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5 Fundamental Facts About Health Insurance Schemes In A Dreadful Economy
1. DOES YOUR HEALTH PACKAGE COVER YOU ON AND OFF WORK?
Many health insurance policies have specific exclusions that exclude benefits for anything that might have been covered under Workers Compensation or similar laws. Now read that last sentence once more.
COULD HAVE BEEN COVERED!?
That is correct. A lot of self employed people and even many small business owners don't carry Workers Comp on themselves.
There are designed insurance plans that will cover you on and off work - 24-hours a day, if you are not expected by law to have Workers Compensation protection.
2. ARE YOU WRITING IT OFF?
Freelance contractors (1099's), home based business operators, professionals and other self employed people usually are not taking advantages of the tax laws accessible to them.
Many people paying 100% of their own costs are able to deduct their monthly insurance charges. Just that by itself can reduce your net out-of-pocket costs of a proper policy by as much as 40%. Ask your accountant if you qualify and/or look up the IRS website for more details.
3. INTERNAL LIMITATIONS
All true health insurance policies use some sort of internal controls to determine how much they will pay out for a particular procedure or service. There are two general methods.
-Scheduled Benefits
Many policies, some of which are specifically targeted for self employed and independent people, have a clear schedule of how much they will pay for a doctor office visit, hospital stay, or even boundaries on what they will pay for testing in a 24-hr. period. This format is usually associated with "Indemnity Plans". If you are presented with one of these policies, be sure to see the schedule of benefits, in writing. It is crucial that you understand these sorts of limits up front because once you reach them the company will not pay anything above that amount.
-Usual and Customary
"Usual and Customary" refers to the amount of payment for a doctor office visit, procedure or hospital stay that is determined by what the majority of doctors and facilities charge for that exact service in that specific geographical or comparable area. "Usual and Customary" charges represent the highest level of cover on most health insurance policies.
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