Cheap Health Insurance Made Easy

Cheap health insurance has become the issue of the moment in South Carolina and across the country. More small businesses are increasingly unable to provide cheap health insurance plans to their employees because of the rising cost and the lack of federal and state legislation that would allow small businesses to purchase cheap medical insurance in pools. In the meantime South Carolina and other states are looking to cut the costs of the Medicare and Medicaid health insurance programs for the elderly and the poor. However, more affordable forms of health insurance plans are available as some private companies are experimenting with a new variation of cheap health insurance known as health discount plans. In the article that follows we’ll explain the various aspects of cheap health insurance in South Carolina and how to find a plan that works for you.

Health Care Costs due to Managed Health Care

The current health care system in America is inaccessible to approximately 47 million poor and lower middle class people. In order to address the growing health care insurance crisis in the U.S. that resulted in health care cost growth in the 1970s and 1980s, health maintenance organizations (HMOs) sprung up. These were initially as non-profit groups designed to separate unnecessary tests and treatments from those that the patient required in an effort to keep costs down. Managed care organizations began screening requested procedures by physicians to pre-authorize what the HMO would or would not cover. However, the number of people who are the riskiest to insure-diabetics, cancer, etc.-continues to rise. Many South Carolina managed care industry experts say the cost of cheap health insurance is still high because of the existing pool of insured people who use the health care system more than an average amount.

The other battle that is ongoing in South Carolina involves the health insurance companies and hospitals, the latter which cannot turn anyone away from care by law. However, as the number of South Carolinians who cannot afford cheap health insurance increases, hospital emergency rooms are handling the majority of the load. More people have to turn to hospitals as their primary health care givers given a lack of adequate or non-existant health insurance coverage.

Cheap Health Insurance Plans Through the Workplace

Most cheap medical insurance policies in South Carolina are usually written through group coverage offered at work by your employer through a private South Carolina cheap health insurance company. This is usually the more cost effective way to purchase cheap health insurance now available since a large number of employees allows South Carolina companies to reduce their insurance premiums. Similar to buying in bulk, the more health insurance plans a business can purchase for its employees the less expensive the insurance is per employee. In South Carolina, like the rest of the nation, the number of companies that can provide cheap health insurance for their employees is declining.

Personal Health Insurance Plans

Health insurance plans can be purchased by individuals and families from virtually every insurance provider in South Carolina. Trying to purchase health insurance on an individual basis can be more expensive if the person already has a health problem, known as a pre-existing condition. Many companies will not cover people with pre-existing conditions if they have no continuation of coverage-renewing health insurance coverage after only a prescribed short period of time-picked up from an earlier cheap health insurance policy.

South Carolina Health Insurance Pool

The South Carolina Health Insurance Pool is a state health insurance plan designed to provide coverage for those that either do not have or have lost medical coverage at no fault of their own and are uninsurable. The pool was created by the General Assembly to help people who couldn’t get health insurance coverage from any other source, including people with certain disabilities. Blue Cross and Blue Shield of South Carolina currently administers the pool.

Coverage is available to a person who has been a state resident for at least 30 days and meets the following criteria:

They were turned down for private health insurance coverage for health reasons;
They were accepted for private health insurance, but have pre-existing illnesses or conditions excluded from coverage, for a period exceeding 12 months;
They are paying health insurance premiums for comparable coverage which are more than 150 percent of the premium levels charged by the pool;
In certain situations, other individuals whose last health insurance coverage was an employer based group health plan may be eligible for coverage.

No matter what your age, there are also several federally sponsored programs to help you if can’t afford the premiums for individual health insurance, providing you meet their eligibility guidelines.

Medicare, a health insurance program for people age 65 or older, certain younger people with disabilities, and people with end-stage renal disease.
Medicaid, a program for the poorest individuals and low-income families with children.
The Children’s Health Insurance Program (CHIP), a plan that provides health care to children whose parents make too much to qualify for Medicaid, but earn too little to afford individual health insurance.

Types of Cheap Health Insurance Coverage

Cheap health insurance plans generally fall into one of two categories: indemnity plans and managed care plans (HMOs, PPOs or POS plans). An indemnity plan allows you to choose your own doctors and pays for your medical expenses totally, in part, or up to a specified amount. Managed care plans generally provide broader coverage within a specified network of health-care providers.

Although you can purchase cheap health insurance plans that cover specific areas of health care (surgical, hospital, physician expense plans) most plans cover varying degrees of health care in a number of different areas. This health insurance coverage, known as major medical insurance, offers extremely broad coverage with a very high maximum benefit that’s designed to protect you against losses from catastrophic illness or injury.

When comparing cheap medical insurance plans, check to see if they provide additional benefits that you may need, including prescription drugs, preventive care, mental health benefits, maternity care, and vision care. A comparison of various health insurance policies and rates through many South Carolina health insurance companies can be obtained at www.insurances.sc.

Cheap Health Insurance Recipient Costs

With most cheap health insurance policies available in South Carolina, the way to control cost is to cut down on the out-of-pocket expenses. Since most health care insurance policies require you to make a co-payment (the amount you pay a health care provider with every visit), anything involving a lot of time spent in the doctor or dentist’s office can become expensive. Most also require a deductible (costs you must cover out of your pocket for any major expense before your cheap health insurance policy picks up the remaining costs). You may also have coinsurance, the percentage of cheap medical insurance cost you will still have to pay after you reach your deductibles.

Another thing to consider is COBRA health insurance. This law allows employees who leave a job the ability to stay on that South Carolina company’s employee health insurance for up to 18 months although they have to pay the full amount of the coverage. Check the COBRA benefits to see if purchasing a less expensive individual health insurance plan may be in your best interest.

How to Buy Cheap Health Insurance

If you need to purchase individual health insurance, it can be expensive. Unlike group plans, in which the costs and risks associated with health care are spread among many people; individual health policies are “medically underwritten” to take into account your personal health history. Any “pre-existing” condition such as heart disease, diabetes, and even pregnancy, can nix your chances of acceptance or boost your premiums.

To determine the acceptability of a particular applicant, a health insurance underwriter can require information regarding the following:

The individual’s age: Age determines rates and whether coverage will be issued at all.
The individual’s gender: at younger ages, males have a lower rate of illness and injury than females. That changes by age sixty.
The individual’s health history and physical condition: Someone who has had a previous condition that can contribute to a future illness/injury is not considered an ideal risk. In response to a less than ideal medical history, modified coverage may be offered depending on the individual’s health, higher than normal premiums may be issued, or the person may be denied coverage altogether.
The individual’s occupation and hobbies: Some occupations such as construction workers have higher insurance rates, along with people who enjoy dangerous activities such as skydiving or bungee jumping. At times certain occupations are considered so hazardous that insurance companies will not cover them at all.

Your first step in getting cheap health insurance coverage is to understand exactly what you need. Think carefully about what coverage you must have. Do you need health insurance for your whole family, or just yourself? Do you want to choose your providers? If you’re over 65, do you need insurance to fill the gaps in Medicare? Do you need – and can you afford – long-term disability and/or long term care coverage? Even if you begin by soliciting cheap health insurance quotes you must still know exactly what you want in terms of health insurance coverage so you will be comparing apples to apples when weighing any cheap health insurance premium quote.

After that, contact a South Carolina insurance agent in your area. Ideally, you can start with an independent South Carolina insurance agent who is familiar with the insurance companies that do business in your area. This agent is also not bound to write coverage for any particular health insurance company so he or she can give you an honest appraisal of various health insurance policies.

When you’ve found the right coverage, you’ll give information to your agent to complete the necessary forms. Be honest. It’s important to disclose your medical history thoroughly and accurately. Report all of your health problems to your agent. If any of your health information is misstated or incomplete, the company might refuse to pay your claims and could cancel your policy.

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Individual Health Insurance Plans FAQ

Most major medical plans require a deductible be paid before they pay out. Additionally, after the deductible has been met, you can expect coverage to be about 80% of the total medical expense incurred. Another feature of major medical plans is that they tend to have high maximum limits- from about 0,000 to Million. Moreover, major medical plans usually cover a wide range of medical costs including prosthetic limbs, x-ray/lab services and prescription drugs, for example. Easy To Insure ME has the answers

Therefore, while major medical plans often offer a wider range of coverage and high maximum limits, they require the insured to share in the costs. On the other hand, basic plans have lower cut off limits, but initiate immediately to cover 100% of the costs. What is needed here is careful consideration- it’s important for you to weigh both options very carefully before choosing the individual health insurance that works best for you.

Are there expenses which are not included in major medical plans?

In short, yes. There are a number of expenses generally excluded from major medical plans. Some include (but are not limited to): elective cosmetic surgery, custodial/convalescent care, injuries or illnesses already covered by workman’s compensation, routine vision and/or dental examinations and annual/routine physical examinations. Read your policy carefully, as all plans vary in what they exclude or include in coverage.

Are substance abuse and mental illness covered by health insurance?

Yes. Treatment for both substance abuse and mental illness are generally covered by major medical plans. However, the insurer may require a higher co-insurance and may reduce the benefits of the policy overall. Additionally, the amount of coverage often depends on the location of the treatment- that is whether it is done on an outpatient or inpatient basis.

What do policies mean by “co-payment”?

A co-payment (sometimes called a co-pay) is a previously specified amount to be paid by the insured at the time they utilize services. Co-pays are generally found in HMOs which often require co-pays for prescriptions and/or office visits for amounts ranging from to .

Please define “co-insurance” and explain how it works.

Co-insurance is often called Percentage Participation and requires the participants to pay for a previously-agreed-upon percentage of the services rendered. For example, if your coverage is 80/20, you would pay 20% of the costs incurred and your provider would pick up the remaining 80%. Co-insurance policies usually have a cap or stop-loss limit so that your out-of-pocket expenses can’t go beyond two or three thousand dollars per event. After reaching that dollar limit, your provider would pay the entire claim up to the maximum amount set out by the policy.

Are there some out-of-pocket expenses with major medical plans?

While major medical plans will include most expenses, you can expect to pay previously agreed upon co-pays or deductibles. For example, if you have an 80/20 co-insurance plan, you can expect to be charged 20% of the costs incurred. Additionally, many insurers will not cover procedures that they deem unnecessary or unreasonable. Providers differ widely on what would constitute “necessary” or “reasonable” care and so, if you are not faced with an emergency, it’s always good to check with the provider before incurring the expense.

What is meant by “pre-existing conditions”?

A pre-existing condition is a medical problem that the insured had- knowingly or unknowingly- for a specified period of time before the date that the policy became effective. Although most policies exclude coverage for pre-existing conditions from three to six months, some may go back as much as a year. Take the time to understand a policy’s pre-existing condition clause before signing on the dotted line.

How do HMOs vary from major and basic medical plans?

With major and basic plans, the insured is generally the one responsible for submitting claim forms for services rendered and following up on the submitted claims. Additionally, major and basic medical plans usually require deductibles or co-pays which add to the out-of-pocket expense of the insured. While the expenses covered by major and basic plans can vary from policy to policy, both generally allow you the freedom to choose your own physician.

HMOs, on the other hand, generally restrict the insured to a previously chosen network of healthcare providers which thereby limits the insured’s choices. HMOs often require no deductibles or co-pays and generally offer fewer exclusions to coverage. Some HMOs will allow you to seek care outside of their network for nominal co-pays.