My Personal Finance Blog

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The game played by politicians is to take an idea from their own agenda and then frame it in a way that sells it to the other side. When the politicians meet in the middle, bipartisan solutions to problems emerge. This reflects the fact there is no monopoly on good ideas, only simple good solutions to difficult problems. In the healthcare debate, one of the solutions proposed by the GOP was to allow people to buy their insurance across state lines. This sounds a good idea. As the law stands, every state regulates the sale of insurance within its own borders. This limits the size of the market. If insurers had to compete with each other on a regional or national level, the premium rates would fall and every citizen would get a better deal. Well, let’s look a little more closely at how it would actually work.

At present, every state has a Department of Insurance to regulate the insurance companies licensed to sell policies. This is a reasonably effective system for consumer protection. But if regional or national insurers could sell policies into many states, it would break the regulatory system. It would no longer be local supervision of local companies. Insurers would decide where to establish and would, of course, choose the states which had the weakest consumer protection regulations, i.e. where they could make the most profit. Think banks and finance companies. These companies broke the US economy and produced the recession because their sales of subprime mortgages and associated derivatives were unregulated. Now apply the same thing to interstate insurance. As a final thought on this issue, remember all US states have different laws and one state cannot enforce another’s laws. That is sovereignty for you. So the state where an insurer is based cannot protect consumers under another state’s laws.

Secondly, opening the market across state lines allows insurers to cherry pick the best people to insure. Without regulations to limit the right to discriminate against people for pre-existing conditions and to increase premiums as people get older and fall ill more often, insurers will just take their profit from all the healthy people and forget about the rest. Thus, instead of increasing consumer choice, it would have the reverse effect. Most insurance companies would close their branches in individual states. Those that remained would keep all the aging and less healthy people. As their claims rise, the companies will make a loss and close. Without a law to mandate regional or national companies to offer some health coverage, it is likely the number of uninsured people would rise.

When you add all this up, it is a good thing the GOP’s proposal was rejected. Health insurance plans are complicated enough without having to change a whole mass of federal and state laws to allow interstate sales. This is not to say that consumers might benefit if there was more competition in the insurance market generally. With a real free market, properly regulated, consumers would get a better deal both in the terms of coverage and in the premium rates they pay. As it is, you must get multiple health insurance quotes. Anticipating their profits will take a hit following this reform, insurers have been raising their premium rates. You must shop around to find the most affordable policy.

In case you are not familiar with the market of insurance in general and healthcare coverage in particular, it can be quite confusing at first. But do not worry, as it is far simpler than you may think. Here’s a short recap of the most important things to know when shopping for health coverage plans. Of course, it’s not that profound to make an insurance specialist out of you in a single read, but it sure will help you find a decent policy with good coverage and low price.

Your options

Individual health policies – it is the most obvious option for most people, especially when not provided with healthcare coverage through their employers. You can find many insurance companies providing individual health plans. There are different regulations in every state regarding individual health coverage so make sure to learn more about your state before actually getting the policy. The best source for this information is your state’s insurance department.

High risk pools – these specific pools are the best solution in case you have been denied ordinary individual insurance due to a pre-existing condition. Not all states have high risk pools, but if your state allows them you will want to look better into this option. They typically have higher rates if compared to usual individual coverage, but it’s far better than having no healthcare coverage at all.

HIPAA coverage – in case you have recently been canceled of a job-base group plan and all COBRA coverage does not apply to you anymore, there’s a thing called HIPAA coverage that may be useful to you. HIPAA (Health Insurance Portability and Accountability Act) coverage is available in all states and can be of a use for people who can’t get individual coverage due to pre-existing conditions. This way HIPAA coverage is a good option in states where high risk pools do not exist. But even if there are high risk polls in your state you should consider both possibilities. Consult with your insurance agent to see what’s more appropriate in your case.

Whom to address

Insurance agents – an insurance agent is the person that will connect you with the insurance company, so it’s better to ask him or her about your options. But before you ask questions, make sure the agent is licensed for providing health insurance in your state. To do so, you can address your state insurance department and check the status of the agent you’ve been talking too. If the person is licensed, their experience in the domain can help you find good health coverage.

Department of insurance – besides giving information about state regulation and agents’ license, your state insurance department can also be a very valuable source of information on the whole health insurance market in your state. Don’t expect any recommendations to be made, though, as the workers are restricted from making any commercial claims. Use the department as your info source to know what companies are working in your area and then contact them directly.

Websites – there are many websites dedicated to health insurance out there and they can be a very good source of information to use. Many sites also provide free online quotes and state-specific data so you won’t have any problems with finding the right deal from a local provider.

There’s a strange contradiction about insurance. It’s an annoying burden every month when the time to pay the premium comes around but, if the worst should happen, it’s a wonderful thing to have had that insurance policy in place. With the family budgets really tight as the recession shows little sign of going away, the monthly bank statement shows the insurance instalments disappearing. You look at your own health. That’s great. You have never had a day of serious illness in your life. It’s the same for your partner. You cannot avoid feeling a little resentful. All those dollars, every month. And then there’s an accident or one of you does unexpectedly fall ill. It’s then you discover whether that plan you have been paying into is actually worth the money.

The market for health plans is divided in a slightly complicated way. It’s really to ensure the insurance companies make a profit as the cost of treatment keeps on rising way faster than inflation. So it reflects a balancing act between allowing the patients some say, and denying them any real control, over access to treatment. The plan most popular with the insurance industry is Managed Care. This requires you to get the insurer’s permission before you attempt to access treatment. The first contact doctor must be from an approved list, and he or she must refer you on for further diagnostic tests or treatment. Failure to get this referral usually means the insurer will refuse to pay. The second option is a Fee For Service Plan where you pay a lump sum at the beginning of each year, followed by monthly instalments. This covers you for the medical services listed in your policy. Basic plans only cover consults with your doctor and a simple set of tests. More expensive plans have a better range of coverage but there are usually co-payments.

Health Maintenance Organizations (HMOs) are networks of healthcare professions. If you stay within the network, your medical needs are covered although, in most plans, co-payments will be required. The next step up is a Point of Service Plan (POS). This is a variation on the HMO and allows a networked doctor to refer you to an outside expert. Finally, there are Preferred Provider Organizations (PPOs) which offer more choice than an HMO or POS both in the doctors you can access and the treatments you can have, e.g. usually include preventative medicine.

Because the service offered by this site is free, you can get as many health insurance quotes as you like for each of the main types of plan. This gives you more information on which to make your decision. But it’s fair to say the decision is not an easy one unless you read the detail of each plan with some care. With all the health insurance quotes available, you are often forced to balance coverage against cost, i.e. you buy the amount of coverage you can afford. This makes the choices something of a gamble. Do you pick emergency care in the event of an accident or focus on a list of the most common diseases or disorders? Do you include long-term care against the possibility you might be more permanently disabled by whatever happens? There is no right or wrong answer to these questions. In the end, it all comes down to what you can afford and what helps you to sleep best at night.

According to the Insurance Institute for Highway Safety, if you collect one speeding ticket, there’s a significant rise in the probability you will be involved in an accident in the next three years. This is not opinion. It’s a statistical fact that the chances of an accident rise by 50%. If you have two speeding tickets, the chances of an accident double. Since insurance companies set their premium rates according to these risk assessments, there’s an automatic linkage between a traffic citation and your premium rate. Depending on who you are, the rate can rise just a little or triple. For example, a wife rushing to her husband’s hospital bedside will be penalized less than a young man out street racing. The reality of the insurance market is that, according to the statistics, you get the premium rate you deserve. Since this is going to make the difference between potential discounts for being a safe driver with no claims and no tickets, and rate hikes worth several thousand dollars over the next three or four years for picking up a ticket, it can be worth fighting traffic tickets.

Obviously, it’s better to drive safely and within the law. It’s just as important to protect your reputation. Every few years, spend a few bucks at your state’s Department of Motor Vehicles (DMV) to ensure your driving record is accurate. If there’s a mistake, have it corrected. This could save you big dollars on the premium rates overnight. Now, let’s face the worst. You get pulled over. Remember never to admit guilt to the officer. Just be polite. Upsetting the officer could result in the addition of “ND” to the citation. That’s a note to the prosecutor not to do a deal, but to push for the maximum penalty. OK, so now you are in the system. What should you do? Don’t ignore the ticket. In many states, the police issue an arrest warrant. The first step is talking to your local DMV. Many states have programs in place to help drivers. For example, some will defer judgment and, if there are no violations in the next six months, the ticket is dismissed. Other states have driver safety courses. For minor offenses, attending a course on driving wipes the conviction from your record. You still have to pay the fine and the tuition fees, but this is less than the premium rate increases.

If you cannot prevent this from coming to court, go to court. Often challenging a ticket persuades the court to reduce the ticket to a moving violation which is not penalized by the insurers. If you show but the officer does not, this can persuade some courts to dismiss the ticket – check your local state’s rules. In the end, politely raising any kind of reasonable objection to the ticket is usually rewarded by the court – getting angry in a courtroom is not recommended. Of course, all this takes time and effort. Should this be too expensive, remember you can be saving several thousand dollars on premium instalments, so paying an attorney up to one thousand can be good value. All of this should encourage you to drive safely. It’s better not to get caught. Your car insurance quotes will come in lower and lower the longer you keep your record clean. If defensive driving fails to keep you safe, fight to avoid the conviction. It’s going to show up in the car insurance quotes over the years to come unless you get the ticket dismissed or reduced to a moving violation.