Wednesday, March 9, 2016

Don't Financially Bleed Out.

Don't Financially Bleed Out.

The amazing facts that go along with health insurance now days are staggering. Even with no cost for preventative visits, co pays and for many the low cost for health insurance, there is still a big out of pocket expense.

The Affordable Care Act has taken the cost of health insurance and tripled it. Now, I am a big proponent of the Affordable Care Act. I feel it is way better than the older plans with underwriting. Guaranteed coverage is what was needed in the market. But it also brought up other issues, cost being the biggest part   If you are not eligible for a "tax credit" and you have to pay full price for your plan, it can be very costly.  even with a substantial tax credit the cost can be huge if a major sickness or injury occurs. Out Of Pocket expense is also another part of cost the needs to be factored in.  With deductibles reaching as high  6850.00 for a single person and 13700.00 for a family. It is scary to think what would happen if a catastrophic emergency came up.  Even a broken arm could be a huge burden financially.

Cheap health insurance is not always better.  Sure, you want to avoid the tax penalty. But, being under insured is now a bigger problem in today's market than not being insured at all. Picking the least expensive plan will almost always put you financially at risk. 62% of all bankruptcies are due to medical bills.  Out of the 62% of people, 71% HAD health insurance. They were under insured.

A study presented at the 2014 Palliative Care in Oncology Symposium found 27 percent of cancer survivors reported suffering a financial problem like debt or bankruptcy. Another 37 percent reported modifying work plans or delaying retirement.
Experts say one of the biggest financial mistakes patients make is letting bills pile up. It’s easy to do when faced with such a tragic diagnosis, but it often leads to even more problems in the future.
Individuals and families feel the financial burdens of cancer on personal levels, but it affects everyone on a larger scale.

So what is the solution, or maybe not the cure all solution, but a good option to greatly reduce out of pocket expenses? It is the same type of solution that Medicare has, and that is chose a comprehensive supplemental insurance plans. 

The solution of insurance supplements have been around for decades. The reason why it has not gone mainstream is large in part of lower deductibles that were available in 2000-2012.  Considering that a high deductible a few years ago was 2000.00 and now it is 6850.00.  The cost of plans were a lot cheaper as well (minus the services that were not covered, of course). The need for a supplemental plan is now more important than ever to keep yourself financially solvent.

Supplemental Insurance Example

Plans very company to company and it is important to to talk to an agent to see to cost difference and the payouts that supplemental plans cover.  The biggest difference between medicare supplements and under 65yr supplements is the under 65yr plans will almost always pay YOU a lump sum or monthly sum.  It is then up to you to pay you bills, premiums, etc..

-WI Insurance Guy

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Sunday, August 30, 2015

5 Common Mistakes People Make When Purchasing Health Insurance

Health insurance is more confusing today than it ever was.

          As an agent, I get non-client calls throughout the year asking about changing plans, modifying existing plans  or canceling all together. The one question I always ask is, "Did you have an agent help you?" Needless to say most of the answers were "No". That is not surprising given the fact that is available to anyone.  Not that's an issue in my book, but it does create the impression that shopping for health insurance is an easy process. If it were easy to find the right health insurance, I would be out of business.  On the contrary, I'm busier than I have ever been before.

Here are the 5 most common mistakes that are made when shopping for health insurance...

1. By-passing professional  help (licensed agent/broker)

Since the ACA there have been the creation of Navigators and CPC's (certified plan counselors). A misconception is that agents/brokers cost money to use. That is a big huge "NO"! Agents/Broker services are no cost to you. Were not mechanics or plumbers. The difference between agents/brokers and navigators/CPC's is, Agent/Brokers have more training, states licensed, state tested, appointed with each individual insurance company they offer, and, have a vested obligation with each of their clients. Agent/Brokers run their business on this standard and they're there to make sure you fully covered.  They have fiduciary responsibly to make sure to ask all the questions they can to find the plan that best fits your need. They help you enroll and are a great resource if you have any questions.

Ask yourself, would you see a certified doctor or licensed doctor? 

Do yourself a huge favor, don't skip professional help. 

2. Shopping by price, not benefits.

 Today's insurance marketing seem to largely focus on price.  How cheap can I get a plan. The problem with that is, yes, it may be cheap, but what does it cover? If you are on moderately expensive medication, that "cheap" plan may not actually save you money. On the contrary, it may cost you twice as much because your plan has a deductible that needs to be met first instead of copay's. The best plan is a balanced approach to the benefits available, deductibles, copay's and cost. Not cost alone.

3. Not checking you network

A very important question to ask is.."Is my doctor covered under this plan?" It seems to be overlooked when shopping for a plan by yourself. Healthcare providers today have "narrow networks". That means you are confined to a local network of doctors and hospitals.The big mistake here goes back to price. Picking the cheapest price could mean that you may have to pick a new doctor. If you travel a lot there is a good chance that you will travel out of your covered area, which means, if you get sick while traveling you could pay the total cost.

4. Supplemental insurance

This is so huge! It is unbelievable the countless amount of individuals NOT covered with supplements. Of course health insurance is there so we can reduce the financial risk of being sick or injured, but it never eliminates that financial rick completely. The most common misconception is that having health insurance give them complete coverage. But what happens if you get sick or injured and you can't work, or you still have a huge deductible to pay before your health insurance kicks in? That is where supplemental products come in. 

6000.00 supplement plan could pay the 5000.00 deductible completely


5. Not looking at the big picture.

Health insurance is really just a core program and needs to be built up. Here is a great example of building up your health insurance.

Building up your health insurance

f.Life Insurance

This comprehensive coverage! If you think this to really expensive to have then scroll back to number 4 and read it again.

Don't make these 5 common mistakes.  
60% of all bankruptcies are because of uncovered health expenses. Get covered correctly and get the professional help to show you how. 

-WI Insurance Guy

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Wednesday, August 26, 2015

The "New" ACA

The ACA has been around since 2010

The Affordable Care Act
But the effects have really been seen since 2013. There has been a huge drop in the uninsured rate (now below 10%) down from over 14%. Millions have entered the marketplace to gain a tax credit that can be used for reducing the cost of health insurance.

The 2 big questions that most people have is..

1. How does the tax credit work?
2. Can I still afford coverage?

I'll break this down a little further so hopefully you will get a better understanding of the basic workings of the ACA (Obamacare).

How does the tax credit work?

   There is an algorithm that is in place that will tell you how much you can receive in a tax credit. The tax credit is given in two ways. 1.A one lump sum at the end of the year as a refund or 2.A monthly credit paid to the insurance carrier you chose to go with. You then are responsible for the difference and pay that difference to your insurance carrier.
The way the tax credit works is based on 4 things.
-Zipcode (geographical location)

So, for instance, a couple that is 35, making 45000.00 per year living in West Allis WI would get Approximately 290.00 for a monthly tax credit they can use towards their health insurance.  But, A couple that is 61, making the same amount, living in West Allis WI would get Approximately 1115.00 for a monthly tax credit. Why the difference? I'm glad you asked! To make health insurance "affordable" you will need to adjust the credit accordingly.  The credit is based on the "average" cost of the second highest bronze plan that is available in your area. Statistically, the older you get the more health issues you have, the cost of insurance goes up dramatically and so does the tax credit to keep it in line with affordability. Women will always pay a little more to off set the cost of pregnancy and you location has a small effect as well. To summarize, unless your a Nobel Peace Prize winner in mathematics and want to figure it out yourself, you can get an idea by going to

Can I still afford coverage?

The answer to that question is kind of open ended, but my answer to you would be, yes, "mostly".
I ask all of my prospective clients "What is your budget?"  I have been able to find a comprehensive 
plan that fits that budget 95% of the time. although biggest part of that equation is the budget that a person has to use for health insurance, another part of that equation is the health of a person. Having health problems increases your premium in a round about way. You will need lower deductibles and lower out of pocket costs compared to someone with no health problems. The best way to find out if you really can afford coverage is to talk to a local agent. Someone who knows the in's and out's of plans available to you. Don't write off your health insurance because you think you might not be able to afford it. I have talked to many clients that said they wished they talked to me months ago! So, the answer to the Million dollar question is.... Talk to an agent, discuss your situation and have them counsel you on your best options.  Ultimately, it is your choice.

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