Health insurance quotes are confusing and full of jargon, some of which I went through and explained last time. This time, I’ll go through some of the most common red flags often overlooked by the consumer.
Some common red flags:
1. What is the cancellation policy? – All policies have provisions where the insurance company can cancel (rescind) the policy if there is evidence of fraud or an omission of a condition or medication. They can also cancel a policy for lack of payment. This is normal. However, there are also policies that state that the insurance carrier can cancel as long as they give the policyholder 30 days written notice. This is a scary proposition! What if you contract an expensive disease that requires months of hospitalization? A letter cancelling your coverage would not give you any options.
2. What are the waiting periods? – Some policies have no waiting periods on coverage. Some will state a 30 day waiting period on doctor’s visits. A 90 day waiting period on elective surgery is normal, but stay away from policies that require a 6 or 12 month waiting period.
3. Does the maximum out-of-pocket include the deductible? – If you have a plan with a $2500 deductible and a $5000 out-of-pocket maximum, it is reasonable to assume that the maximum you will spend is $5000. But the scary truth is, some plans don’t include the deductible into that equation. If you are comparing two plans side by side and they seem equal but are vastly different in price, this might be the reason. It can be easily overlooked.
4. Is the deductible per year? – This seems like a stupid question at first. Most deductibles are per year, after you spend your deductible in that year then you may or may not have more to spend before you reach your out-of-pocket maximum. But there is one company in particular that offers a lower-priced policy with a deductible per incident. Yikes! What if you have 3 separate surgeries in the same year? That could get very expensive very quickly.
5. Is the out-of-pocket maximum too high? Some plans will have a reasonable deductible, like $2500, and then put it with an out-of-pocket maximum of $10,000. That’s pretty high! Sure it looks like a bargain, but in reality may be similar in price another company’s plan with a $5000 out-of-pocket maximum. Why not get something that will cost you less in the long run, even if it costs a few dollars more now? I can help.
Most people are confused by insurance quotes or statement of coverage. Don’t just skim over it. Figure out what you are buying (or already have bought) or at the very least let me take a look. I understand it and won’t charge you anything. I won’t even try to sell you something unless there is a red flag that needs to be corrected or I can get you better coverage for less money. Give me a call.
