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What is Supplemental Insurance?

A “supplement” insurance policy is one designed to help pay for the out-of-pocket costs associated with treatment for a health issue.  Examples are Cancer insurance, Heart and Stroke insurance, Accident insurance, etc.  Generally, the benefits of the policy are payable directly to you, the insured, instead of to the health care provider.  You can then determine how to use the money — pay your medical bills, your light bill, your grocery bill — or whatever you choose.

Supplements cost much less than regular health insurance, but are typically purchased in addition to it.  Although they can often be used as stand-alone products, the best benefit to the insured is when they are used in conjunction with your health insurance.  In these days of “mandated” health insurance, a supplement enables you to purchase less expensive, higher deductible coverage, knowing that you have a cost-effective supplement to help if you need it.

Cancer Insurance – Who needs it?

Almost everyone knows someone who has had cancer.  The current statistics are that 1 in every 3 women, and 1 in every 2 men will develop cancer in their lifetime — regardless of family history.  Although there have been advances in the treatment of cancer, it’s still a word that strike fear in the hearts of those who hear it applied to themselves or a loved one.

Research has shown that one of the most important aspects of surviving cancer is the mental and emotional state of the person.  Worry, fear and stress all apparently work to suppress the immune system and depression can inhibit the will to fight.

People often think they are covered financially if they have good health insurance — failing to consider the hidden costs of cancer treatment like deductibles, co-insurance, co-payments, etc. There is also the possibility of lost income due to treatments and time off from work.

Cancer insurance obviously cannot treat cancer.  But it CAN greatly reduce or eliminate your out-of-pocket costs and lost income, enabling you to focus on getting well instead of worrying about how to pay the bills.

We offer one of the most comprehensive cancer plans available on the market, and we know what we’re talking about because it’s the one we have and used when we were each diagnosed!  Call us for more information at (903) 825-2069 or (800) 439-7073.

 

Paycheck Insurance a.k.a Disability Insurance

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Disability Insurance is one of the most important coverages you can have, yet many people say “I just can’t afford it.”  The truth is, most people can’t afford to be without it if something happened that prevented them from working for over a couple of weeks.  You may have sick days or vacation time that could ensure you receive income for that long, but if you had to be off work due to sickness or non-work related injury (such as an auto accident, or recovery from major surgery), how would you pay your bills?  Even seemingly minor ailments such as broken bones and nagging medical conditions can lead to temporary or permanent disability.  Any type of disability can have a disastrous effect on your earnings, savings and lifestyle.

Disability Insurance is really “Income or Paycheck insurance” — guaranteeing you continue to receive income during the time you can’t work.  The maximum amount you can purchase  is two-thirds of your annual income, but you may choose a lower amount than that.  You can also adjust your cost for this critical coverage by choosing different waiting periods — the amount of time you must wait before collecting benefits.  The longer the waiting period, the lower your monthly premium will be for the dollar amount you choose.

Who needs it?  Anyone who depends on their income to make ends meet.   Other than your medical insurance, Disability Insurance is the most important coverage you should have!

The “Metal” Plans – General Info

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There are four health care plan categories: Bronze, Silver, Gold and Platinum (dubbed “the metal plans).

The different levels are intended to meet various health and financial needs, and are based on the percentage that each plan pays towards health care services. The plan levels also indicate the percentage you will pay towards the health care you receive. Your portion of these costs is in the form of:

  • Deductibles – the amount you owe for covered services before insurance kicks in;
  • Copayments – a fixed amount you pay for a covered health care service; and
  • Coinsurance – your share of the costs of a covered health care service.

This chart shows how much the different plans will pay of your health care costs (coinsurance), not including premiums, co-pays or deductibles:

Plan Level What the Plan Spends What you Spend
Bronze 60% 40%
Silver 70% 30%
Gold 80% 20%
Platinum 90% 10%
The lower the amount of coverage, the lower the premium you must pay to maintain coverage. Bronze level plans have the lowest premiums, but also the lowest level of coverage. As the plan levels increase (from Bronze to Silver to Platinum), your monthly premium increases but so does the level of coverage. For example, you will pay a higher premium for a Platinum plan but you will pay less for each doctor visit, prescription, or health care service that you use.
The amount of subsidy you might receive, if eligible, is based on the Silver Plan.  More to come on the subsidies in a future post!

Hold That Checkbook!

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Health care bills are the one area that it pays to pay slow!  Many of you conscientious quick-payers are paying more than you actually owe the providers (and most are NOT going to refund you the money on their own!)  You should not pay a bill from your provider until you’ve checked it against your Explanation of Benefits (EOB) for that particular claim.  Why, you ask?  Because if your provider is “in-network”, they’ve agreed to accept a lesser amount for their services than what they billed.  And in most cases you are NOT responsible for the difference.  Say a facility charges $3,400 for a PET scan, but they have agreed with your insurance company to accept $2,600 for that service.  After you’ve met your deductible, you are only responsible for 20% (assuming an 80/20 co-insurance) of the $2,600 less deductible, not the $3,400 less deductible.

These days you can usually register with your insurance company online so you can see and print your claims and EOB information.  Follow these steps to save $$ —

  1. When you receive a bill from a health care provider, go online to see if they have submitted a claim with your insurance company and whether or not it has been processed.
  2. When available, print out the EOB (Explanation of Benefits) for that particular claim. Hint: when you have multiple claim submissions, be sure to match the date of service and claim amounts with your bill.  On your EOB look at the Amount Billed, the Amount Allowed, the Amount Paid by Insurance Company, and Amount You May Owe.   You should not pay more than the Amount You May Owe Provider (IF dealing with In-Network providers!).
  3. If you receive a past due notice from your provider before you can see your EOB online, call your provider and let them know your are waiting to check the EOB against their bill.

Confused About Health Insurance?

Is everybody thoroughly confused by the ObamaCare, I mean, Affordable Care Act, I mean, U.S. Health Care Reform Act, yet?!  As an educated and licensed insurance agent, I can tell you that its muddy waters to me!  I shudder to think what the non-insurance industry person must be experiencing!  According to the insurance company rep I spoke with today, Texas doesn’t even have their “Metal Plans” in place yet, which means you can’t sign up for anything.  Lovely.  

  • Must sign up for plan
  • Penalized if you don’t sign up for plan
  • Plans not yet available
  • CAN’T sign up for plan!

That’s our government and tax dollars hard at work for you.

DISCLAIMER:  Walker Insurance Services does not endorse Dr. Beller or any other political candidate.  However, we wholeheartedly believe that “laughter is good medicine”, and this video is just plain funny!