medical – Susman

January 16, 2017

Travel Time

Any time is a good time to travel. Sure, it depends on where you want to go and the weather season, but for most of us, everything from a quick getaway to an extended exotic vacation is something we love to do and can’t ever come soon enough.
You find the perfect location, plan your adventure, book the tickets, and upon check-out you are ask if you would like to purchase insurance to protect your trip.

Would you? Should you?

Often times not only do you wave goodbye to your family when departing for your vacation, but also to your insurance coverage – especially as soon as you leave the United States.
The most common items (deemed reasonable) covered by travel insurance include medical emergencies, visitor health insurance, delayed, lost, or stolen baggage, and trip cancellation/interruption (death, bodily injury, illness, disease, pregnancy complications, termination of employment, deployment, prohibition of travel to the destination, evacuation from the destination). Sometimes additional policies can be purchased for more specific needs such as pre-existing conditions, elective treatments or surgery, war, and terrorism. An added bonus of travel insurance is it is often there to help 24 hours a day/7 days a week.

So do you need it?

If you are a worrier, this might be a good way to give you peace of mind. If your trip is just a couple days domestically, you probably don’t need it. We gave you some of the pros and the type of coverage you can get, but there are also reason why you might decide not to get travel insurance. For example, you might already be covered on your current insurance, your credit card might already offer additional travel protection, or maybe you just aren’t worried about any type of loss. It all depends on the individual.

It is definitely worth the time to do some research about the coverage available and the health care services available at your destination. As always, it is better to be over-prepared.

July 29, 2016

Brandon Talks Critical Illness

From Br andon:

Twelve years ago, I finally opened the business of my dreams. After decades stuck inside an office, I was able to leave it all behind for a now thriving coffee house.

From day one, it was perfect. Sure there were some struggles here and there, but nothing that killed my spirit or deterred my motivation. The location was perfect and my business quickly became crowded with ‘regulars’ every day. A dream come true!

Unfortunately, only three years into my new business, my health wasn’t doing as well as my business. I had a stroke before leaving my home one morning. Thankfully my wife noticed me acting different prior to the onset of the stroke, so when it happened, emergency responders were already on the way and the aftermath wasn’t as bad as it could have been. However, I still had astronomical medical expenses for the incident itself, as well as financial burden for aftercare and further treatment.

Anyone else I know would have been extremely worried about this situation. Dealing with the medical issue is bad enough, but how do you cope with the financial stress and stay healthy at the same time?

You do it by having Critical Illness Insurance part of your policy plan.

Prior to opening my coffee house, I met with my insurance agent to discuss the exact coverage and policies I needed to protect my family and protect my business. He suggested I add Critical Illness along with Disability and Life Insurance. Had I ignored that suggestion, my situation would have been much worse. Because I took his advice and had Critical Illness Insurance, I received a cash payment that allowed me to cover all of the remaining medical expenses, lost wages, and keep the coffee house form sinking until I could get back to work. My wife and I carefully planned and budgeted and were able to make it through my extended medical treatment plan with only a small amount of out-of-pocket expense.

I still have the coffee house. I still have Critical Illness Insurance.

I wouldn’t choose to live without either of them.

Critical dollar

December 6, 2015

Health Insurance Up 78 Percent Since 2000, Along With Policy Terminations!

Health insurance went up 7.7 percent this year, thats twice the rate of inflation. Premiums have increased by 78 percent since the year 2000 compare that to salary increases of just 20 percent and the real picture starts to have an impact.

Individuals are now averaging a little over $4000 a year in premiums with American families paying out almost $11,500 this year. Companies offering health care benefits now st ands at 61 percent this is down from 69 percent in 2000. It’s estimated that over 155 million Americans will get their health care benefits from their employers. To lower the over-all cost of the insurance plans many companies are now offering benefit packages with higher deductibles. It should be noted that this report comes out after a recent Census reported that 1.3 million Americans where added to the ranks of the uninsured during 2005. What becomes clear here is the long term trend towards the decline of coverage supplied by small businesses from their employees.

“To working people and business owners, a reduction in an already very high rate of increase just means you’re still paying more” said Dr Drew Altman, president and chief executive of the Kaiser Foundation.

Insurance companies have been under attack recently for dumping families that build up large medical bills. In an ongoing case in California the state is investigating a claim against Blue Cross who stopped coverage for a family when it’s medical bills reached $20,000. The family have been left with outst anding medical bills of over $60,000. The company have accused the family of failing to disclose in their coverage application an undiagnosed lump on one of the children’s chins. The family say they (or their physician) knew nothing of any tumor when they made the application.

These types of cancellations of coverage have now created a massive backlash towards the insurance companies and resulted in a number of ongoing lawsuits. The policyholders are saying their polices were illegally terminated which resulted in substantial financial hardship. State regulators are investigating and have said they are now preparing to take action against Blue Cross.

Something needs to be done to protect (us) the public against these (insurance) companies. The hardship caused when a family is faced with these medical bills at a time when they really need the most support is nothing short of criminal. Having taken our money every month for years on end they should not have the right to terminate our coverage. They should by law be forced to honor the agreement they wrote and we agreed too.

November 24, 2015

Health Insurance And Insurance Brokers

If you are in the market to purchase your own health insurance coverage you can save yourself precious time and money by shopping and comparing policies right online. Sites dedicated to giving you quotes on various types of insurance make it very easy for you to get an idea of what your coverage and costs will be. However, please be forewarned that there are some pitfalls in using an insurance broker as I discovered within the past year.

As a self employed person, I carry my own health and life insurance for my family. When making the move from New Jersey to North Carolina in 2004 I knew two things about our health insurance:

1. I would have to shop for a health insurance provider covering North Carolina.

2. Rates would be cheaper than in New Jersey, with costs being about half of what I had been paying and with slight better coverage.

Several weeks before we moved I contacted a well known internet insurance broker and received quotes. We selected one company and received the paperwork from the broker about ten days before our move. Quite frankly, I wish I had started the process a little earlier as all of our free time was dedicated toward preparing and making the move. So, I ended up packing the paperwork with my personal stuff and was only able to fill it out and submit it one week after our arrival in North Carolina.

Dealing with the online insurance broker was a simple task, but I soon discovered that they were an extra step in the application process, one that only slowed down our approval.

Once the paperwork was received by the broker, they acknowledged the same via email and mentioned that they would review our package before forwarding it to the health insurance company.

Over the next couple of weeks we received messages from the insurance broker stating the following:

1. We are in the process of reviewing your application.

2. We have sent your application off to the insurance company.

3. The insurance company has your application and will be reviewing it in about one week.

4. The insurance company expects a delay in reviewing your application due to the high volume of applications received.

5. Please do not contact the insurance company directly; we will keep you posted as to the status of your application. Yeah, right.

Originally, we were assured by the insurance broker that the health insurance company would review and approve our application within two weeks. Follow up phone calls by us to the broker along with several exchanges of emails revealed that this was not going to happen. In addition, when we contacted the health insurance company directly – at the encouragement of the broker – the health insurance company had difficulty finding our application. Within a few days the application was found sitting in another department; our contact at the health insurance company blamed the broker for sending the information to the wrong address.

As it turned out, the original insurance quote we received online was off by just over 20%. Once the health insurance company determined that certain pre existing conditions needed to be factored in our rates rose accordingly. Of course, when working with the internet broker we knew that the rate quoted wasn’t ‘absolute’ but the big jump was still a bitter pill to swallow.

Among our thoughts at that point in the process were:

1. Had we known ahead of time that our “final rate” would be so high, we would have shopped around some more.

2. Because of the delays and the passage of time, we needed to complete the application process as our coverage with the NJ health provider would need to be canceled, preferably by the end of the year.

By the middle of December, a full ten weeks after we submitted our paperwork, we received official notification that our application was approved and that we were covered. During the last couple of weeks of the lengthy application process we contacted the health insurance company directly several times to learn what the status of our application was. At no time during the process were we assured that we would receive approval; essentially we were told that coverage would begin pending approval.

In conclusion, I offer the following recommendations for shopping for health insurance:

1. Comparison shop online. Get quotes through the online brokers to get a general idea of what your costs will be. If you have pre-existing conditions, the prices quoted will not be reflected in your quote.

2. Narrow down the list of companies quoted to three and then contact them directly. Bypass the broker as they are an unnecessary additional step in what certainly is not a quick approval process.

3. If you need insurance by a particular date, apply well in advance to allow for delays, for misplaced paperwork, changes in your application, etc. Our insurance coverage was approved effective a specific date, but we were able to move it to another date to coincide with the dropping of our NJ health care provider.

In all, the experience was wearisome at times and a real eye opener. I know you see ads all the time for online insurance quotes. I am not saying to avoid the sites, but please consider what we went through before using an online broker exclusively.

November 16, 2015

Health Insurance – It’s Important To Know What’s Not Insured!

Around 7 million people in the UK are covered by health insurance, the majority being covered through their employers. The problem is that few have really studied their policy documents and many misunderst and what is covered. And perhaps just as important, what isn’t. If you expect health insurance to pay all your health costs, you’re mistaken.

Health insurance is designed to provide protection for curable, short-term health problems and allow policyholders to jump the NHS queues to see consultants, be diagnosed, receive surgery or be treated. That sounds fine, but before you buy you need to appreciate the treatments and situations that fall outside the scope of the cover.

But first a word of warning. This article does not relate to any specific policy and the terms and conditions issued by individual insurers do vary. So please ensure you also check your policy documents. After reading this article, you’ll know what to look out for!

Sorry – it’s a chronic condition

If a condition can be cured and is not a long-term problem, your insurance company will classify it as acute and should meet the cost. If your problem is incurable or it’s a problem that, despite appropriate treatment, will be with you for a long time, then your insurance company will classify it as chronic – and no, you won’t be covered.

But drawing a firm line between what is acute and what is chronic is fraught with problems, and leads to the biggest area of conflict between insurer and policyholder.

Everyone agrees that diabetes and asthma are chronic conditions as you’re likely to suffer from them for the rest of your life. So those sorts of condition are not covered.

Problems arise when the medical team initially considers a patients’ illness to be curable, but the condition subsequently deteriorates and the doctors change their mind, it’s now become incurable. This can happen especially in the treatment of some types of cancer.

In these circumstances, the condition is initially defined as acute and is therefore insured, but deteriorates and becomes chronic – and outside the terms of cover. This is possible as insurers retain the right to reclassify a condition from acute to chronic during treatment.

Sorry – it’s too long term
The insurance company will not pay out for long term treatment. But you need to check your policy documents to see how they define “long-term”. You can find the situation where a course of drugs extends for say 12 months, but the insurer will only pay for ten months.

Sorry – it’s preventative
Your insurance is designed to pay for the treatment and cure of conditions when they arise. It is not designed to pay for treatments that are used to prevent an illness.

Again, the problem of definition arises. Sometimes it is arguable whether a treatment is preventative or a cure. Take the drug Herceptin for example. This drug can be used in the early stages of breast cancer. Research shows that Herceptin can halve the incidence of cancer returning for women who have a particularly virulent form of the cancer known as HER2. In this situation, is Herceptin offering a cure or is it a preventative?

Insurance companies are split on the debate. Norwich Union, WPA, BUPA and St andard Life Healthcare will pay for Herceptin for HER2 patients whereas Legal and General and Axa PPP will not.

Sorry – the drug is not approved
Two of the main attractions for taking out health insurance are: to jump the queues at the NHS, and to get the latest treatments and drugs. But there’s a rider.

Unless the drug has been approved for use by the NHS in Engl and and Wales, by the Institute for Health and Clinical Excellence, your insurer is unlikely to approve its use. The problem is that the Institute’s brief is not simply to decide whether a drug works, but to carry out a cost/benefit analysis to ensure that the benefits to the nation outweigh the financial costs of using it in the NHS. Not an easy brief – and one that has placed the Institute under scrutiny for the extended delays in drug approval.

The compromise hit on by the Financial Ombudsman is that if a health policy won’t pay for the use of experimental treatments, then it should meet the cost of an approved conventional treatment with the policyholder footing the bill for the balance if the experimental treatment is more expensive.

Sorry – it’s a pre-existing condition

The basic principle is that if you are already suffering from a condition when you start a policy, then that condition “pre-exists” the policy and any claims for its treatment are invalid.

For this reason, insurance companies insist you complete an exhaustive questionnaire before they agree to insure you. After all they need a clear picture of your medical condition before they quote. For many applications, the insurer will, with your approval, also write to your GP for specific details of your medical history. They like to have a complete picture.

So lets say some years ago you injured your knee playing football. It appeared to recover but now it turns out that you have a torn cartilage and need an operation. The insurer could argue that this is a pre-existing condition and you have to pay for its’ treatment.

Some insurers try to accommodate these grey areas with a moratorium provision within your policy. These provisions typically say that so long as you have been symptom free for two years relating to any condition you’ve suffered from within the last 5 years, then they will pay for subsequent treatment. Not all policies have these moratorium provisions and the time periods do vary between insurers. You should carefully read your policy.

Sorry – its not covered

Health Insurance is an annual contract – just like your car insurance. So when it comes to renewal, your insurer is at liberty to review not only your premium but also change the conditions on which your cover is provided.

Therefore, if your policy comes up for renewal mid way through a course of treatment, it’s possible to find that your new policy no longer covers that particular treatment. This means that you will have to foot the bill for the balance of the treatment.

Furthermore, with ongoing advances in medical research, more and more conditions are becoming treatable. This progress has the effect of shifting back the dividing line between chronic and acute conditions.

This hits the insurers’ pocket in two ways. With more conditions being reclassified as acute, the number of claims is increasing. And there’s also a trend for new treatments to cost more – Herceptin being a good example. The net result is that the insurers are finding themselves having to pay out far more. This is inevitably passed back to you through increased renewal premiums. And in an attempt to reduce their risk exposure, insurers have a tendency to adjust their definitions and exclusions. This means that you must read your renewal notice closely before you decide to renew.

So when you are considering Health Insurance, be aware that everything is not always black and white. And if you’ve got insurance and need treatment, always contact your insurer without delay and get them to confirm that your treatment is indeed covered

November 7, 2015

Growing Old

There are a couple of things in life that we know, at some stage, we will be worried about. Growing old certainly seems to be one of them. More and more, our culture is becoming obsessed by the cult of youth. Not only are film stars and musicians young and beautiful, but increasingly, politicians and newsreaders are getting younger also. Add to this the extraordinary lengths to which the not so young among the elite are going to maintain their youth and appear young and you will quickly see why so many people are becoming distressed about growing old.

There is one thing that people have known, at varying levels, for centuries however. This is that old age is a state of mind. Therefore, the secret to staying young lies also in the mind and not in the body. When someone mentions Madonna, we don’t think about old age or an elderly woman, but is this because she still looks quite young, or because she is as active and controversial as ever, releasing hit albums and doing what she has always done? In many senses it is a combination of the two, but I would propose that it is the young mind that keeps the body young rather than the other way around.

There are many things that you can do to keep your mind young and active. One is to keep up the old hobbies and pastimes that you have enjoyed for your whole life. Try to keep physically active. Consider walking and swimming which are less stressful on joints and bones than some other activities.

At the end of the day, it is not such a young person’s world out there. The charity. Help the Aged, defines the elderly as anyone above the age of 50. There are many 50 year olds around who would defy this but the fact is that many people, by this age, are already preparing for retirement. Age discrimination has also been recognised by the government who in 2006, will bring into force the age discrimination act that outlaws discrimination on the basis of age in the workplace.

Also, the over 50 age group is not only the fastest growing segment of the population, but 80% of the nation’s wealth is owned by the over 50s. They are also one of the freest and least tied down segments of the population. As society’s attitudes change towards old age, perhaps the time is coming to let loose and enjoy old age for all the potentialities it provides.

September 10, 2015

Expensive Health Insurance? Ways To Cut The Cost.

You may have noticed an increase in your health insurance premium recently. Here we examine some of the possible reasons for this and look into ways of combating them.

According to the market-research group Datamonitor, medical inflation is the reason for yearly increases of 8% in health insurance premiums. The steady progress in the development of new drugs, therapies and equipment used to diagnose medical conditions and the resulting costs are an obvious reason for this. This is underst andable and everyone wants the latest in diagnostics and treatments. Equipment becomes obsolete with time and invariably the very words newer and improved mean a rise in cost.

Another reason may be that insurance risks and therefore costs increase with age. Many insurance companies still use age b ands, where costs increase at the end of a ten-year period. For example, someone aged between 40 and 49 would pay their normal agreed premium. Reach the dreaded 50 and the next bracket is between 50 and 59, and so on. The increase is greater with age and could be as much as 50% in the 60 to 69 category.

Many insurers have chosen to smooth out the increases on a yearly basis. BUPA, Pruhealth and Axa PPP are three of these. Axa PPP customers, for example, should expect a rise in the cost of premiums by about 2%, due to their age. Other insurers are said to be thinking of introducing this method.

The fast rising costs of medical insurance is worrying consumers and many are making the decision to terminate their policies when they’re coming up to their 60’s and this may be just when their need is greatest. Datamonitor has issued figures showing that there was a drop of 15.2% in the number of people with private medical insurance in the 7 years prior to 2004.

With this in mind, insurers have come up with some ways to cut the costs. You could opt for an excess on the policy, effectively working out a plan to suit your budget. For instance BUPA tell us that if you were willing to pay a £2000 excess, you would halve your premium. An excess of £100 could quite well reduce your bill by around 10%.

No-claims discounts are another possible way to reduce your premium and it’s possible to obtain up to a 50% saving. You should be able to transfer this if you decide to change providers.

There’s a big variation in the way in which companies treat no claims discounts. Axa PPP offers an immediate 27.5% no claims discount at the start of a policy, but make a claim and this is lost. Not all BUPA’s policies include the provision for no claims discounts, but some do and they guarantee that in the event of a claim, the resulting rise in premium will be a maximum of 10%.

Pruehealth encourage their policyholders to stay healthy in order to reduce their premiums. You can get between 25 and 100 per cent off next year’s premium, depending on the effort you put into it. Points are given for various activities and lifestyle changes.

With all these choices, it’s an excellent time to investigate the options. Don’t just keep paying out and certainly don’t lose that valuable cover by cancelling your health insurance, just get on line and find an insurance broker who will find the right cover for you at a price to suit your budget. Your pocket will benefit too, with the on-line discount.

August 22, 2015

Do You Need Health Or Travel Insurance?

Obtaining medical treatment and hospital care can be costly for travelers who are injured or who become seriously ill overseas. The Social Security Medicare/Medicaid program does not provide coverage for hospital or medical services outside the United States.

Before you leave the United States, you should be informed about which medical services your health insurance will cover abroad.

Senior citizens may wish to contact the American Association of Retired Persons for information about foreign medical care coverage with Medicare supplement plans.

If your health insurance policy does not provide coverage for hospital or medical costs abroad, you are urged to purchase a temporary health policy that does provide this type of coverage. There are short-term health and emergency assistance policies designed for travelers.

You can find the names of companies that provide such policies from your travel agent, your health insurance company, or from advertisements in travel publications. In addition to health insurance, many policies include trip cancellation, baggage loss, and travel accident insurance in the same package. Some traveler’s check companies have protection policies available with the purchase of traveler’s checks.

Medical Evacuation

Although some health insurance companies may pay “customary and reasonable” hospital costs abroad, very few will pay for medical evacuation back to the United States. Medical evacuation can easily cost $10,000 or more, depending on your location and medical condition.

One of the main advantages of health and emergency assistance policies is that they often include coverage for medical evacuation to the United States. Even if your regular health insurance covers you for emergencies abroad, you should consider purchasing supplemental insurance to cover medical evacuation.

Whichever health insurance coverage you choose for travel overseas, remember to carry with you both your health insurance policy identity card and claim forms.

Do You Need Travel Insurance?

You may not need travel insurance, if you are already adequately covered by other insurance policies.

Depending on the travel insurance plan, travel insurance usually promises to cover you for cancellation or interruption of your trip, some form of emergency medical care while you are traveling, lost or stolen luggage, and various other troublesome occurrences.

Before you decide on a travel insurance plan, it is wise to investigate the plan carefully and read the fine print. You should closely check any agreements with your travel agent, tour operator, airline, or other companies involved with your travel plans. The agreements may include written guarantees.

If you have a fully refundable airline ticket, you may decide that you would not need trip cancellation/interruption insurance.

On the other h and, it may be worthwhile noting that certain insurance plans can protect you by covering the financial costs in case of the following situations:

A sudden, serious injury or illness to you, a family member, or a traveling companion.
Financial default of the airline, cruise line or tour operator.

Natural disasters or strikes that impede travel services.

A terrorist incident in a foreign city within 10 days of your scheduled arrival in that particular city.

The fact that you, a traveling member of your family, or a traveling companion were quarantined served with a court order or required to serve on a jury.

A circumstance in which you were directly involved in an accident enroute to departure for your trip.

It is a good idea to check your other insurance policies. For instance, your homeowners or tenants insurance may cover the loss or theft of your luggage.

Certain credit cards may also provide additional travel insurance, if you have used them to purchase the ticket for your trip.

Your health insurance may provide certain coverage, regardless of where you travel. But it is very important to note that some policies only partially cover medical expenses abroad. Moreover, as previously explained in the section on Health Insurance, Medicare/Medicaid will not cover hospital and medical services outside the United States.

Your travel agent should be able to advise you about the right plan for you. Before purchasing travel insurance, review the plan carefully, and be wary of buying coverage that you may already have.

July 2, 2013

Long Term Care insurance will save me a fortune someday

As a person gets older they begin to realize that it is expensive to get the health care they need. There is coming a time when you will need the care to help you stay healthy and to care for your every day needs. Here are some facts about long term care and how it could save you money.

Talk to us about obtaining Long Term Care Insurance. We offer California Partnership plans!

Fast Facts About Long Term Care

The policy is usually for people who have become disabled, have reached a certain age or needs help with at least two daily activities.
A premium is paid on a monthly basis in order to own a policy.
Health care costs are going up and a long term care policy will help you save money in the future as it pays out.
Long term care pays longer that short term care insurance does. Short term care is usually for a stated amount of time. Once the time is expired you lose the benefits of care.

Every person will have to see a doctor at some point in their life.The difference will be how much one person pays and how much the other person saves because of the type of insurance they have. Go ahead and research your options regarding long term care insurance and see how much you can save in the future.

March 29, 2013

A ‘No Medical Physical Life Insurance Policy’ Can be a Lifesaver

Many people put off getting life insurance. There are a lot of reasons why. One that tops the list is because of the full medical physical we think we have to take. Squeamishly, our minds ration why we keep putting it off. Usually it comes down to dreading the needle that takes our blood, finding out we gained weight or we just hate to go to the doctors.

No physicals needed

What happens if you are at a parade and one of the large character balloons burst? It falls and covers your body. You are slowly suffocating. As you are, you realize you never obtained life insurance for your family. This may sound silly but weirder things have caused deaths.

Most of us do not even know that we can obtain a life insurance policy without a physical. Now-a-days, it is a myth to think otherwise. One of the most important benefits of going this route is that it can usually be approved in about 24 hours. There will be no more financial worries. Your loved ones will be taken care of if something happens to you in the future.

Questions that will be asked

Some health questions will be asked. None of them will require checking your doctor’s records. As with any insurance policy, the rate or the cost of the insurance will be derived from certain things that you write on your application.

It is easy to acquire quotes from insurance carriers before your final decision is made. Making a decision sooner than later can be a life saver for your family.

Travel Time

Fast Facts About Long Term Care

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