s also keeping people from visiting the drive threw as often and forcing them to eat in. Home cooked meals are usually healthier anyway.

Now I know some people have been blessed with good health and others by no fault of their own misfortune of an illness. But many of us otherwise healthy people have just become lazy. If more of us get up, dust of that old bike in the garage and ride it to work or to the market a few times, we might just fight off that extra 10 pounds, and become healthier.

This is where we come full circle in regards to “price”. By biking or walking to work we’ll become healthier and this will help reduce our cost for health care. Some people may be able to reverse or minimize symptoms or illnesses such as diabetes or even prevent them in the first place by walking or biking to work. If we are healthier, we can also consider health insurance plans with lower premiums thus saving money. Healthier people don’t need to see the doctor except for maybe once a year. So why buy an expensive health plan? Buy a plan like an HSA health plan that has cheap rates and covers you very well on a big claim. I think it’s a smart choice for many people wanting to save on health insurance premiums.

I may be painting a rosy picture here but, when life gives you lemons… These high gas prices are forcing many people to revisit the old Schwinn. I say take advantage of it. Become healthier and reduce your health care cost.