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Health Insurance Information - BizSmart Insurance Group

Health Insurance Information

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There are basically two types of health insurance:  Fee-for-Service and Managed Care. Despite the fact that they are not the same, both insurance has a selection of medical which includes surgical and hospital expenses. It likewise takes care of the prescription drugs while a few has dental coverage as well.

  1. Fee-for-Service
    This type of plan typically means that the medical professional is paid a certain fee every time medical attention is extended to the patient. The patients are provided medical help by the doctor of their own preference and claim is filed by a medical provider or the patient.
  2. Managed Care
    More than 50% of all Americans has some sort of managed care plan. Different plans diversely accomplishes what a person needs which can include: health maintenance organizations (HMOs), preferred provider organizations (PPOs) and point-of-service (POS) plans. These policies care for complete health services to their policy holders and provides financial motivation to patients who utilizes the providers in the health insurance plan.

What is “Long-Term Care”?

Due to an injury, physical or mental ailment, or old age, certain people needs assistance in bathing, dressing, eating, toileting or restrain, and/or shifting out of a chair or getting out of bed. These actions are referred to as Activities of Daily Living-sometimes they are also called ADLs. As a whole, if you cannot accomplish two or more of these undertaking or if you have cognitive impairment you are in need of a “long-term care.”

The usage of long-term in this kind of situation is not really useful because it might not even last that long. Not much people who require ADL services could potentially need it only for a couple of months or maybe just a month.

Another misconception of long-term care is that it is only given in nursing homes. Well, that is possible but it could also be done in an adult day care center, a housing facility for the elderly or disabled people that provides special care, or even in the comfort of your own home.

Assistance with ADLs that is referred to as “custodial care,” may be given in the same location. But do not confuse it with “skilled care” because these are two different services. Skilled care provides nursing, medical, rehabilitative services, which includes assistance in taking medicine, those who needs testing like blood pressure, or other such services. This distinctiveness is vital because usually Medicare and majority of private health insurance pays solely the skilled care and not the custodial care.

Take a good look at our long-term insurance page for further details on eligibility or costs.

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What are the types of Disability Insurance?

There are two kinds of disability policies and they are: Short-Term Disability (STD) and Long-Term Disability (LTD):

  1. Short-Term Disability policies (STD) has a waiting period of 0 to 14 days with the maximum benefit period of no more than two years.
  2. Long-Term Disability policies (LTD) has a waiting period of a number of weeks to a number of months with a maximum benefit period spanning from a couple of years to the entire of your lifetime.

Disability policies possess two distinct protection qualities that are vital to know.

  1. Non-cancelable suggest that the policy can never be cancelled by the company apart from the non-payment of premiums by the policy holder. This also means that you can renew your policy yearly without additional cost and without taking out any benefits stated in the policy.
  2. Assured extendable provides you of being in the position to renew the policy having the same benefits without any cancellation on the part of the company. Nevertheless, your insurance company has the right to raise your premiums for as long as the other policy holders of the same class has the same increase.

Beside the standard disability policies, there are various alternatives that you should assess when buying a policy such as:

  • Increased buying alternatives
    You are given the option to purchase additional insurance after a certain period from your purchase of the first insurance policy for only an additional cost.
  • Integration of benefits
    The benefits you have from your insurance company depends on your disability benefits. Your policy stipulates a specific amount that you will receive from all the policies you purchased. This policy will compensate the difference which was not indemnified by the other policies you own.
  • COLA or cost of living adjustment
    COLA raises your disability benefits after a period of time depending on the inflated cost of living which is determined by the Consumer Price Index.  Should you prefer a larger premium, chose COLA.
  • Residual or partial disability rider
    This condition permits you to go back to work on a part-time basis, get your wages and likewise receive partial disability payment that is, if you are yet partly disabled.
  • Return of premium
    This provision imposes the insurance company to partly refund your premium if no one makes a claim for a particular period that is stated in the policy.
  • Waiver of premium provision
    This clause tells you that there will be no premium payment on the policy if you are disabled for 90 days.

To speak with BizSmart’s health insurance risk advisor, kindly fill up the form below.

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