Consumer's Health Insurance Blog

Can’t Get Medical Insurance? Move!

Jonathan Pletzke — Fri, 25 Jul 2008 11:14:10 +0000

I know it sounds crazy, but did you know that if you move to another state you may easily get health insurance, no questions asked? The reason is because some states do not allow medical underwriting when applying for health insurance, whereas the bulk of them do. So those states that don’t allow medical underwriting are much easier to get health insurance regardless of medical status - the application forms don’t involve disclosing your detailed medical history.

Sure there’s a waiting period for pre-existing conditions (perhaps six months), but then you’ll have your health insurance - and having health insurance is an essential component of many people’s financial picture. For whatever reason you no longer have health insurance, whether it due to an illness, a family situation, a layoff, or one of the many other reasons, getting it back can be essential. Relocating to a friendlier state may be your solution, along with considering the other options available without moving, including obtaining employment that offers health insurance or buying your own (and making sure that you know all of your options - that’s why I wrote a book on health insurance!)

Moving is not to be taken lightly - there are many consequences and expenses involved with moving. However, you can move to your new state in a very lightweight way, simply by establishing a residence consisting of no more than a studio apartment or a bedroom in a shared house. As you further transition to your new state, you may begin moving more items to the new state, and continue to make your transition. Some people never move everything they own to a new state, but have a second residence elsewhere (such as the scenario that many retirees desire - with a residence in Florida and a second home elsewhere). So long as you meet the defined requirements of residency in your new location, you’ll still continue to be able to travel and visit anywhere that you wish.

So which are the states that offer guaranteed issue health insurance without medical underwriting? Presently the short list of states includes:

A few more states that I’ve found have special programs that really help people in need of guaranteed issue health insurance (check with your state department of insurance as well as others before you make a move):

If you don’t wish to move, then you may find that your state offers guaranteed issue health insurance, subsidized rates for certain income levels, and special programs and special times of year when health insurance is not medically underwritten. There may also be specific special programs for those that have lost employment due to jobs moving overseas, or certain other industry and natural events. The best place to start finding out about these programs is with your state department of insurance. You can find contact information for your state department of insurance at State Health Insurance Resources at http://www.besthealthinsurancebook.com/state-health-insurance-resources/

As always, consult your team of financial and medical professionals before making a move. With these ideas and their advice, you may be better off.

This post originally appeared at HealthCentral.com at http://www.healthcentral.com/caregiver/c/76590/31355/insurance-move

Jonathan Pletzke is a consumer expert on health insurance and author of the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, available online and at bookstores nationally. Additional details can be found at the consumers health insurance book and resources website www.BestHealthInsuranceBook.com. Copyright 2007-2008 Aji Publishing.

Cavalcade of Risk Blog Carnival

Jonathan Pletzke — Fri, 18 Jul 2008 01:51:57 +0000

Cato Institute’s Michael Cannon hosts this compendium of insurance/risk related posts

Medicare: What’s Covered and What’s Not

Jonathan Pletzke — Tue, 08 Jul 2008 00:00:00 +0000

Medicare - What's Covered and What's Not

Medicare can be confusing. There are a number of pieces to the Medicare puzzle, and understanding how they fit together and where the gaps are is important to knowing where Medicare coverage begins and ends. For the official U.S. Government perspective on Medicare, visit the Medicare Options Compare website. Remember that Medicare is a financial tool and should be used with your own common sense to determine things you may also want above and beyond Medicare.

Pieces of the Medicare Puzzle

Medicare comes in four parts, with variations, and can be supplemented with other health insurance options purchased privately or from an employer retirement plan. The four parts of Medicare have evolved over time, and names have changed, too. They are now known as Part A (Hospitalization), Part B (Medical), Part C (Medicare Advantage), and Part D (Prescription). The other popularly known piece of the puzzle is Medigap, which is private insurance that supplements the other parts.

Part A: Hospitalization

If you end up in the hospital, you're likely to have significant medical bills. Medicare Part A, hospitalization insurance, is intended to help you reduce your liability for those charges that occur when you are in a hospital, a skilled nursing facility, or hospice, along with some home health care expenses.

View an Instructive Diagram of Medicare Part A Coverage

Premium: Varies based on your eligibility. Can range from nothing to several thousand dollars depending on whether you've worked the minimum 10 years to qualify.
Out of pocket: You must pay an annual deductible that is close to $1000 for the first 60 days of hospitalization. For 61-90 days in the hospital, you must pay about $250 a day. For 91-150 days in the hospital, you're on the hook for about $500 a day. Go over 150 days and you pay it all.
Providers: Anyone who takes Medicare Hospitalization.

Part B: Medical (Doctor)

Unpredictable medical expenses can make your financial life a mess. Medicare Part B, Medical Insurance, is intended to balance out the financial ups and downs to help you stay financially sound in the face of medical needs, including outpatient services, doctor visits, and some home health care. It specifically does not include vision, dental, routine foot care, hearing aids, and routine doctor visits.

View an Instructive Diagram of Medicare Part B Coverage

Premium: about $100 a month or more
Out of pocket: You pay 20% of the total allowable charges, Medicare picks up 80%.
Providers: Anyone who takes Medicare Medical.

Part A + B Supplement: Medigap

The Medigap supplement reduces the difference between what is paid by Medicare and what is charged by the healthcare providers. This can really make a difference once you look at the out of pocket costs of Medicare Part A and Medicare Part B. Since it is purchased from private insurers, the quality of the insurance company should be foremost.

Premium: Varies. For a 65+ in excellent health, insurers in my county are charging from $60 to $250 a month per person.
Out of Pocket: Varies
Providers: Anyone who takes Medicare Hospital & Medical

Part C: Medicare Advantage from a private insurer

When managed care was introduced for Medicare recipients, many insurers entered the market only to withdraw after a few years, leaving their policyholders unable to get coverage at the same rates. While this market has settled down, there is still a slight risk that this might happen again. Medicare Advantage Policies cover parts of A (hospitalization), B (medical), and D (prescription) and may cover other things, such as vision or dental. These are purchased from a private insurer and feature a "network" of authorized medical providers, much like an HMO or PPO, that restrict which providers you may see in order to be covered.

Premium: Varies, perhaps slightly more than A+B+D together
Out of pocket: Varies
Providers: Restricted to a network of providers. Utilization outside of network may result in higher costs or denial of coverage.

Part D: Prescription

Anyone who is taking significant prescriptions or who may take significant prescriptions may want this coverage. While the premium may exceed the cost of prescriptions while healthy, you may find that it works well if you need medication due to an illness. This is a particularly tricky one to figure out the point at which you break-even on the premiums due to the complex nature of the way it pays for medication.

View an Instructive Diagram of Medicare Part D

Premium: Varies, less than $100 a month
Out of Pocket: Varies. An example, after a deductible near $250 a year, you pay 25% until you've paid over $500, and then you pay about another $1500 before you get benefits again: where you pay 5% of prescriptions. Confusing? Yes!
Providers: Most pharmacies

Your Medicare Mileage will vary...

It may take some work to figure out the best Medicare options for you and your spouse. There are a few other things to keep in mind before jumping in:

Get a good insurer - if you're selecting Medigap or Medicare Advantage, you'll be working with a private insurer - and there is variance in satisfaction.
Make sure you play by the rules - ask first, don't assume, make sure it is necessary or covered when possible.
Know when to appeal - to the insurer, to the government.
Never miss a payment - if you do, you may not be able to get back into the plan, and if you can you may have to wait or pay a higher rate.

What is and is not payable under the plan is always changing - new items are added regularly, and things that you might have had last year may no longer be covered. You should check with your provider to determine what they believe is covered - and hold them to it. If in doubt about coverage of specific items, check with the Medicare Coverage website.

This post originally appeared at HealthCentral.com at http://www.healthcentral.com/caregiver/c/76590/29443/medicare-covered

10 Must-Have Investing and Insurance Books

Jonathan Pletzke — Sat, 10 May 2008 18:36:30 +0000

Get a Good Deal on Your Health Insurance Without Getting Ripped-Off named to "10 Must-have Investing and Insurance books"

"Dummies and Idiot’s guides may get you started in investing and help you understand the intricacies of your insurance policies, but these books are must-haves if you want to be an intelligent investor and consumer." - writes Dave Ralis of PhillyBurbs.com, the online version of the Bucks County Courier Times, who placed Get a Good Deal on Your Health Insurance Without Getting Ripped-Off on his list of "10 Must-have Investing and Insurance Books".

Five Star Book Review: Health Insurance Book at Retire Early Home Page

Jonathan Pletzke — Tue, 22 Apr 2008 23:10:20 +0000

Another 5 Star Review for "Get a Good Deal on Your Health Insurance Without Getting Ripped-Off" was posted recently at the Retire Early Home Page, one of the most interesting and useful sites for people interested in what it really takes to retire early. John P. Greaney, who successfully retired early at a young age, has very useful information covering all aspects of early retirement.

FM Talk 101 Audio Clip

Jonathan Pletzke — Wed, 13 Feb 2008 20:01:37 +0000

Listen to a brief audio clip from an appearance on FM Talk 101 with Brad and Britt in the morning. The format of the program was an introduction of Jonathan and the health insurance book Get a Good Deal on Your Health Insurance Without Getting Ripped-Off, followed by discussion with the hosts about the health insurance book, and then to the callers, who provided questions that Jonathan was able to answer well.

Cavalcade of Risk #45: Is love a risk?

jpletzke — Wed, 13 Feb 2008 17:32:44 +0000

The latest Cavalcade of Risk blog carnival is lovely. It is hosted this time by I’ve Paid For This Twice Already and includes some excellent reads on risk (health insurance being my favorite). My blog posting on health insurance copayments is included.

Best Hip Replacement Procedure Saves Money, Time, and Anguish

Jonathan Pletzke — Thu, 07 Feb 2008 19:17:10 +0000

Today’s post about hip replacement surgery reminded me of the huge difference in money, time, and anguish that can occur when a hip replacement is needed. We had a family member who has had a hip replaced in the “regular” way - with months of rehab, following a few weeks in the hospital. Had we known in advance about procedures like the one mentioned in the InsureBlog post “Nice joint. Thanks, I’m hip.”, our family member would have saved months of recovery, thousands of dollars in hospital costs, and been back on her feet in days, back at work.

When looking at the cost of health insurance and procedures, we often overlook the non-covered costs to the patient and family, which can sometimes exceed the costs of the procedure. Being out of work for months, needing additional care at home (or in a facility), and the physical pain and accompanying mental anguish are large costs, too. If you are in the market for a hip replacement, or know someone who might, shop around for different doctors and different approaches. There might be a huge difference.

And while I don’t know alternative treatments for many other maladies, there have got to be some other big ones, such as the difference between back surgery versus chiropractic or osteopathic medicine.

Health Wonk Review at the Health Business Blog

Jonathan Pletzke — Thu, 07 Feb 2008 15:44:14 +0000

It took me some time to figure out that a Health Wonk is a Health Policy Commentator, and this week the Health Business Blog hosts the Health Wonk Review, which includes folks saying what the candidates should be thinking about regarding health policy, including health insurance. You’ll notice my post Two Specific Areas for Improvement in U.S. Healthcare is included, along with some other interesting insights. Go read the posts!

Cavalcade of Risk #44 by the Silicon Valley Blogger at TheDigeratiLife.com

Jonathan Pletzke — Thu, 31 Jan 2008 01:50:29 +0000

The latest cavalcade of risk (#44) bi-weekly carnival of risk related blog posts is up at The Digerati Life. Check out what’s happening in the world of risk management, insurance, and the like.