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When Health Insurance Isn’t Enough

When health insurance isn’t enough

Take a moment and think about your current health insurance plan. (You have one, right?) How much does it cost? What does it cover? More importantly, what doesn’t it cover?

A United Healthcare Consumer Sentiment Survey showed that only 9% of Americans surveyed “showed an understanding” of four basic health insurance terms — health plan premium, health plan deductible, out-of-pocket maximum and co-insurance. While that’s two percentage points better than a year ago, 9% is still an alarming number. All of these terms represent numbers- important numbers that tell you how vulnerable you are financially should you have a medical emergency. Here are the definitions in case you need them.

These terms represent gaps in coverage, and almost all health insurance plans have them. In 2016, the average family deductible was $7,983. That’s $7,983 that has to come out of your pocket before insurance helps. Now, for some people that is not a struggle, but for most Americans that is a crippling amount.

The good news is there are tools that can help with this, and if you’ve found a skilled insurance agent, they should be able to build a plan for you that includes major medical coverage  complemented by other tools to make sure there are no financial gaps. When all the right pieces fall together you can feel confident that you’re financially prepared for any medical emergency. Below are a few examples of these tools and how they work:

Accident coverage: These plans are usually designed to pay lump sum amounts in the event of an accident. For example, if you were to skip a step on the stairs and break your ankle, these plans would pay a lump sum amount to offset your out of pocket costs.

Critical Illness/Term Life Coverage: These plans have a double benefit. They are a life insurance policy, meaning it will pay out in the event of death. These policies are a bit different than traditional life insurance, because they also have living benefits- in the event of a critical illness.

They can range from $25,000 to $100,000 and can be used to cover the gaps in your coverage or to help supplement your income should you need to be off work. Examples of a critical illness include: cancer, heart attack, stroke, etc.

The Triomed: This plan includes both accident and critical illness protection in one step. It is designed to pay your out of pocket expenses for accidents and pays lump sum amounts if there is a critical illness diagnosis. It can range in value from $2,500 to $30,000 and can be personally designed to fit the specific gaps in major medical coverage.

While these are just a few examples of a wide variety of options available, a qualified health insurance agent can help you build coverage that will leave you confident you are protected in the event of a medical emergency. No one should have to be distracted by the cost of care when healing is the most important priority.

At Crosspointe Insurance Advisors it’s our mission to make health insurance simple and clear. We are happy to sit and discuss all of these options to make sure you not only have the most cost effective and thorough coverage available, but that you understand it. Peace of mind can be invaluable. Contacting us is easy.  Simply call us at 812-401-7556 or visit www.crossepointeinsurance.com

Employer Sponsored Coverage vs Individual Coverage

Employer Sponsored Coverage vs. Individual Coverage

 

When it comes to group vs. individual plans, you probably know the basics: Health insurance that an employer provides its workers is group coverage. Health insurance that someone buys on their own is individual coverage. But what makes one plan better than the other for you? Let’s take a deeper dive to understand the differences.

Under the Patient Protection and Affordable Care Act, there are minimum standards for individuals and companies regarding healthcare coverage. Most employers with 50 or more employees must offer health care plans. Self-employed individuals who do not work for an organization full-time also must have coverage, according to HealthInsurance.org.

What to Expect from Employer-Sponsored Coverage
Of Americans who have health coverage, nearly 60 percent have a group plan, according to HealthInsurance.org. If you’re in this majority, here’s what you can expect from employer-sponsored coverage.

Your employer may:

Include a range of plan options, including HMO, PPO, or additional coverage options, including dental, vision and life insurance.
Be responsible for a significant portion, or all, of your monthly premium.
Deduct the share of your premium from your paycheck each pay period.
Provide additional assistance through their human resources department, where you can access documents relevant to your plan and direct questions about coverage.

If You Don’t Have Group Coverage, What Can You Expect from Individual Coverage?
Americans without group coverage fall into the individual health plan category. With individual coverage, you’ll likely:

Choose a plan that covers you and your family, and pay the monthly payments.
Plan on enrolling during an open enrollment period. You can only enroll at other times of the year if you qualify for special enrollment.
Determine if you qualify for cost assistance also known as (Subsidy eligible).
Select from Bronze, Silver, Gold or Platinum plans through the health insurance marketplace, through a broker, or directly from a carrier if you are not subsidy eligible.

Sometimes navigating through individual health plans on your own can be difficult; having the proper health insurance for you and your family is important. Understanding your options when you don’t have an employer plan can be confusing. Take the time to educate yourself so you can choose the right plan for your family.

Let us help you shop and tailor the perfect insurance coverage for you.

Keep Calm – Get Covered

Finding it painful to shop for Healthcare for your family? Interested in what alternatives are available for Healthcare outside of Open Enrollment? Qualify for a Special Enrollment? Contact one of our talented advisors today!

Every year come Fall we gear up for Open Enrollment and work diligently to enroll thousands of families and individuals for yet another year of financial peace of mind. This election period is from Nov. 1st – Dec. 15th for a January 1st effective date this gives our nation an allotted time to choose their healthcare plans for the following year. The Affordable Care Act as we know it has been the go to for our nation’s healthcare since March of 2010. Nevertheless, many will not take advantage of this opportunity or will miss it for various reasons.

First and Foremost, certain life events qualify you for a special enrollment period. A special enrollment period is a period of time (usually 60 days) during which you can buy a health plan through the individual Marketplace, even if it’s outside the normal Open Enrollment period. The events that trigger a special enrollment period are called qualifying life events, such as, loss of creditable coverage through an employer, marriage, divorce, birth of a child, or you move to a new state.

For those of us who do not qualify for a Special Enrollment, just know, you have options. We want to be sure that you know the best options and the perfect fit for you and your families. For those who want to avoid the tax penalty mandate a great alternative which is about half the cost of an average Marketplace plan is an option from Christian Care Ministry called Medi-Share. These plans offer affordable healthcare at its finest. They offer an Open Access PPO Network (PHCS) which offers a large provider network, coverage across state lines, and provide continuous coverage throughout each year. Keep in mind, Medi-Share is not for everyone, nevertheless, it has been a perfect fit for many of our clients.

Another go to alternative outside of Open Enrollment would be our Term Major Medical plans with National General Accident and Health, an Aetna Meritain company. These plans are non- religious and offer medical coverage that provides protection from a variety of medical expenses. They provide immediate coverage for the very next day. Choose a provider within the Aetna Open Access Choice PPO Network, which has more than 664,000 participating providers in various specialties. Like Medi-Share, you have the flexibility to travel across state lines and not have the worry about losing coverage. These plans accept healthy tobacco- users and are great for an individual or family that need insurance for a short time period.

Healthcare is expensive, fortunately YOUR insurance doesn’t have to be! Pick and Choose a Level of Benefits with one of our Foundation Health Plans from National General Accident and Health. These plans offer more affordable and predictable ways to get the coverage you need immediately without the battle of deductibles and coinsurance! Using a Medical Indemnity plan just got easy on your pocket book!

Lastly, pair any of these great healthcare alternatives with our plan enhancers! Who plans for unexpected out-of-pocket costs associated with accidents, hospitalization and critical illnesses? Our clients! That’s Who! Consequently, what does an individual do that finds it financially important to carry healthcare? Let the experts at Crosspointe educate you!

The Language of Health Insurance


The Language of Health Insurance:
What Does It Mean?
By Bernice Jones

Gambling with your Healthcare Coverage
If you’re like most people, you pay your premium, hand over your insurance card, then hope for the best. STOP! You don’t have to take a risk every time you walk into the clinic or pharmacy. Deciphering what your plan covers is frustrating and confusing when you don’t know what the terms mean. Here are some of the major/most important terms broken down to help you understand.
Premium
What you pay for the coverage you recieve. This varies depending on coverage, age, location and tobacco use. It’s easy to be drawn toward the lowest number but be aware of what those plans will cost you throughout the year. Low Premiums usually result in High Deductibles which cost you more upfront. Things that help lower your premium:
-Marketplace Tax Subsidies -Employer contributions

Deductible
The amount you’re responsible for BEFORE the plan starts covering you. This is a major factor in choosing the right plan for yourself. What are you comfortable paying before your plans major benefits kick in? Plans are usually set up in two ways:
Copayment Style
Copayments for set services are not subject to the deductible while while other services are deductible dependant.
Deductible Style
Deductible must be met before any service is covered.
Copayment
Set payment amounts for services like physician visits, prescriptions, etc. These services are not subject to the deductible if there’s a Copayment for them in your plan. This is beneficial because you can have coverage for these things without meeting your deductible. Keep in mind, ONLY the consultation at the physician’s office is included so you are billed for any extra services like x-rays or laboratory testing.

Coinsurance
The percentage you pay for service AFTER the deductible is met.
Example: Policy with 20% Coinsurance with deductible met: X-ray cost $200-80%=$40 patient responsibility.
Example: Same policy with deductible not yet met: X-ray cost $200=$200 patient responsibility.

Maximum Out of Pocket (MOOP)
The most you will pay annually. It’s the “Worst Case Scenario” part of your plan. When reached, coinsurance stops and you’re covered at 100%.
Example: Sadies policy has a $2,000 deductible, 20% coinsurance, and a MOOP of $6000. She breaks her leg and has surgery. Her medical bills are $27,000. Here’s how it breaks down:
$27,000-$2,000 (Deductible)=$25,000
$25,000 x 20% (Coinsurance)=$5,000
Sadie’s responsible for the $2,000 deductible Plus the Coinsurance ONLY up to her MOOP. So even though the deductible plus coinsurance is $7,000, Sadie only pays $6,000. This is where her responsibility ends. Also, medical costs that Sadie has for the remainder of the policy year are covered at 100%.

Ask Questions!
A knowledgeable Agent can help you weigh the available options and understand the plan you choose. Medical costs can be astronomical. Understanding your coverage can reduce your risk of those costs becoming your responsibility.

Request your Health Insurance quote today!

Deductible Disasters

Avoiding Deductible Disasters

What’s a deductible? Why are deductibles used and what are their benefits? Most importantly what can you do to protect yourself from your deductible?

Well for starters a deductible is the specified amount of money that the insured (you) must pay of their own healthcare costs for the year before the insurance company kicks in and pays any expenses. This includes all doctors visits, medications, surgeries, and ambulatory care. In a sense the higher your deductible is the lower the risk on the insurance company. Higher deductibles keep the insurance company from having to incur the costs of all the small healthcare needs of the insured which in return helps keep the costs of your monthly premium lower.

Many people have recently chosen to go with a high deductible plan for themselves or their family with the intentions of saving money immediately. There are also several other benefits of going with a high deductible health plan:

Your insurance company will negotiate a lower rate for all of your healthcare costs even before you hit your deductible.
In most cases preventive care is covered at 100% and not subject to your deductible, if you have an affordable care act compliant policy.
Depending on your plan there are varying levels of prescription coverage.
These plans act as a safety net to protect you against unplanned major medical expenses.

You have a high deductible health plan in place to protect you in the event of an untimely major medical catastrophe, but what happens when that unfortunate event becomes a reality? Luckily you have insurance which is going to kick in and help pay for major costs, after you’ve met your deductible. Nonetheless that still leaves you fiscally responsible for all the medical costs incurred up to the point that the insurance kicks in. What kind of plan do you have in place to protect your life’s savings?

Fortunately there is a perfect way keep a major medical event from affecting you financially. The best plan of action in order to give yourself that peace of mind and financial protection is to pair your health plan with a supplemental policy.

Supplemental policies are stand alone policies that work side by side with your medical insurance.These plans pay you upfront cash benefits in the event that the unthinkable does happen. Depending on the policy the benefit would either match your out of pocket expense amount or exceed that amount allowing you to have extra funds. Being diagnosed with a critical illness could mean you’re unable to work, choosing a policy with a higher benefit amount would make sure you were able to pay your bills in the meantime. We have supplemental plans to fit everyone’s needs or budget some even starting as low as $21 per month.

Don’t let yourself get stuck in a deductible disaster. Call Crosspointe today to speak with one of our skilled Health Benefits Advisor’s at no cost to you. A single phone call could potentially save you thousands of dollars.

If you’re ready to find a plan, give us a call at 888.788.1565 or submit a request for a quote online.

I’m young and healthy, why do I need insurance?

Written by Licensed Health Advisor, Lindsey M. Tieken 

Congratulations! Age and health history are the first major hurdles people have to face when purchasing insurance. Being young and healthy will do nothing but improve your chances of spending as little as possible for health and life insurance, and there will never be more options for you than there are right now!

ACA Compliant Plans offer coverage for everyday things that you may not expect. Need a physical for school or work? Free! Need your annual pap smear? Free! Need a preventive mammogram or colonoscopy? Free! Having these tests regularly are a HUGE component to maintaining your health and discovering potentially life threatening illnesses early enough to be treated. The cervical cancer death rate  alone declined by more than 50% over the last 30 years, and this has been attributed to access to regular screenings. Another important component of these plans is that they are required to cover mental health needs. Access to a variety of therapy options is an increasingly valuable benefit considering 56% of American adults are living with an untreated mental illness.

Hopefully, annual exams are the only thing for which you will ever need your insurance. Unfortunately, that is usually not the case. Over 62% of Americans between the ages of 18 and 44 had medical expenses over $100 in 2013. A simple broken leg can cost up to $7,500, and a complicated illness can cost hundreds of thousands of dollars. 48.3 million Americans had problems paying their medical bills in the first six months of 2016 alone. In addition, most insurance programs will not accept new participants if you become sick. If you are diagnosed with an illness while you have no coverage it will certainly limit your healthcare options- potentially making you fully responsible for the medical expenses or lack of medical support you may encounter.

Having health insurance is the most responsible decision for your financial future. A 2015 poll done by NPR, Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health found that 50% of respondents had their credit adversely affected by medical bills. This was through credit cards, loans, and even collections that lead to complete bankruptcy. It is common knowledge that having credit issues can and will limit your options on making major purchases- such as homes and cars.

The time is now to invest in your health and your financial future; don’t allow yourself to spend another day unprotected. Your wallet and your family will thank you.

 

If you’re ready to find a plan, give us a call at 888.788.1565 or submit a request for a quote online.

 

What does a consultation with a Crosspointe Insurance Advisor look like?

Q8: What does a consultation with a Crosspointe Insurance Advisor look like?

A:We want to educate you on all of your insurance options, so we begin by asking a few questions. We don’t charge you any fees for working with one of our agents on your health insurance plan. While we can do consultations over video chat or telephone, we prefer in-office meetings so we can talk about finding a plan that covers what’s most important to you. Once we have an understanding of your needs and current situation (e.g. family size, income, assets, and smoking habits), we will walk through policy options, together. Once we find the right policy for you, we will talk you through the process and complete the paper work. Have the experience of an insurance expert on your side, and remember, our expert advice is free. Give us a call at 888.788.1565 today or submit a request for a quote online.

FAQs, Part I

^3957EAB73AB5DD5D7176CF849E79CFEE91E1E0C2B9026C039B^pimgpsh_fullsize_distrAs our clients grow into educated insurance consumers, we often get a lot of questions along the way. Here we’ve compiled a list of the questions we’re most frequently asked, so you can understand some of the complexities in shopping for insurance. Make sure to check our blog weekly for the latest videos and answers to your insurance questions. Click the question below to view the full post and video.

Q1: Are there fees for working with a Crosspointe Agent?
A1: No! There are no fees for working with an agent at Crosspointe! Whether you shop online by yourself or talk to one of our expert insurance advisors, your plan premium will be the same. Another benefit of working with one of our advisors is that you’re working with an educator, not a sales person. You’re getting an expert, focused on finding the right health plan that covers you and your family or your business based on your needs. We want to help you find the plan you need, and the best part is: It’s always FREE.

Q2: How does ACA impact Small businesses?
A2: In 2015, businesses with 50 or more employees will be required to offer health insurance, but those with less than 50 employees hold no similar obligations. Many small businesses find that health insurance is their largest expenditure (second to payroll). By offering employees a group insurance plan, they may be preventing them from taking advantage of premium tax credits. These tax credits are only offered to those who do not receive benefits from their jobs or are 400% below the poverty line. Because employees may be subject to these benefits, employees could receive Federal tax credits to help pay for their insurance premiums; employers could save money themselves by not offering group insurance.

Q3: Why do I need a health insurance broker?
A3: The Internet puts a lot of information at your fingertips, including everything you ever wanted to know about health insurance. While it’s nice to have this information available, finding the right health insurance plan is important and there are a lot legislative complexities to navigate. It can be very difficult for consumers to sort out their best option on their own. The new healthcare laws impact how tax credits work and without the help of an agent, it can be hard to figure out how to use them to your advantage. Crosspointe makes the process of finding the right insurance plan simple, guiding you through your entire enrollment process. Purchasing a plan with the aid of an advisor has NO ADDITIONAL COST, so there’s no reason not to consult an expert.

Q4: How are premiums calculated?
A4: In the past, it was necessary to answer questions about everything from family history, lifestyle, employment history—everything but the kitchen sink! With the new laws and the Affordable Care Act, premiums are calculated based on: Age, where you live, whether you use tobacco or not, and household income. If your household income is at or below four times the federal poverty level, the cost of your plan will be reduced to make it more affordable. You also won’t have to worry about seeing your rates increase or being denied coverage based on a pre-existing health condition. You cannot be turned down or charged more; only the above four factors apply.

Q5: How do I know if I qualify for tax credits?
A5: Tax credits are based on household size and income, and will come in the form of an immediate reduction on the cost of the insurance plan that you choose, allowing those eligible the freedom to choose the plan that makes the most sense for their lifestyle. If you are a small business owner, self-employed or don’t have coverage through your job, you may be eligible for a tax credit.

Q6: I don’t want to use Obamacare (Patient Protection and Affordable Health Care Law). What are my options with insurance?
A6: The Affordable Care Act is a collection of rules and regulations related to how health insurance operates in America. The ACA is not an insurance program. In the law, there are two main components that are meant to help make health insurance more affordable for the general population. The first ensures that you or a loved one cannot be denied or charged more for coverage due to a pre-existing health condition. The second element allows for tax credits for reducing health care cost depending on access to health insurance coverage, your income, and employment.

Check out our blog for more videos and more answers, coming soon!

Are There Fees When Working With An Insurance Agent?

Q1: Are there fees for working with a health insurance agent or broker?

A: No! There are no fees for working with an agent at Crosspointe! Whether you shop online by yourself or talk with one of our experts, your plan premium will be the same; we help you get the right plan. With our approach, you’re working an educator, rather than a sales person. You’re getting an expert focused on finding the right health plan that covers you and your family or your business based on needs and the best part is: it’s FREE.

What are my insurance options without the Affordable Care Act?

Q6: I don’t want to use the Affordable Care Act. What are my insurance options?

A: “I don’t want anything to do with Obamacare.” “I don’t want to sign up for health insurance through the government!” We hear these concerns and understand, but the law is not a health plan, or coverage, ACA contains the rules that govern health insurance in America. The new laws focus on two key elements:

  1. If you have a pre-existing health condition, you will not be denied or charged more for coverage.
  2. Depending on household income and access to coverage through your employer you may have access to a credit that will reduce your healthcare costs.

We are not here to debate the merits of the ACA, but rather, we want to find the ways it can best work for you. Don’t wait or get penalized for not having health insurance in 2015. Give us a call at 888.788.1565 today or submit a request for a quote online to discuss the options available currently and what you can do to cover yourself, your family or business.