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Reader’s Choice: Top Ten Health and Life Insurance Questions

Instead of the normal articles about the industry and how health insurance in general works, today we’re going to focus on you. Since this website has been launched, I’ve been asked a ton of questions by you guys about how health insurance works. So today, we’re going to take a look at the top ten health insurance questions as asked by you, our readers.

1. Should you buy health insurance from an agent, or directly from the company?

This one’s easy: use an independent health insurance agent. The rates are the same since they’re set by law, and agents don’t charge any sort of “broker’s fees” or anything to use their service. Agents tend to know a lot more about your options than your average call center employee, and they’ll work with you for the life of your policy.

2. What are the top five health insurance companies in Georgia?

Based on my personal experiences (level of client service, ease of application, claims payment record, etc.), I’d say that the top five individual health insurance companies in Georgia are:

Golden Rule (the individual division of United Health Care)
Humana
Aetna
Kaiser Permanente

Each company has its quirks, of course – Golden Rule is great if you’re in perfect health, but they love to issue riders. Aetna will decline anyone with three prescriptions. Humana doesn’t offer maternity benefits, and Kaiser requires you to stay within Kaiser facilities with most of their plans. Every company is different.

3. Can I still get COBRA if I was fired?

In most cases, yes. There is a provision in the COBRA law that says you are ineligible for COBRA if you were “terminated for gross misconduct,” but that has never been tested in court. Generally, if you leave a company (either voluntarily or involuntarily) and that company stays in business and keeps the group plan that you were on in force, you can get COBRA.

4. Is there such a thing as emergency maternity coverage?

No. If you’re already pregnant, no major medical insurer will issue a policy to you. Now, there are some guaranteed issue policies that will cover you, but you must be extremely careful with those – oftentimes, you’ll either end up paying more for the policy than you would for the pregnancy, or you’ll get stuck with a bill that the insurer will weasel out of. Never purchase a policy like that without consulting with an agent, preferably an independent agent who can compare it with true major medical plans.

5. How do I get my pre-existing conditions covered with an individual health insurance policy?

Depending on the condition, it’s possible that you can just apply for coverage and have it covered. Things like high blood pressure, cholesterol, and most allergies aren’t generally excluded from coverage under individual health insurance policies (however, the rates to cover these conditions may be higher). If you have a more serious condition, like diabetes or Crohn’s Disease, your options are more limited. In Georgia, there’s no state risk pool, so if you’re above the income level for Medicaid then you’re not eligible for state assistance. Your best bet is to find employment with benefits, or, if you’re self employed, talk with an agent about going on a small group plan. That’s a tricky option, but it can be done. There are some guaranteed issue plans in Georgia that will cover pre-existing conditions, but like with question four, you must be extremely careful with those. You can wind up losing a lot of money if you’re not.

6. What does maternity insurance cover?

Maternity insurance covers the costs associated with a normal pregnancy. Depending on how your specific maternity benefits are structured, you may either have a set amount of money to apply to maternity costs or your maternity costs may apply to a separate deductible. It’s worth noting that true emergency c-sections are covered by your normal health insurance plan.

7. What do I do when my COBRA runs out?

When your COBRA eligibility runs out, you can do one of two things. You can either purchase an individual policy, or you can elect to use a HIPAA conversion option. With HIPAA conversion, the health insurance company that administered your COBRA plan will switch you over to an individual plan, and you can’t be turned down for coverage. HIPAA conversions aren’t available until you have used up your entire COBRA eligibility period.

8. How does my deductible work?

Your deductible is the amount of money in medical costs you’ll be responsible for before your insurance company starts picking up part of the bill. If you have a copay plan, your copays generally will not apply to the deductible. Once you meet your deductible, then (depending on your plan) your insurance company will either pay 100% of the rest of your bills, or you’ll pay a small percentage until you reach your out-of-pocket limit. That small percentage is usually 20%, but some plans do increase that amount.

9. How did the new stimulus package change COBRA?

Previously, if you wanted to go on COBRA then you had to pay 102% of your health insurance premiums. That came as a shock to many people who went on COBRA, because they were used to paying only a portion of the full premium while their employer picked up the rest of the tab. Now, for the first nine months of COBRA eligibility, you’ll only pay 35% of your premiums and your former employer will pick up the other 65% (they’ll be reimbursed in the form of a payroll tax credit). At the end of those nine months, things go back to the way they used to be and you’ll start paying 102%.

10. What’s the best life insurance option for me?

Most people are best served with simple term life insurance. Get a policy that’s guaranteed renewable so that you never have to worry about being uninsurable, a face value that will provide for your loved ones (don’t forget to pay off debt and account for lost income when you’re figuring out how much you should get), and discuss the various riders available with your agent. In my humble opinion, variable life, universal life, and whole life are just not worth it for the vast majority of people. Term is simple, term is easy, and term is what you need. There are a ton of life insurance options out there, and with all the riders available you can really customize your term life insurance to fit your needs.

Bonus!

11. What does “no-stone-unturned” quote mean, anyway?

I get asked this one a lot, so I thought I’d toss it in there. I’m an independent agent, so when you come to me with a health or life insurance question I work with a bunch of different companies to make sure you’re getting the best deal on the market. Instead of just sticking you with an easy-to-issue policy, I leave no stone unturned to make sure that when I run a quote and write an application with you that I’m doing what’s in your best interest.

Did I miss any burning questions? Anything you’re absolutely dying to know? Then feel free to comment on this post, use the contact link at the top of the page to email me, or just call me up at 404-660-1020 and I’ll be happy to answer any questions you might have. Who knows, your question might make it into the next edition of this article! Or if this cleared up all of your questions and you’re ready to see how much you could be saving on your insurance, then head to our free insurance quote page and get a no-obligation, personalized quote!

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