July 2015 - Susman
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Dental Insurance

Dental costs are becoming an increasingly significant health care expense and more and more people are making sure they are protected against these costs with a dental insurance policy. Dental insurance policies typically work in the same way as any other medical insurance policy. You will pay your monthly premium and this will entitle you to specific dental care procedures such as checkups, cleaning and x-rays. You will also be covered for other procedures that are deemed necessary to keep your teeth and gums in good health.

Comprehensive

As with all insurance policies, they will vary in what treatments they cover and how much they cost. While more expensive policies will give you greater benefits and allow you access to a greater range of services, cheaper ones will be restricted in what they cover and you will be required to contribute to the cost of procedures you require. If you think you will need dental surgery, oral implants, the services of an orthodontist and other more expensive forms of treatment, you will probably want to go for a more comprehensive policy.

One of the main differences between medical and dental health care is that children generally require far more treatment and expense than adults do. This is true right up through your child’s teen years when orthodontists’ bills can often be extremely expensive. You may therefore wish to cover only your children with dental insurance and you should check with your insurer to see if this is possible. While some insurance companies will allow children to have their own dental insurance policies, others will only insure them as part of an adult or family plan and if this is the case you will require to insure them with your own dental insurance provider and this may mean taking out dental insurance for yourself if you do not already have it.

Discounts

Another option offered by some insurance companies is to take a form of dental discount card. This is not dental insurance in the strict sense of the meaning but does provide you with discounts on dental treatment when you require using them. They can be a cheaper way of obtaining limited protection against dental costs and for this reason are growing in popularity. Not all insurers will provide them so shop around and see what’s on offer. As with all insurance, there can be great differences is what you will be offered for your money and considering that dental insurance can be a significant expense, it is wise to make sure you know what is available before you decide to opt for any policy.

Delta Dental Insurance 101

Delta Dental Plans Association, more commonly known as Delta Dental, is one of the best known dental insurers in the United States. Delta is a not-for-profit association that offers dental plans of all types for companies across the U.S. Their 39 member companies administer dental benefit plans whose main focus is providing and improving access to dental care for all. Today, Delta Dental associates provide dental coverage to over 46 million people through over 80,000 employers and agencies.

Delta Dental insurance offers three major plan types to suit a wide range of needs. The benefits vary by plan, and costs vary by region and employer.

Delta Dental Premier (formerly DeltaPremierUSA)
Delta Dental Premier is a traditional fee-for-service insurance plan. If you have Delta Dental Premier, you can visit the dentist of your choice within or outside their provider network. The dentist bills Delta Dental directly, and Delta Dental pays their portion of the bill (most often a set dollar amount), then sends you an explanation of your portion of the bill, which you pay to the dentist.

Ex. Delta Dental pays $45 for a filling. Your dentist charges $60 for a filling. You pay the dentist $15.

Delta Dental PPO (Preferred Provider Option)
Like the Premier plan, Delta Dental PPO pays a fee for each service. You may also visit any dentist that you choose, but will pay lower fees to dentists who are part of Delta’s Preferred Provider network. The dentist handles all the paperwork and claim forms. Delta generally pays a percentage of the procedure rather than a set dollar amount.

Ex. Delta Dental pays 70% of the fee for an extraction. Your dentist charges $210 for an extraction. You pay the dentist $63.

DeltaCare HMO
DeltaCare focuses on prevention and maintenance of your dental health. When you enroll in DeltaCare, you choose a primary care dentist who will be responsible for your dental care. If you require specialty services – orthodontics or oral surgery, for example – your primary care dentist must refer you for services. You pay a low or no co-payment for any dental services provided.

Ex. Depending on the plan, you may pay a $10 co-payment for office visits, no matter what the procedure.

The cost and availability of each option is dependent on the company through which you enroll. As the nation’s largest provider of dental insurance, the costs are significantly lower than most other plans.

Definition of Whole Life Insurance

Whole life insurance, also known as “cash-value” insurance is a basic and consistent type of permanent life insurance which remains in effect your entire life at a level premium. This life insurance is a good choice got you if you do not expect your life insurance needs to diminish over time. A portion of your premium goes into a reserve fund called ‘cash value’ that builds up over the years your policy is in affect. Your reserve fund is tax-deferred and you can borrow against it, until you withdraw it.

The premiums must generally remain constant over the life of the policy and must be paid periodically according to the amount indicated in the policy. You may also have the option of a single premium — paying all of the premiums at once with a single lump sum. Your cash values will grow to equal the amount of the death benefit when you turn to age 100.

Although, whole life insurance is very expensive, and if you’re on a limited budget, you may not be able to afford all the insurance coverage you actually need. But the plus point is that the death

benefit is guaranteed as long as premiums are met. Also death benefit will never decrease if you don’t borrow against it.

Whole life insurance policy’s returns will fluctuate with the markets and will usually follow returns

available from other investments like equity mutual funds. However, if you decide to quit your policy, your cash value can be paid in cash or paid-up insurance.

Whole life insurance is most suitable for you, if you want to:

• use it as a tax and estate planning vehicle,
• accumulate cash value for a child’s education or retirement,
• pay final expenses,
• provide money for a favorite charity,
• fund a business buy/sell agreement,
• provide key person protection.

Before buying the whole life insurance, you need to think carefully about choosing your level of

coverage. Too often people make the mistake of insufficiently covering or even worse, financially

overextending themselves. This would be a tragic error with whole life insurance policy because

defaulting on premium payments can mean policy cancellation and the loss of your entire investment. So be careful and make sure you:

• pick a life insurance policy that has a guaranteed cash value starting at the very first year,
• choose the one with the highest cash value in the very first year,
• consider “participating” insurance policies which can pay dividends, increasing your policy’s value by boosting both the total cash value and the death benefits,
• beware of any insurance policy that levies “surrender charges” when you cancel.
• if you ever need to stop paying premiums, your policy lets you use the accumulated cash value of the life insurance policy to pay the premiums, thus keeping your coverage current.

Defining Point of Service (POS) Health Insurance

A POS or Point of Service plan is kind of like an HMO and PPO combined type health care plan. You have more flexibility than a regular HMO, but pay a smaller fee and deducible than a PPO. It is perfect for those people who need more flexibility but want to pay less. You will be asked to select a general provider that is off the list of acceptable doctors. This will be your primary care physician and he or she will be the one to manage what care you receive. He or she will direct you to specialist and hospitals as needed that are also participants in the plan. Usually there are many providers from each specialization to choose from and typically covers a wide geographic area. With this type of policy, you will not have a large deducible if any, and still have a minimal co-pay on visits and prescriptions. Of course, this is if you stick with the preferred providers list. You also may want to make sure what drugs are covered under this plan and if you have to pay more for newer on not generic medications. Some doctors don’t think about what kind of insurance you have when writing out the prescription and you need to remind him or her if you are only allowed to buy generic to be covered.

You will also have a choice to see out-of-network providers when you need a specialist and they are not on the list. Most POS plans require you get a doctor’s referral prior to seeing another doctor or specialist. Once referred to a specialist within the network, you will have to be prepared to pay more. If you choose to do this, you will be billed directly and must submit the claim to the insurance company your self. Your insurance company will pay their flat rate for whatever you had done and you will be responsible for the rest. You may also be responsible at the time of service to pay the entire amount and wait to be reimbursed your self from your insurance. If you chose to see a specialist on you own, the cost will be higher and around 50% if you were not referred. You will be required to pay a higher amount if you go out-of-network. So in essence, you have the right to see whom you chose, but at your own expense. The POS plan will only pay their flat rate for specific medical issues and not above it, unless it is an emergency situation. Many people like the idea of having more say in their health care choices, while others care more about saving money and don’t care who they go to. What you chose will depend on what you personally want and what is more important.

The emphasis on this plan is prevention of illness or disease to cut the cost to both the individual and the insurer. Most other plans such as HMOs and PPOs have the same basic emphasis. You are encouraged to take an active roll in your health and do what it takes to remain not sick and disease free for as long as possible. The idea is to see the doctor less so both you and your carrier together spends less money. The idea with this plan is that if you have to put more money into your health care you will think twice at whether or not you really need to go. If you want to waist the insurance companies money you have to waist your own too to do it. Medical insurance companies are in business to make money, they want you to stay healthy so they can collect your premium and not have to pay it out to the health care provider. So, for those people who do not want to pay as high as a monthly premium tends to opt for this type of health insurance plan. This one will ensure a low rate with out having to worry about huge deductibles or co-pays if used more like an HMO. So, if you think that this sound like something you are interested in, talk to several different companies and get some policies to look at. Make sure to look at what is covered as well as the price. Do a little research in the various insurance policies that are available. The one that you need to pick will depend on your priorities.

Deciding if you need Life Insurance?

Most people are aware of how life insurance works and what are the events and dangers that it is designed to protect against. They may also have family commitments and people who they provide for and know that some sort of life insurance would protect their family financially, if something were to happen to them. However, it is still often a very difficult decision to make if you are trying to decide whether or not you need life insurance.

Life insurance is a big commitment financially speaking. The premium can vary in cost but can be considerable, then there is also the issue that life insurance often extends over many years, even decades. This means that not only are you committing to pay the premium for this year, but also for many years into the future. There are not many people who can say with certainty what their earnings will be in ten or fifteen or twenty years time.

There are also early termination penalties, which means if you want to end the policy before the expiration of the entire term, you will be financially penalised. This is generally more relevant for life assurance but can also apply to life insurance if your rate has been calculated on the condition that you remain insured for so many years into the future.

If you have life assurance, then it will also be a method of saving for the future. This is a very popular concept, especially these days with the growing concern about the state of pension funds, but it again deserves careful consideration. There are many ways to save for the future, and by deciding to do so by way of a life assurance policy still entails deciding that life insurance is something that you want and are willing to pay for. If you do not need life insurance, then there are probably more efficient ways of saving for retirement than with life assurance, which places a proportion of your savings against the insurance aspect of the policy.

In general, most people will really only be considering life insurance if they have a family to support. This can be a spouse and generally children. However, situations frequently change, people get divorced, and children always grow up and become independent. If your family situation is likely to change, you should familiarise yourself with the ways you can end the policy early and what penalties would apply. However, if you have a young family and are concerned about their financial security for the future, then life insurance will be a great opportunity for you to provide for these concerns.

Criticism of Insurance

Insurance policies work by taking premiums from customers in exchange for baring the risk of certain costly events occurring. For example, if there is one fire in your town each month, everyone could just sit tight and hope their house doesn’t burn down next, or could pitch in and pay an insurance premium each month and this is then used to rebuild the house that burns down. Very simply this is how insurance works. It is a method of spreading a risk over a far wider area, so that it will not be as devastating as if it was concentrated solely on the person who experiences the loss.

Exclusion Clauses

There are a few problems with this however and they attract much criticism. One criticism is that by taking on the risk for people, insurance makes people take greater risks than they otherwise would. For example, if you know your home contents are insured against burglary, then you may not be as careful about locking the doors and windows every time you leave the house. Or if your bike is insured, you may not bother to lock it as much as if it wasn’t insured. In the insurance industry, this problem is known as the moral hazard.

Insurance companies protect themselves against this by inserting exclusion clauses into their contracts, which remove their obligation to pay out if the insured performs or fails to perform certain stated actions. They might for instance require that you fit smoke detectors, or use good locks on your doors, or other things that will reduce the risk of the insured against event occurring.

Too Complex

There are also certain risks that you are not allowed to insure against in most countries. This is first of all because it would be too difficult for the insurance companies to quantify, but mostly it’s because they are risks that governments want the person at risk to bare himself or herself. They generally apply to multinational companies.

There is also the criticism that insurance policies are far too complex for the vast majority of consumers to understand. It is simply unreasonable to expect the customer to understand lengthy documents that have been drafted by not one, but usually teams of specialised lawyers. This can lead to consumers being misled or buying insurance policies on unfavourable terms. To get around this, most countries regulate the content of insurance contracts to ensure that they remain fair to consumers.

There is also the option of using the services of an insurance broker to shop the market for you.

Critical Illness Needn’t Hurt Your Bank Account, Too

In the time it takes you to read this sentence, the bills from a critical illness may have forced yet another American to file for bankruptcy. It could be as a result of their own illness or a loved one’s, but the result’s the same: Half of all bankruptcies are due to serious illness, according to a recent Harvard study, and-of those-75 percent were forced to file despite having health insurance.

One new option consumers have to help cover all expenses associated with critical illness is called, appropriately, Critical Illness Insurance. This specialized insurance provides a lump-sum payment should a subscriber suffer from certain specific critical conditions.

Right now, one of the few companies offering such insurance is Stonebridge Life Insurance Company. However, experts say that as Americans continue to survive critical ailments that were fatal only a few years ago, the need for the insurance is increasing. Stonebridge Life Insurance Company gives policyholders a one-time payment of up to $50,000 as soon as they’re diagnosed with a covered cancer, stroke, paralysis or a heart attack. The payment is intended to help people meet basic expenses, such as mortgage payments, car insurance, groceries, child care-even ballet lessons.

“Many people aren’t aware of the financial consequences of surviving a critical illness, especially if they’re unable to work for an extended period of time while they recover,” said Marlene Jupiter, author and expert on personal finance. “Now that medical progress and early detection are helping more people live through serious illnesses, people need to plan for how they’re going to financially survive the aftermath.”

For monthly premiums as low as $20, Critical Illness Insurance from Stonebridge Life is a direct-to-consumer product offering lump-sum payment options of $10,000, $20,000, $30,000 and $50,000. As an added benefit, the plan offers a return of premium option. Customers who sign up before the age of 50 and select this option may receive their paid premiums in full if they don’t make a claim before age 65.

“There is an increasing need for critical illness insurance because it helps close the gap that exists between health and disability plans, making sure that survivors are financially supported throughout their recovery process,” explained Lew Whalen, vice president of Stonebridge.

Critical Illness Insurance The Non-Disclosure Problem

If you’re in the unfortunate position of having to make a claim on your critical illness insurance policy, the last thing you want is insensitive hassle or apparent non co-operation from your insurer. But according to numerous newspaper articles, that’s precisely what’s happening. The core problem is that before they’ll pay out, the insurer will always want to make exhaustive enquiries about your past health record. Whilst you’ll have provided them with lots of similar information when you initially applied for the cover, the insurers will now insist that all the information is rechecked. And if at the time you said you weren’t a smoker, they’ll now want this verified by your doctor.

The reasons are obvious. They’re faced with a big claim, typically way over £100,00, and they want to be certain that you told them the entire truth about your health when you first applied. This means that now you’ve claimed, they’ll crawl over your medical records in great detail checking that you disclosed everything on your application. Every small and apparently insignificant detail will be subject to intense scrutiny. The problem is that their reams of correspondence can be quite upsetting for you.

The insurers defend their procedures saying that they need to be certain that when they accepted the business, you disclosed the full truth about the factors affecting your health. They want to be sure that you didn’t cheat by omitting some information in order to dupe the company into issuing a policy when they otherwise might not, or to help you qualify for a lower premium. Either way, non-disclosure as they call it, is cheating and a valid reason for them refusing your claim. It doesn’t even matter if the information you omitted ultimately had nothing to do with the illness that occasioned the claim. The insurers position is that every piece of information you provide was used to work out your premium and any omission affects the calculation.

The insurers are particularly distrustful if the claim arrives within the policy’s first five years. Any claim arising during this period is classed as an “early claim” and the insurers are particularly watchful for policyholders who took out the critical illness insurance already suspecting that that they were already ill.

The problem is that all this intense scrutiny attracts a very bad press. If you’re very sick and distressed, the last thing you want is lots’ of questions and high-handed hassle from your insurer.

There’s undoubtedly a conflict here. If they are to neutralise the bad press, the insurance companies need to work much harder at softening the enquiry process and they must liase much more closely with their claimants. Insurers must present a much softer centre at what is a most distressing time for their claimants.

All this adverse PR has had two effects on the critical illness insurance market. Applicants have apparently been favouring insurers who publish the lowest rejection rates and others have withdrawn from making any application.

In practice, avoiding insurers who publish high refusal rates has little benefit. That’s because the published figures can be misleading. The latest figures show that Scottish Equitable Protect has refused to pay out on 28% of critical illness claims followed closely by Friends Provident at 25%. If you compare these figures with Scottish Provident at 13.7%, many potential policyholders can be forgiven for favouring Scottish Provident. But that’s not necessarily the best decision.

The problem with interpreting these figures is that the figures themselves can be distorted by how long the insurer has been active in the critical illness market. As rejection rates are highest with policies that have only run for a few years, then companies that are new to the critical illness market will automatically have the highest rejection rates. This leaves companies such as Guardian Financial Services looking good with a rejection rate of just 10%. The truth is that the Guardian has been in the market for over 15 years and has a mature book of business.

And it’s a pity that all this negative publicity has undermined confidence in critical illness insurance. In our view, this insurance plays an important part in protecting family finances but people are being deterred from buying it, leaving their family unit exposed if they become seriously ill. After all, if the main income provider is taken seriously ill, the family’s income can plummet. That means that the tax-free lump sum paid out by these policies can become central to the family’s financial survival.

Our advice is if you think you need critical illness cover press on. But be aware that these policies vary a lot in the cover they offer – so straight price comparisons aren’t really meaningful. Basic plans will cover one or more of the most serious conditions but comprehensive plans cover many more – for example:

Alzheimer’s disease
Aorta graft surgery
Aplastic anaemia
Bacterial Meningitis
Benign brain tumour
Blindness
Cancer
Cardiomyopathy
Chronic lung disease
Coma
Coronary artery by-pass surgery
Creutzfeldt-Jakob disease
Deafness
Dementia
Heart attack
Heart valve replacement or repair
HIV or AIDs from an assault, blood transfusion, occupational duties or accident
Keyhole heart surgery
Kidney failure
Loss of independent existence
Loss of limbs
Loss of speech
Major organ transplant
Motor Neurone disease
Multiple Sclerosis
Paralysis/Paraplegia
Parkinson’s disease
Progressive Supranulcear Palsy
Stroke
Third degree burns
Total and Permanent Disability
Cover for children

This complexity means that you really need independent advice. There are plenty of web sites that can help you. Just search for “critical illness insurance” and make sure you can talk to an adviser before you buy.

Critical Illness Insurance Is Critical

A difficult time in life can teach you what’s really important. Just ask anyone whose life took a sharp turn when a medical problem was discovered.

First off there are expenses, a difficulty for any family but which are a special challenge for any family who are covered by a limited medical insurance policy or have no insurance at all.

If you have limited medical insurance, there is sometimes just not enough to pay the bills. You could have costs of staying near a clinic while hoping and praying that you will get well.

Some people have family members and friends who have started get well funds to help pay expenses. But all of this doesn’t answer why there was no critical illness insurance.

This Is Why Critical Illness Insurance Is Important

Critical illness insurance is important as what you are doing is insuring your income , just like you insure your house. You wouldn’t own a house without insurance, so why do you walk around without insurance against a personal catastrophe? You’ll never know anything about expenses until you confront expenses caused by a major illness! From no income coming in to all the savings going out, families can be left in a great bind. Now that you’ve bothered to read this article, call your life insurance broker who sells critical illness insurance and get to know the difficulties you may face. And more positively, how you can solve them.