1. DOES YOUR PLAN COVER YOU AT WORK AND AWAY?
Many health insurance plans have specific exclusions that eliminate your benefits for anything that might have been covered by workers' compensation or similar laws. Now read that last sentence again.
COULD HAVE BEEN COVERED!?
That's right. Most freelancers and even some small business owners do not carry Workers Comp themselves.
There are insurance plans designed that will cover you on and off the job - 24 hours a day, if you are not required by law to have workers' compensation coverage.
2. DO YOU WRITE IT?
Independent contractors (1099), home-based business owners, professionals, and other self-employed individuals generally do not take advantage of the tax laws available to them.
Many people who pay 100% of their own costs can deduct their monthly insurance payments. This alone can reduce your net outlay of a suitable plan by up to 40%. Ask your accounting professional if you are eligible and/or check the IRS website for more information.
3. INTERNAL LIMITS
All real insurance plans use some form of internal controls to determine how much they will pay for a particular procedure or service. There are two basic methods.
-Planned benefits
Many plans, some of which are specifically marketed to the self-employed and self-employed, have a clear schedule of what they will pay per doctor visit, hospital stay, or even limits on what they will pay for. testing per 24 hours. period. This structure is usually associated with "compensation plans". If any of these plans are presented to you, be sure to review the Schedule of Benefits, in writing. It is important that you understand these type of limits from the start, because once you reach them, the company will not pay anything beyond this amount.
- Usual and customary
"Usual and customary" refers to the rate of payment for a doctor's visit, procedure, or hospital stay that is based on what the majority of doctors and facilities charge for that particular service in that particular geographic area or comparable. The "usual and customary" charges represent the highest level of coverage of most major medical insurance plans.
4.YOU HAVE THE ABILITY TO SHOP!
If you're reading this, you're probably shopping for a health plan. Every day people shop, from groceries to a new house. During the buying process, typically, value, price, personal needs and the general market are assessed by the buyer. With that in mind, it's very disconcerting that most people never ask what a test, procedure, or even a doctor's visit will cost. In this ever-changing health insurance market, it will become increasingly important that these questions be asked of our healthcare professionals. The asking price will help you get the most out of your plan and reduce your out-of-pocket expenses.
5. NETWORKS AND DISCOUNTS
Almost all insurance plans and benefit programs work with medical networks to access discounted rates. Broadly speaking, networks are made up of health professionals and institutions that agree, by contract, to charge reduced rates for services rendered. In many cases, the network is one of the defining attributes of your program. Discounts can vary from 10% to 60% or more. Medical network discounts vary, but to ensure you minimize your out-of-pocket expenses, it is imperative that you preview the list of doctors and facilities in the network before committing. This is not just to make sure your local doctors and hospitals are in the network, but also to see what your options would be if you were to need a specialist.
Ask your agent what network you're in, ask if it's local or national, and then figure out if it meets your own needs.
