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Waiting For Ohio Medicare Coverage To Begin – Low-Cost Options

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Are you waiting for your Ohio Medicare benefits to begin? Perhaps you know which policy you’re going to select and you have already selected your Supplement contract. But, it’s getting there that’s the immediate concern since your current private health insurance ends soon and you have a gap to fill.

Fortunately, there are some great “gap fillers” that will provide solid healthcare coverage until you’re ready to enroll in  Medicare,  along with supplement coverage. And these plans are issued by companies you’re familiar with, such as Anthem Blue Cross, Humana, UnitedHealthcare, Medical Mutual and Aetna. Smaller less-recognizable companies also can provide worthwhile options, such as Premier, SummaCare, and CareSource.

Need Coverage For A Month, A Year, Or Longer?

The most important issue you face is the length of time you need coverage. For example, if you are less than six months from becoming Medicare-eligible, a very common and inexpensive option is a temporary policy. This type of plan is very affordable, and is generally considered the most economical type of medical coverage.

Senior Ohio Medical Coverage Before Medicare

Don’t Gamble By Being Uninsured. Get Short-Term Health Insurance

Although existing conditions are not covered, and virtually all benefits must meet a deductible, it’s a great stop-gap type of coverage that works well. However, it’s important to coordinate your pre-65 and your post-65 healthcare plans so there is no lapse in coverage. Also, if you are currently enrolled in a subsidized Marketplace plan, it may be advisable to retain coverage until you are no longer eligible.

Prices For Temporary Coverage

If you are a healthy 64 year-old female in Montgomery County (rates vary by county), a short-term plan from UnitedHealthcare costs about $122 ($5,000 deductible) or $152 ($2,500 deductible). A $1,000 deductible option is also available and costs just $234. These are monthly rates. Anthem and Medical Mutual also offer temporary contracts, although currently, their rates are higher. Naturally, rates will be less if you are younger and medical conditions could impact the rate.

If the gap between when your existing coverage ends and Medicare begins, is more than 12 months, then a conventional policy is recommended. What type of policy? That depends on how much money you want to spend, the type of benefits you need, and the medical conditions you are being treated for. A federal subsidy my help you pay premiums, although the entire household income is considered in the eligibility calculation. Thus, your spouse’s income must be taken into consideration, regardless if they are to be covered under the proposed policy.

Low-Cost Coverage Until You Reach Age 65

If you are reasonably healthy, a simple high deductible plan (perhaps between $3,500 and $6,800) will keep your Ohio rates low, and still provide excellent coverage. Once the specified deductible has been reached, you can have complete coverage with no further cash outlay for healthcare expenses. However, you also won’t have to pay for most preventive services and you’ll receive a negotiated price break on most other treatment, courtesy of your insurer that is negotiating on your behalf. For example, the cost of an MRI might be reduced from $2,000 to $1,400, while the cost of routine lab services may also reduce from $150 to $30.

If you feel you are unable to medically qualify for a new health insurance plan, as long as you apply during Open Enrollment periods, your acceptance is guaranteed. COBRA, although expensive, will continue to provide benefits for any conditions have. And if you develop new health issues, they will not be excluded from your current health care policy.

For persons that are uninsured and still want to buy a policy until Medicare starts,  you can apply for any of the types of policies previously mentioned. Normal underwriting guidelines will be used on any submitted short-term application, and if approved, you won’t have to worry about the gap until Medicare benefits begin. However, no medical questions will be asked for Marketplace coverage, and pre-existing conditions will be covered.

UPDATES:

January 2015 – The Ohio Senior Health Insurance Information Program (OSHIIP) netted savings of almost $20 million in 2014. About 200,000 state residents were helped by the program. OSHIIP has a consumer hotline and helps answer questions about prescriptions, Medigap coverage, financial assistance, long-term medical care, and other state residents that are disabled and eligible for Medicare benefits.

Will Medical Insurance Increase For Having Too Many Claims?

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The more claims you submit on your medical insurance, the higher your rate will become. Is that true here in Ohio? Well, not really. Whether you have an incredibly healthy year or just one of those years when you and other family members caught the flu six times, it will not make a significant difference in your healthcare premium. The price you pay is determined by your age, where you live, the type of plan, the carrier, your smoking status, and the amount of your federal subsidy (if applicable).

I realize many Ohioans may not be aware of this. You’re probably used to your auto insurance tripling after three or four accidents in the last three years. Or perhaps your homeowner’s policy was canceled after two roof claims and a hailstorm that ruined your shed. But healthcare is different now, compared to prior when Marketplace options were not available.

Fewer Claims Probably Means You Have No Major Medical Conditions

Of course you want to have very few claims each year since the result is that you and other family members were healthy. And presumably, other than your premium, very little copays, deductibles or coinsurance were paid. It also means that if you had an active Ohio Health Savings Account (HSA), more of your contributions stayed in your account, instead of being disbursed for qualified expenses. The unused funds can continue to accumulate and be utilized in the future for any family member listed on the policy.

However, to the surprise of many Buckeye State residents, generally, your medical insurance rate does not necessarily increase based on the volume of claims you submit. For example, if during the calendar year, you have numerous surgeries, along with many prescriptions and specialist office visits that total more than $100,000, your insurer is not going to attempt to “recoup their losses” by doubling or tripling your rate. Of course, if a significant number of individuals and families submit catastrophic medical claims with the same carrier, prices will be impacted.

Why Do Rates Increase?

Health insurance rates do increase just about every year. But the real cause of your premium going up may not be you. Here’s how it works: When you originally bought your medical insurance plan, you were “clumped” together with similar persons that purchased that same type of policy at the same time. Thus, if you purchased your coverage in March of 2016, you are unlikely to be placed in the same group of persons that bought their policy in June of 2013.

Very extensive statistics are kept on the block of business for your specific plan. Over time, some policyholders will cancel, others will renew, and some will add or subtract dependents. And of course, there will be families that have very few claims and others with huge claims each year. The process of submitting a health insurance claim is typically the same, regardless of the dollar amount involved.

Typically, those insureds in very good or excellent health will tend to shop around for better rates within a few years and many will cancel their coverage and start a policy with a different company. For example, a person may purchase a policy with Humana. And after three years of rate increases, they buy a similar plan from Medical Mutual and reduce their premium by 20%. Does this sound familiar? That’s why it pays to shop every 3-5 years (although there are other considerations).

Let’s take this a step further. Let’s say you have a block of 10,000 males in their mid-40s that bought the same type of Ohio medical insurance policy in a given year. Five years later, 2,000 of the healthiest policyholders switch to a different company to get a better rate. Now, you have a block of business of 8,000 persons and the percentage of claims paid per premium has jumped. So guess what else must jump? That’s right…the rate.

And so eventually, you may have a block of business that consists of even more unhealthy persons submitting multiple claims and far fewer extremely healthy people submitting very few claims. If you’re uninsurable, you may be stuck. If you are reasonably healthy, you can find an alternative.

So…although your own claim history won’t alter rates, collectively, many policyholders can.    Should you now shop for new health care coverage every year? Every six months? The answer is no. But if you notice that your premiums are constantly increasing by larger amounts each year, then contact us and we’ll review your current policy and determine if there are better options for you.

Reduce The Deductible On Your Ohio Health Insurance Policy

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A relatively unknown feature of many medical plans, makes reducing the deductible on your Ohio health insurance policy possible without increasing your rate.  UnitedHealthcare and Assurant now offer reductions to your major medical deductible if you meet certain conditions. It’s very possible if you and other family members remain healthy, your potential medical  out-of-pocket expenses will come down. Here’s a quick look at each company’s program:

UnitedHealthcare

UnitedHealthCare’s “deductible credit” provides a 20% reduction  on your policy every year you don’t meet that amount. This discount will be applied every year until you reach 50%, which is the maximum. The savings can be substantial, especially if you have a high deductible, such as $10,000. Even on lower amounts, it’s an easy way to save money if you have a big in-hospital  or other large claim. It’s also incentive, of course, for you to stay with UHC for many years.

So, hypothetically, if you rarely (if ever) meet your deductible, you could effectively  lower your premium by selecting a higher amount, wait a few years and eventually it becomes that lower amount you wanted! But you saved a few thousand dollars every year (assuming a family plan). This isn’t a bad concept! Maybe UnitedHealthCare’s  plan is even better than we thought! And they are one of the few carriers to offer this feature. In most areas of the state, they are a competitive option.

Lower Your Healthcare Deductible

Earn Deductible Dollars When You Do Not Submit Claims

The most cost-effective plans offered by UHC are their “Saver 80,” “Copay Select” and HSA policies, so these options may be best suited to consider the  credit during the purchase process. The “Copay Select” is the most expensive plan of the three, since it includes an office visit and prescription copay. However, that means this feature is more valuable on this particular policy.

Assurant

Assurant offers a “One Decreasing Deductible” feature that uses “credits” twice per year in the amount of 10% of your current choice. These “credits” accumulate and are posted the first day of January and July once your personal policy has been in effect for 60 days. If you have met  the amount within the last 12 months, the credit still is applied.

It’s possible that your plan deductibles could decrease to $1,500 for an individual and $3,000 for a family. Total reduction could be as much as 50%-70%. Not too shabby! However, this benefit is only available on Assurant policies with 100% coinsurance. And in most areas of Ohio, Assurant’s rates tend to be rather high, although they seem to be reducing. Their VERY high out-of-pocket plans are the most competitive.

What about Anthem BC, Aetna and Medical Mutual? Not quite yet although Anthem does offer this benefit in Indiana. We expect more companies to offer a variation of this coverage within the next 12-24 months. And, most importantly, often, you are still better off with a policy from a company that does not have the vanishing deductible option. The rates and coverage may be superior to the companies that have it.

Regardless, we always give you an unbiased opinion, the lowest available Ohio health insurance rates and three easy ways to apply for coverage. If a “vanishing deductible” concept is cost-effective for your specific situation, we will recommend it.

Ohio Health Insurance Exchange Will Not Cover Abortion

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Abortion coverage will not be provided by Exchange plans in the Buckeye State. John Kasich, Ohio’s Governor, signed a bill that prohibits the purchase of any policy in the Marketplace that covers abortion. Naturally, opponents and supporters of the bill voiced their opinion on the legislation.

The group “Ohio Right To Life” generally supports the bill, agreeing that consumers have a right to health care, but not at the expense of a “death to an innocent child.” The American Civil Liberties Union (ACLU) is not happy with the bill and has threatened to sue the state. Other smaller groups and organizations have also expressed strong opinions on this very contentious subject.

Who Pays For Ohio Abortions?

One of the key issues is whether citizens of the state should be forced to pay for abortions if “Obamacare” is fully implemented. Individual states are allowed to exclude abortion from covered benefits if it is stipulated by law. This recently signed bill actually originated in 2010 and had both Democratic and Republican support in June of this year. It would not be surprising to see other states pass similar bills.

Of course, the “Exchange” may never become a reality anyhow since it is part of the controversial Patient Protection And Affordable Care Act (also known as “Obamacare”). Currently, OH residents can purchase a wide variety of policies at affordable rates directly through our website or other  insurers and brokers. The purchase process is relative simply and usually, experienced unbiased assistance is available.

However, if the Ohio Health Insurance Exchange does ever go into effect (probably 2014 or perhaps earlier), consumers may not have the choices they have now, and may not enjoy the free advice of experienced licensed professionals. As a government-run entity, many questions still remain on how high medical rates will become and how quickly they’ll increase.

Although federal subsidies will offset some of these costs (not all of them), it remains unclear who will ultimately pay for them. Most of the details (we hope) would be worked out by 2014 although full implementation will not be completed until well after that date. Because pre-existing conditions will be automatically covered, and no medical questions will be required, rates will undoubtedly increase. The unanswered variable is how much of the increase will be covered by federal subsidies.

Future Of ACA Legislation

Regardless of the future of the Protection And Affordable Care Act, We will continue to provide the most current information needed to properly compare your options. Ohioans like (and demand) to work with a local experienced firm that provides the lowest cost policies and is available to explain in detail individual and family options.

So…whether the Exchange gets off the ground or not, your best bet may be working directly with us, so we can guide you through the process. And as most of you know, we will continue to offer the lowest rates that are offered for private medical insurance here in Ohio.

UPDATES:

April 2016 – Obamacare is still alive although not doing as well as many had expected. UnitedHealthcare may not offer Marketplace plans in Pennsylvania next year, and many other carriers are losing millions of dollars by paying more claims than anticipated.

Can I Trust Purchasing Ohio Medical Insurance Online?

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Is it safe to buy your health insurance policy through a website? Yes. When you purchase a medical plan online through us, any information you provide is kept private and the quoted prices are the best rates you can find from any broker, internet site or directly through an insurer. You save time and money while you are getting expert guidance from a local resource.

Most applications and enrollments are submitted online through a link you are provided on our website. You create your own log-in name and password that only you know. Any information you provide is electronically forwarded to the carrier. We do not view any of the details unless you allow it. Of course, we help you throughout the entire enrollment process. If you apply during an Open Enrollment period, no medical questions will be asked and an instant federal tax credit (subsidy) will be applied to the premium.

Fax Or Email Applications

You can also trust the other methods of purchasing coverage. Many customers  prefer to fax or email the actual applications. We provide a secure email and fax system that ensures that only ONE person will receive your paperwork before the insurer receives the enrollment form. Depending on the company, it’s possible you may not have to provide any type of billing information when you apply. Of course, we’re always happy to explain each company’s guidelines. And we make it very easy and understandable for you.

However, the simpler and quickest method of securing coverage is the provided online link. Correspondence is forwarded to you directly, and you can easily request to change benefits, billing, or the persons named on the policy.

Plans From All Companies Are Available

The plans you see on our website are the best policies offered by each Ohio health insurance company. There are more than 500 available plan combinations so we carefully choose the best 40-80 policies that provide the most benefits for the lowest price. We realize that’s still too many to consider, so upon request, we’ll look at your specific requirements, and pick out the best 4-8 policies. Just call or email us.

We understand that every individual or family has different needs. For some, low office visit copays and mid-range deductibles may be important. For others, high deductibles and cheap premiums may be what they are looking for. If you tell us what type of coverage you want, we’ll save you a lot of time and money by finding it for you.

Making The Best Choice

Sometimes, Anthem Blue Cross is the best available choice. But many times Medical Mutual Rates In Ohio, UnitedHealthcare, or perhaps even a smaller company such as Premier will provide the specific benefits you need, and also include the specialists and/or hospitals that are critical to your treatment. We’re here to advise you and make the decision-making process easy.

As an extremely trustworthy resource for Ohio consumers that buy health insurance online, we never accept any advertising, and do not allow commercial content to be displayed on our website . The combination of live assistance and modern technology that we provide, is a potent combination!

So yes, it is indeed very safe to apply for coverage online in Ohio. We’ll help you qualify for the lowest possible rates and make sure you’re comparing the most suitable  policies for your unique needs.