Consumers Beware: Individual Health Plans Are Confusing.Avalon Avalon (ăv`əlŏn), in Celtic mythology, the blissful otherworld of the dead. In medieval romance it was the island to which the mortally wounded King Arthur was taken, and from which it was expected he would someday return. Healthcare CEO (1) (Chief Executive Officer) The highest individual in command of an organization. Typically the president of the company, the CEO reports to the Chairman of the Board. Provides Tips on Buying Individual Plans in Today's Health Insurance Market TAMPA, Fla. -- Consumers who purchase individual health insurance plans solely on the initial price they are quoted by a broker or via the internet could be hurting themselves financially and be missing out on important benefits they probably want, states Charles O'Neill Charles O'Neill (March 21, 1821 – November 25, 1893) was a Republican member of the U.S. House of Representatives from Pennsylvania during the American Civil War and Reconstruction. O'Neill was born in Philadelphia. , CEO of Avalon Healthcare. More than nine percent of all people insured buy individual plans and the numbers in Florida Florida, state, United States Florida (flôr`ĭdə, flŏr`–), state in the extreme SE United States. A long, low peninsula between the Atlantic Ocean (E) and the Gulf of Mexico (W), Florida is bordered by Georgia and are increasing, O'Neill said. Avalon is Florida's newest statewide health plan selling individual and group consumer directed health insurance plans. "Buying health insurance is confusing con·fuse v. con·fused, con·fus·ing, con·fus·es v.tr. 1. a. To cause to be unable to think with clarity or act with intelligence or understanding; throw off. b. and while products may look alike, most are not," O'Neill said. "As more Floridians purchase consumer directed health plans for themselves and their families, they need to become better educated about the products they are buying. Remember consumers are now more responsible for the financial and physical well-being of themselves and their families so as painful as it may be to learn about, its an essential exercise." O'Neill offers these tips for consumers seeking to buy individual health insurance plans. * Don't just look at price. The price may be low but so are the benefits. There are many health plans available that look good at first glance but once the consumer reviews the entire benefit design they can see the "holes" in the plan. For instance, a plan may have a low deductible That which may be taken away or subtracted. In taxation, an item that may be subtracted from gross income or adjusted gross income in determining taxable income (e.g., interest expenses, charitable contributions, certain taxes). of $1,500 but might have a maximum out of pocket cost of $10,000. That means that even though the upfront dollars are low to get some benefits, the outlaying of up to the $10,000 out of pocket maximum is required before the health plan pays 100% of the benefits moving forward. Does the consumer have the money to pay the deductible? * Select the benefit design you want first. Look for the deductible and co-insurance co-insurance Managed care A cost-sharing requirement in many health insurance policies or health plans, in which the insured and insurer share payment of an approved charge/fee for covered services in a specified ratio, after an annual deductible is paid, up to a options that best fit your medical needs and budget, then seek out quality plans to price. * Watch out for hidden costs. Some plans have added bill fees and other "association" expenses that can drive premium up more than 25% from what is originally quoted. Add up all the costs before considering the price. * Be careful of plans that cut corners - while it may not be the most exciting read in the world, it is highly beneficial to compare ALL benefits between plans. Many individual plans like to cut some benefits or place limits on the number of times a consumer can see a physician. * Buy from a plan approved by the State - ensure that the plan you buy from is regulated directly by the state in which you live. Plans called "association plans" can sell in many states but are not subject to the tighter regulations often set by the department of insurance, therefore consumer protections against benefit changes, price increases and other issues are not in place. * Get a good idea what the final price will be - underwriting Underwriting 1. The process by which investment bankers raise investment capital from investors on behalf of corporations and governments that are issuing securities (both equity and debt). 2. The process of issuing insurance policies. departments should be able to get a good idea as to what the final premium will be if a consumer fills out a "prescreen pre·screen tr.v. pre·screened, pre·screen·ing, pre·screens 1. To view (a movie) before release for public showing. 2. " form and submits it to the insurer An individual or company who, through a contractual agreement, undertakes to compensate specified losses, liability, or damages incurred by another individual. An insurer is frequently an insurance company and is also known as an underwriter. . This form will let the consumer know within 15% what the final premium will be, if the consumer has provided all the medical detail required. Be careful of plans that "jack up" prices after you expect a certain premium price. * Ensure that the rate is guaranteed for 12 months - some plans change rates on a person's birthday or every six months as standard practice. O'Neill also says that most insurance brokers are the best advocates for consumers when shopping health insurance but consumers still need to be well educated. "I don't think any consumer would buy a car or a house without doing their homework and the same should be with health insurance," O'Neill noted. "Insurance is now one of the top three or four expenses a consumer pays out each month. Make sure you know what you are buying." Florida based Avalon Healthcare is an innovative health insurance company offering consumer directed health plans to employers and individuals who need affordable healthcare and live and work in Florida. The Company offers a variety of plan benefits including co-pay Co-pay A type of insurance policy where the insured pays a specified amount of out-of-pocket expenses for health-care services such as doctor visits and prescriptions drugs at the time the service is rendered, with the insurer paying the remaining costs. plans and HSA HSA Health Savings Account (US) HSA Human Serum Albumin HSA Human Services Agency (Nevada) HSA Health Services Agency HSA Health and Safety Authority (Ireland) compatible plans. Based in Tampa, the Company is quickly becoming one of the most well-respected, quality health plans available statewide. |
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