After the Honeymoon: Insurance Advice for Newlyweds

Want to demonstrate your true love for your new spouse? Take out an insurance policy. Compared to planning your wedding and honeymoon, buying insurance may not seem very romantic but, in reality, coverage that protects you and your spouse against life’s unforeseen risks is an important part of planning your life together. The following provides an overview of the types of insurance protection you should consider.

Life Insurance – to do or not to do

Newlyweds with children from a previous marriage and couples with only one working spouse should seriously consider purchasing life insurance for both spouses. Young married couples who both work and have no children may not need life insurance now. However, most CPAs agree that there are advantages to purchasing life insurance early in life. Buying coverage while you’re young and healthy gives you the opportunity to “lock in” favorable rates.

For most newlyweds, term insurance is the best way to get adequate coverage at an affordable cost. Expect to pay more for

permanent life insurance, such as whole life, which offers an investment component in addition to the death benefit.

If you already have life insurance, contact your agent to have the beneficiary named on your policies changed to your new spouse.

Disability Insurance – better safe than sorry

As important as life insurance is, statistically, young married couples are more likely to be disabled than to die prematurely. That’s why disability insurance is so important. Disability insurance provides you with a monthly income in the event an accident, illness, or injury leaves you unable to work. You may be able to purchase long-term disability insurance from your employer.  If not, you can buy it on your own. Compare policies and select the one that meets your needs at a premium you can afford. If finances are tight, you can do reduce the cost by extending the waiting period before coverage kicks in.

HEALTH INSURANCE – DON’T BE WITHOUT IT

Increased health care costs make it more critical than ever for newlyweds to consolidate health insurance so they are not paying for duplicate coverage. If you and your spouse both have health insurance through your employers, compare your coverage and costs to determine which plan best fits your circumstances and finances.

Auto insurance – cheaper for the wedded

You’ll also want to review your auto coverage. If you each have a car registered in your own name, combining them in one policy may qualify you for a multi-car discount from the insurer. Since the policy rates for married drivers are usually lower than for single policyholders, be sure to notify your agent of your marriage.

Home or renter’s insurance

Couples who rent should consider obtaining renter’s insurance to cover the value of their possessions. As you and your new spouse combine households, you’ll want to drop one policy, making sure that the remaining one covers both of your possessions. A renter’s policy also includes liability coverage. Your renter’s policy should become effective as soon as you move in, particularly if you are not living together yet.

The main purpose of homeowner’s insurance is to protect your home and your personal property from fire, theft, and similar perils. In addition, homeowner’s insurance, like renter’s policies, provides liability coverage as well. Most lenders require homeowner’s insurance in order to get a mortgage.

Keep in mind that since most homeowner’s and renter’s policies have a limit on jewelry coverage, you may need to add a rider to your policy to cover expensive engagement and wedding rings.

SHOP AROUND FOR THE BEST COVERAGE

Assessing and addressing your insurance needs early on will help get your marriage off on the right financial footing. To get started, you should carefully review your financial situation and objectives.

Health insurance cheap?   To learn more about the accounts and to find MSA providers, check the website run by the Council for Affordable Health Insurance (www.cahi.org). Even if the bill doesn’t pass, MSA holders can continue their coverage as long as they qualify. Although the law authorizing MSAs is set to expire next year, supporters in Congress have introduced legislation to reauthorize them.

This could be a big plus for the employee or solo worker who uses few medical services over the years. The unused cash grows untaxed, and the employee can withdraw the balance tax-free at retirement. Of course, since the accounts must be replenished annually, cash in the trust account may grow to cover the gap. In the event of unexpectedly high medical expenses, the employee must dig into his own pocket to cover any gap between the insurance policy deductible and the amount in the savings account. But MSAs pose a financial risk.

(In comparison, deductibles on a traditional major-medical policy typically range from about $200 for singles to $1,000 for families.) No matter who funds the account, the money in it belongs to the employee. Not surprisingly, the second option has proved unpopular with some workers because deductibles for MSA insurance policies range from $1,550 to $2,300 for singles and $3,050 to $4,600 for families. If you have employees, you can put in the money or require them to cough up the cash. If you work by yourself, you’ll have to fund your own account.

However, up to 65% of the amount of the deductible (75% for families) must be deposited in a tax-deductible trust account to pay for medical services until the insurance kicks in. Medical savings accounts help self-employed individuals and business owners with fewer than 50 workers shave premium costs by 50% or more by purchasing coverage with a high deductible. Consider the pros and cons of medical savings accounts (MSAs). The website run by Georgetown University’s Institute for Health Care Research and Policy (www .georgetown.edu/research/ihcrp/hipaa) outlines protections for individuals and small businesses in each state.

Some state regulations, such as uniform premium rates, help keep down costs, but specifics vary according to your location. HIPAA doesn’t limit premium costs, but if you’re self-employed you can deduct 60% of the premiums on your federal income taxes without meeting the 7.5% adjusted gross income (AGI) threshold that applies to other medical expenses. Be sure to apply for coverage before your policy lapses, though, since HIPAA requires that you obtain health insurance within 63 days after your COBRA coverage expires. However, insurers can limit the number of choices they offer. HIPAA provides that individuals who have had group coverage for at least 18 months and aren’t eligible for other insurance, such as a spouse’s plan, can’t be denied insurance because of medical problems.

(For more details, see Health Benefits under COBRA, published by the Department of Labor and available on the Web at www.dol.gov/dol/pwba or by calling 800-998-7542.) Even when your COBRA coverage runs out, you can’t be refused health insurance, thanks to the federal Health Insurance Portability and Accountability Act of 1996. If you qualify for COBRA, your employer must notify you of your option to continue coverage, and you, in turn, must act within 60 days. For those over age 50 or with health problems, it’s likely a better value. You may experience sticker shock, especially if the plan is generous, but the group rate is likely to be lower than you’ll find on your own for the same coverage.

This law gives you the right to stay on your current plan so long as you pay the entire premium, plus a 2% administrative fee. As long as your employer has 20 workers or more, you’re covered by the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. If you’re about to leave a job with health insurance to become self-employed, you can probably keep your current coverage for at least 18 months. SEE IF YOU’RE ELIGIBLE FOR COBRA.

To learn more about purchasing co-ops and to find out if there is one in your area, check the website run by the nonprofit Institute for Health Policy Solutions (www.ihps.org). Co-op rules require you to subsidize your employees, usually paying an amount equal to at least 50% of the lowest-priced plan. To join a co-op, you will have to pay a membership fee (generally $100 or less). However, explains Rick Curtis, president of the Institute for Health Policy Solutions in Washington, D.C., “the main attraction of these programs is not cost savings, but value and convenience.” Co-ops offer a menu of insurance plans with standardized benefits, making comparisons easy and allowing employers to provide their workers with a choice of options. Co-ops offer solid coverage at a decent price.

In general, purchasing co-ops serve businesses with two to 50 employees, though some admit sole practitioners or larger employers as well. JOIN A PURCHASING CO-OP. Finally, we’ve assessed a controversial small business insurance product that self-employed individuals and small business owners should approach with caution. The first one is targeted primarily to small firms; the second, to individuals launching a solo venture.

Here are two strategies that can make shopping for health insurance easier. Plus, where group purchasing is impossible, small employers find it impractical–and expensive–to offer a choice of health plans. And since coverage varies widely among plans, it’s almost impossible to comparison shop for the best value. For companies with more than 200 workers, premiums increased just 3.3% to an average of $462 for family coverage. The Kaiser study reports that premiums for firms with fewer than 10 workers jumped 8% in 1998, averaging $520 a month for family coverage.

One reason for the coverage gap may be that small businesses are often stuck with the highest prices. Roughly 65% of unincorporated solo workers and 81% of incorporated ones carry insurance, according to a 1999 study by the Kaiser Family Foundation. Self-employed individuals are somewhat more likely to buy coverage. That may be why the Employee Benefit Research Institute reports that only 54% of businesses with fewer than 200 employees offer health insurance. But for many small business owners and self-employed individuals, buying health insurance presents several hurdles.

Jost is fortunate enough to live in an area where small business owners have banded together to obtain some of the buying advantages of large employers. It’s good coverage and that gives my employees good feelings about their work,” he says. “I’m glad to do it. Jost picks up the entire cost.

The monthly premium for each employee ranges from $187 to $373, depending on the insurer, the type of plan and whether the employee needs individual or family coverage. Thanks to his membership in the Colorado Health Care Purchasing Alliance, Jost can give his small staff a choice of four insurers, each offering two health plans. “The best workers won’t settle for a job without these benefits,” insists Jost, president of American Data Group, a $1.3 million software-design firm in Denver.  To Mark Jost, it’s just good business sense to provide health insurance to his five employees.

Maryland Health Insurance

The Maryland Insurance Administration is responsible for regulating all types of insurance sold in the state of Maryland - including health insurance policies.

If you are looking for health insurance coverage, the Insurance Administration can help you find an insurance agent or insurance company that is licensed to do business in Maryland. You can contact them at the phone number listed below, or conduct your own search online.

If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Insurance Administration. Contact the Insurance Administration at the phone number listed below, or file a complaint online.

Maryland Insurance Administration
525 St. Paul Place
Baltimore, MD 21202-2272
Phone: 410.468.2000 or 1.800.492.6116 (toll free)

Senators precisely how I feel about America’s health care system today. my ring finger at $12,000, I’ll choose to have my middle finger sewn on first just so I can visually demonstrate to U.S. And if, like one person featured in the film, I ever have to choose between reconnective surgery for my middle finger at $60,000 vs. It opens on June 29th. Go see it. It’s all true, and it\’s pretty damn scary. In fact, as a person who has been writing about America’s health care problems for four years, I didn’t detect a single false statement in the film. It’s surprisingly even-handed and well grounded, never resorting to unsubstantiated claims merely to shock the audience.

The bottom line on SiCKO It’s a must-see documentary. In fact, it will join a long (and growing) list of civilizations that have risen and fallen, securing its place in the pages of history as yet another imperialist nation that thought it could rule the world while abandoning the needs of its own people. It won’t be the first empire to crumble from arrogance and corruption. I predict America will not survive its health care crisis.

And make no mistake: that’s what’s coming. The Big Business sick care industry has a stranglehold on the American political system, and the whole ugly thing will mostly likely have to collapse and be rebooted before we\’ll see significant change. Personally, I don\’t see that meaningful reform is possible under the current system of politics in America. They\’re only concerned about the next election, and raising campaign reelection funds means kow-towing to the interests of the powerful corporations that really run Washington.

Lawmakers, you see, have no interest in actually saving America from financial demise. I\’ve offered many suggestions in a popular article, The health care reform legislation that Congress should pass, but won\’t. Truly radical changes must be put into place. As Moore points out, however, there is a chance to save America, but only if we make significant changes starting now.

No nation that abandons the health of its people can expect to have a future. Under the current system of massive debt spending, widespread political corruption, war mongering and health care failures, the United States of America will simply not survive another generation. (Click here to see my CounterThink cartoon on this topic.) The future of America looks dim Clearly, something has to change in this country if we\’re going to survive as a nation. The American Cancer Society, in my opinion, is a supremely corrupt, big-business front group that actually takes steps to ensure more cases of future cancer by \”preventing prevention,\” the American Diabetes Association takes money from candy and soda manufacturers, and the American Psychiatric Association is so steeped in Big Pharma money that they\’ve practically become inseparable. Drug advertising has taken over the media, the FDA has suppressed natural alternatives, and the American Medical Association continues to peddle such health nonsense that it\’s amazing the AMA hasn\’t yet been invited to join the Smithsonian\’s Museum of Outdated American History.

Nearly 50 percent of American adults are now taking pharmaceuticals, most of which are utterly unnecessary from a medical point of view. You can\’t \”treat\” your way out of a nation that has become so over-drugged, over-fed and over-diseased that even the little children are now being put on speed (also called \”Ritalin\”). But as I\’ve pointed out in a previous article, Where\’s the Health In Health Care Reform?, almost nobody is considering proposals that would genuinely solve the health care problem in America today. The movie will definitely get America talking about serious health care reforms.

Ron Paul, of course). The truth is, Big Pharma owns virtually all the politicians in Washington (except Rep. Edward Kennedy. Democrats, though, are also on Big Pharma\’s payroll, as was obvious with the recent voting record on the FDA Revitilization Act co-sponsored by Sen. This is a tough call for Republicans, since most Republicans support Big Pharma and the corporate control of modern medicine, usually at the expense of the people.

Those politicians who run on a platform of radical health care reforms are likely to pick up a lot more support than those unwise enough to try to defend the current system. I think SiCKO\’s timing is perfect, and I think the movie will be a significant factor in the upcoming 2008 elections. How will SiCKO play? To learn more, read my article The lawlessness of the FDA, Big Pharma immunity, and crimes against humanity.

That\’s astounding, given that I\’ve solidly established the Food and Drug Administration is far more dangerous to the health and safety of the American people than all the terrorists in the world. A recent poll revealed that nearly 45% of Americans still trust the FDA! But sadly, the truth is that most Americans are sheeple who just follow the herd and do what they\’re told. Moore is an independent thinker who simply refuses to follow the crowd, and with this film, he\’s doing the job that the American people should have been doing all along — questioning the sanity of our health care system.

operates today. Regardless of Moore\’s present physical fitness challenges, he\’s obviously operating with a great degree of healthy skepticism about the way the U.S. That\’s not a joke. doctor is less than a Cuban peasant. The average lifespan of a U.S.

Many aren\’t any healthier than Moore, and they work in the industry! And besides, if you want to argue about the health of \”experts,\” just walk into any hospital and take a look at the health of all the people who work there. Moore is simply pointing out what\’s wrong with America\’s health care system, and he does so brilliantly and convincingly, regardless of his own personal health status. So the critics who attack Moore\’s own personal health are missing the whole point of the film. But he never claims to be.

Of course, it might be tricky for Moore to argue for disease prevention given that he is obviously not the poster boy for ideal physical health. Of course, that\’s not really what SiCKO set out to do, and this topic would require another film all by itself, but personally I wouldn\’t have minded a stronger nod towards solving our nation\’s health care problems through genuine prevention (rather than the current policy which is basically centered around waiting for everybody to get sick and then treating their symptoms while ignoring the true causes of their disease). But there\’s something missing from the film: A serious discussion about how a nation can prevent disease using nutrition, medicinal herbs, sunshine, clean water, avoidance of toxic chemicals, smart dietary choices, banning the advertising of junk foods and pharmaceuticals, and so on. What\’s missing from SiCKO The material that\’s in SiCKO is hard-hitting, and it accomplishes what it sets out to do.

We have a health crisis in this country, and it\’s going to take genuinely radical reforms to turn this around and save America from a financial wipeout exacerbated by runaway health care spending. Most people simply don\’t take care of their own health, and while I could argue for days about the need for more patient responsibility alongside corporate responsibility, the fact is that relentless advertising from drug companies and food manufacturers has bred a mindset of disease, junk food consumption, pharmaceutical dependence and patient victimization. (I posted my health statistics at www.HealthRanger.org if you want to see my blood workup.) At the same time, I realize that not everybody is in such a fortunate health position. I don\’t get annual physical exams, and I have zero risk of cancer, heart disease, diabetes or other common health conditions. I have no need for a doctor, or a pharmaceutical, or a health insurance policy.

I\’m a holistic nutritionist, and I exercise, eat right, get lots of sunshine and gorge on superfoods and raw berries. Personally, I opted out of the American health care system long ago. health care system. It\’s so bad that most informed world citizens wouldn\’t be caught dead in this country, unless of course they actually visit America and have an accident that lands them in the U.S. America\’s health care system is an embarrassment to the nation, and to the world.

Because Michael Moore is right. Why? People attack Moore personally, but they won\’t dare debate what he\’s presenting in the movie. Other critics of Moore are either the greedy, corrupt corporations impacted by his film (drug companies, health insurance providers, hospitals and so on) or juvenile stay-at-home back-seat Internet critics who don\’t like Moore for the simple fact that he dares to stand up and say \”The Emperor Has No Clothes!\” Nearly all the criticism leveled against Moore is without substance. Just ask all the scientists who publicly disagree with the Bush Administration\’s hopelessly politicized view on climate change…

Humiliating the King is a quick way to find your head on a chopping block. Moore is clearly being targeted not merely because he took some 9/11 heroes to Cuba and got them health care, but because he dared to make it all public. officials isn\’t appreciated much in police-state America these days, where practically anyone who dares question the wisdom of the government is branded a terrorist. That kind of \”in-yo-face\” embarrassment to U.S.

In fact, Cuba is willing to take care of a few American citizens that America abandoned! The message is hard to miss: Cuba takes better care of its citizens than America does. and brought them to Cuba where they received free, quality health care in a modern Cuban hospital. Because Moore gathered a dozen Americans who were denied health care in the U.S.

And why? government officials are investigating Moore for violating travel restrictions to Cuba. For starters, U.S. Why Moore is being so vicious attacked Moore, as usual, is being targeted by all sorts of critics who would like nothing better than to see this guy disappear and stop rocking the Good \’ol Boys boat that seems to be floating just fine in America (as long as you\’re part of the wealthy elite, anyway).

See my CounterThink cartoon, The Disease Economy, for a visual representation of this mess we\’re in, or read my book Natural Health Solutions and the Conspiracy to Keep You From Knowing About Them to see just how evil and corrupt our modern health care system really is. Only America practices medicine in the Dark Ages, tied to a hopelessly corrupt system of financial exploitation and monopoly price controls, where Big Pharma gets richer, the FDA gets more powerful, and the American people get the shaft. and even some not-so-modern nations. It\’s called universal health care (or \”socialized medicine\”), and it\’s a system followed by nearly every modern nation in the world… all countries where health care is free to everyone.

In contrast to all this, Moore shows us the universal health care systems in countries like Canada, the UK, France and even Cuba… In one segment in the film, he features archival footage of former President Nixon, who strongly approves of a new 1970\’s health care concept called the \”HMO\” where the more patients are denied health care services, the more money the hospitals and health insurance companies rake in! In SiCKO, what Moore does very effectively is tells this story to a mass audience, weaving together the emotionally-charged stories of American citizens who lost husbands, daughters and other family members to preventable disease, all thanks to intentional, well-planned payment denials by health insurance companies. Click here to read my recent report on the American Cancer Society\’s refusal to help prevent 77% of all cancers using affordable, scientifically-proven vitamin D supplements.

There\’s no money in preventing disease, especially in the cancer industry. I\’ve been ranting about America\’s health care failures for years, and as I\’ve consistently stated to the amazement of some, the health care corporations actually have a plan to keep people sick. It reveals the deep-rooted corruption in America\’s health care system and explains why the whole system was actually designed to deny health care to the American people. Watching this movie will leave you either steaming mad or shedding tears (or both). Forget whatever criticism you may have heard about SiCKO — this is a Michael Moore masterpiece: A courageous, impactful and outrageous documentary that exposes the arrogance of modern medicine and the utter failure of America\’s corporate-controlled sick care system to provide decent health care to the people.

SiCKO is a must-see documentary SiCKO creator Michael Moore answers that all-important question in his best documentary yet. (Click here to see our CounterThink cartoon on President Bush\’s price negotiations with drug companies.) What\’s wrong with America\’s health care system? Why are hospitals literally dumping uninsured patients on the street, abandoning the sick to protect profits while our politicians actually negotiate on behalf of Big Pharma to make sure Americans keep paying the highest prices in the world for medications? But if our health care system is really so good, why do 50 million Americans have no health insurance? We spend more on health care than anyone, we pay the highest prices for medications, and we\’re constantly told that we have the best medical technology in the world.

Meanwhile, the American people are the most diseased people in the world among advanced nations. to learn more about this topic. See my CounterThink cartoon, Disease Mongers, Inc. Drug companies are now among the richest corporations in the world, and they got there by inventing fictitious diseases, then selling drugs to people who mostly don\’t need them.

And while the American people get sicker, the drug companies, insurance companies and many health \”care\” providers (it’s really more like \”sick care providers\”) are rolling in cash. The drug companies, surgeons, medical specialists, health insurance companies and private hospitals are making out like bandits, raking in multi-million dollar CEO salaries and — I\’m not making this up — greater than 500,000% markups on prescription drugs. But not everybody’s doing badly. are due to medical expenses.

Meanwhile, 50 percent of personal bankruptcies in the U.S. Multinational corporations are fleeing the United States due to health care costs, taking jobs and economic productivity with them. Just about everybody\’s either financially strained or going broke due to spiraling health care costs: the people, the employers, state governments and even the federal government. America\’s disastrous health care system is heaving the country head-first into near-certain economic collapse.

1. What is the Texas Health Insurance Risk Pool? The Texas Health Insurance Risk Pool is an individual  health insurance program created by the Texas Legislature to provide health insurance to Texas residents who either (i) cannot obtain adequate health insurance coverage as a result of their medical conditions, or (ii) are considered “Federally Eligible Individuals,” as defined by the Health Insurance Portability and Accountability Act of 1996, commonly referred to as HIPAA.
2. When was the Health Pool started? The Health Pool was originally created by the Legislature in 1989 in a bill sponsored by Representative John Gavin. The Legislature, however, did not provide funding for the operation of the Health Pool. In 1997, the 75th Legislature amended the 1989 legislation in a bill sponsored by Senator David Sibley and Representative Kip Averitt, which, among other changes, provided a funding mechanism. It also included $500,000 of state appropriated funds to cover the start up expenses of the Health Pool.
3. Who manages the Health Pool? The Health Pool is managed by a nine member Board of Directors, appointed by the Commissioner of Insurance. The Executive Director’s office oversees the day-to-day operation of the Pool.
4. Who can be a member of the Board?The statute requires that certain interests be represented on the Board of Directors. These are: health insurance companies and persons who are eligible or who are parents of someone eligible for the Health Pool coverage. Additionally, Board members may be physicians, hospital administrators, advanced nurse practitioners or members of the general public, not affiliated with the insurance and health care industries.
5. Who are the current members of the Board?
   • Gary C. Cole, Chair - Public Representative
   • Phyllis Gordon, APRN, Vice Chair - Professional Representative.
   • D. Greg Barbutti, Secretary/Treasurer -  Insured Representative
   • Ed Baxter,  Public Representative
   • Robert Emmick, M.D. - Professional Representative.
   • Pati McCandless - Industry Representative
   • Rick Ott, CLU, LUTCF - Industry Representative.
   • William C. Rainey, M.D.- Insured Representative
   • Vacant
6. When did the Health Pool begin operations? The first Health Pool policies were effective February 1, 1998.
7. What type of health insurance is provided by the Health Pool? The policy issued by the Health Pool provides major medical expense coverage including coverage for prescription drugs. Benefits are provided up to a $1,500,000  lifetime maximum benefit. The coverage is subject to a calendar year deductible and coinsurance payments by the policyholder. For a more complete explanation, see the outline of coverage.
8. How are the operations of the Health Pool financed?The Health Pool charges premiums for the policies that it issues. When claims and expenses for the Health Pool’s operation exceed collected premium, the Health Pool  collects additional funds from the health benefit issuers through assessments.
9. Who sets the premiums charged? The Board of Directors recommends the premium rates to be charged and the Insurance Commissioner approves the rates.  Rates shall not exceed 200% of the standard premium rate.
10. What is a standard premium rate? A standard premium rate is a rate typically charged by commercial carriers for similar coverage. The Board of Directors engages an independent actuarial firm to set a standard rate for the commercial market. The Board uses this standard rate when setting the premium rates for the Health Pool policy.
11. What premium is charged for the Health Pool policy?Effective January 2004, the multiplier above the standard premium rate was raised to the 200% statutory limit. Rates will continue to be reviewed twice a year and raised, when necessary, to maintain this level above the standard rate.
    For a more complete description of premiums, see the Rate Information page.
12. Who is eligible for the Health Pool Coverage? See Health Pool Eligibility
13. How do I apply for coverage? Interested persons may request an application by contacting the Health Pool at (888) 398-3927 (e-mail address, texasriskpool@bcbstx.com). The application package will contain an Outline of Coverage, an Application for Coverage and a table of premium rates. You can also download the application package - See Application. Anyone interested in applying must return the completed application with the appropriate amount of premium. If the applicant is accepted, coverage becomes effective on the first day of the month following approval of the application by the Health Pool administrator.
14. Can I be turned down for coverage? Yes.  See Health Pool Non-Eligibility.
15. What about preexisting conditions? See Health Pool Eligibility - Preexisting Conditions
    

   16.  Can I obtain or keep Pool coverage if I am under
age 65 and I become eligible for Medicare
disability?

          In the case of coverage by Medicare, you are allowed to retain
Medicare coverage if you otherwise qualify for the Pool, but the
Pool will provide medical coverage on a secondary basis, and
no coverage for outpatient prescription drugs.

   17.   Can I go to any doctor or hospital?

             The Health Pool Board of Directors selected the BlueChoice
Network as its Preferred Provider Organization (”PPO”).  An
individual covered by the Health Pool may go to any medical
provider or hospital he or she chooses.  However, if the covered
individual chooses a BlueChoice provider, the individual will pay
a smaller coinsurance payment.  If the person chooses a provider
outside the network, the person will pay a higher coinsurance
payment.  In addition, PPO providers do not charge the covered
person for charges in excess of the PPO contract rate.  A
non-PPO provider, that is not a ParPlan provider, may charge the
difference between the benefits paid by the Pool and the
provider’s billed rate; therefore, the Pool member will be
responsible for any charges over the allowed amount.

18.  What are the health care benefits provided by the Health Pool?

         After the covered individual has satisfied the deductible each
year,   the Health Pool will pay the amount of covered expenses in
excess of the required coinsurance amount, payable by the
individual, until the individual meets the  coinsurance maximum for
the year.  After the individual meets the coinsurance maximum for
the year for PPO covered expenses, the Health Pool will pay
100% of covered expenses for the remainder of the year, subject
to the maximum lifetime benefit amount of $1,500,000. It should
be noted that the calendar year deductible, the emergency care
deductible and charges for outpatient prescription drugs do not
count towards the annual coinsurance maximum.

  19. What are the deductible amounts?

        The Health Pool offers three plans. Plan I has a $1,000 deductible,
Plan II has a $2,500 deductible, and Plan III has a $5,000
deductible.  The deductible amount selected may not be changed to
a lower amount after the Policy is issued. You may request to
change to a higher deductible, if offered, but only one such change
will be allowed in a calendar year.

20. What are the coinsurance amounts? In addition, the policy requires a 20% coinsurance payment for PPO providers and 40% for non-PPO providers. The annual out-of-pocket coinsurance maximum is $3,000 for PPO providers.  There is no coinsurance maximum for covered expenses from non-PPO providers.
21. What are the policy exclusions? See Health Pool Benefits and Exclusions.
22. When does the policy terminate? The Health Pool may cancel coverage for non-payment of premiums within the 31-day grace period.

    The policy is renewed each time the required premium is timely paid, but coverage will terminate for each person insured under this Policy:

    a) 31 days after the day on which a premium payment for the Policy becomes due if payment is not made before that date;

    b) the earlier of the premium due date or the first day of the month that follows the date on which the Pool determines:
    1) an Insured Person is no
    longer eligible for coverage
    under the Pool;
    2) an Insured Person is no longer
    a resident of the state of
    Texas except for: a child who
    is student under the age of 25
    and financially dependent upon
    You or Your spouse; a child
    for whom You and Your
    spouse is obligated to pay child
    support; or a child of any age
    who is disabled and
    dependent on You or Your
    spouse;
    3) an Insured Person is 65 years
    old;

    c) 30 days after the date We make inquiry concerning an Insured Person’s place of residence or any other eligibility criteria and You do not reply;

    d) You request coverage to end;

    e) on the date of death; or

    f) state law requires cancellation of this Policy.

23. How are payments of premiums handled? Premium may be paid monthly by automatic bank withdrawal or quarterly, semi-annually or annually by direct payment. Rates are based on age, gender, zip code and smoker status. Rates are subject to change with 30-days notice. An initial premium payment must be submitted with each application.

There is a free Guide to Minnesota’s public health care programs available at this link.

There are three publicly funded health care programs available to Minnesota residents. All three programs have eligibility requirements. The three public programs are:

• Medical Assistance (MA)
• General Assistance Medical Care (GAMC)
• MinnesotaCare

How do I apply for Medical Assistance?

To apply for MA, call or go to the human service agency in the county where you live. County agencies are listed toward the end of this brochure. You can apply even if you are not sure that you are eligible.

When you apply, you will fill out an application form and be asked for proof of some of the information you give.You also will talk with a person who works for the county agency. There are people at the county who can help you fill out the application. You can print a copy of the application from the Web at www.dhs.state.mn.us and mail it in.

Your county agency will let you know if you are eligible for assistance within 45 days (60 days if they need a disability certification; 15 days for pregnant women). If a decision is not made in that time, the county agency will explain why in writing.

If you are found to be eligible, the county will enroll you in the MA program. Every six months a county financial worker will review your situation to see if you are still eligible for health care assistance. You must complete, sign, date and return all forms sent to you by your county agency. If you do not, you will lose your Medical Assistance.

Your financial worker may ask you to provide:

• your last checking or savings account statement and/or sign a release-of-information form for your bank

• proof of ownership for stocks, bonds, savings certificates, trust funds or other financial assets

• proof of current unearned income

• your pay stubs for all employed family members for the last 30 days and/or your most recent tax form

Click here to learn more about Minnesota health care.

If you are looking for information on how to get Minnesota Health insurance, there are a few great resources you should look up online.

http://www.health.state.mn.us/  Minnesota Health Information from the Minnesota Department of Health

 http://www.health.state.mn.us/healthcare.html Minnesota Health Insurance information

There is a lot of good health insurance information for the state of Minnesota on this website. If you need coverage (especially if you can’t afford health care) then you really need to read up on it. You can get free health care if you qualify!

If you live in Louisiana and need affordable health care, you might try some of the resources wee compiled below.

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There are many different types of health insurance, and some of these can seem confusing. Here are types of health coverage, what each type of health coverage means, and how to understand them. Read the rest of this entry »

Being a self-employed freelancer is a wonderful thing in many ways. It allows you a flexible schedule, you can generally do jobs that you like and you get to have almost complete control over your work environment. But these benefits come with a cost; you lose out on certain things by not being the employee of a small business or larger company. One of these things is health insurance. Health insurance is almost a given in places of full-time employment, and you should consider it a given when working for yourself, even though you are going to have to do the footwork to make it happen. Read the rest of this entry »