How to Avoid the Hidden Traps
What Some Insurance Companies Won't Tell You
It is no secret that the cost of health care in America continues to rise dramatically. Currently, one out of every five dollars the government spends goes toward Medicare or Medicaid. In 2008, America spent more than $2 trillion on health care and some experts say that number will nearly double in eight to 10 years.
As a result, many Americans find themselves in stressful financial situations when unexpected challenges such as a serious accident, illness and disease occur. Most of these circumstances can be avoided if customers knew the right questions to ask and traps to avoid when choosing individual and/or family health insurance.
Avoiding hidden costs and coverage limitations is key to choosing the right health insurance provider and a plan that won't leave you in a financial predicament. At TSCRA Insurance Services, we focus on helping our customers choose an affordable plan that meets their specific needs—making sure they know exactly what they are getting.
To assist our members in making smart insurance choices, TSCRA Insurance Services identified the 10 most important issues customers should be aware of to avoid hidden traps including:
- Preventive care: Most plans do cover preventative care which typically entails routine doctor visits, immunizations and screenings. Routine check-ups and maintaining a healthy lifestyle can prevent common health problems. Check to see if your plan places limits on preventive care.
- Rate increases: Some service providers can raise rates two to three times a year. Look for plans that only evaluate your premiums on an annual basis, leaving you with no unexpected mid-year surprises.
- Caps on benefits: Insurance plans have caps on the amount of coverage they will provide in a year and in a lifetime. Look for plans that will cover you at least up to $2 million.
- Caps on prescription drugs: Many Americans spend more money on prescription drugs than any other medical treatment. Prescription drugs costs are rising in the midst of a weak economy. Make sure your plan covers 100 percent of prescription drug charges. This is especially important for the elderly, children and those with health complications.
- Premiums: Be sure you understand how your premium relates to your total health care spending. Make sure you know how it impacts your deductible, co-pay and lifetime benefit caps. It is important to look at the overall amount you will spend on health care, rather than just the cost of premiums.
- Deductibles: High deductibles mean that you will pay more out of your own pocket before your plan kicks in to cover the health care charges. In the event of an unexpected medical condition, a high deductible can often leave you in financial distress.
- Out-of-pocket maximum: Make sure you look for a company that does not require you to pay over-the-top fees for your medical coverage. This will ensure that your insurance company is paying for the bulk of your coverage and that you will not be left with unexpected fees should there be a health issue.
- Co-Pay: Doctor visits can add up, especially when you least expect them to. Make sure you know how much your co-pay will be and compare it with your deductible. Does your plan limit the number of co-pays each year?
- Co-Insurance: Make sure you're aware of what percentage the insurance company will pay toward your coverage. A standard amount is when the plan covers 80 percent and you cover 20 percent.
- Network Providers: Check to be sure that the network you choose is widespread and has a comprehensive list of doctors.
This is especially important for farmers and ranchers. Research in California found that even though farmers and ranchers are likely to have higher-than-average incomes, a high percentage are burdened by the cost of health coverage and care.
For specific policy questions about TSCRA Insurance Services, please contact client services at 800-252-2849.