The Pilgrimage for the Right Health Insurance Policy Cost vs. Coverage

Posted on September 9, 2010.

Author: Frank N Darras

Shopping for the right health insurance policy for you and your family can feel like the longest pilgrimage you've ever attempted. Fortunately, with today's technology the process should be shorter if you approach it systematically.

"First take a look at the carrier," says Frank N. Darras, the nation's leading insurance attorney. "The reliability and financial security of the insurance company should be your top priority."Read about their financial prowess; look them up in Moody's or Bests. Search the net for legal or class actions to see if there are any pending legal actions against them.

Get recommendations from family and friends who have enjoyed success working with their own insurance company? After your research make a short list of companies before proceeding to the next step.

Next, list your health needs (you and your family's) for one year and the costs for those services. If you have any pre-existing health issues, see which of your short-listed carriers provides the best coverage for your individual needs. At the same time, price each carrier to see what your premiums would be given the type of coverage you would require from each in order to meet your needs.

Here are some things you should not forget:

Read each offering very carefully

Make sure you understand everything that is being offered. This will probably be the task that takes the most time. Persevere! Ask a lot of questions if you don't understand something. Make a list for each company on your short-list so it will be easy to compare apples to apples.

Be honest at application time

Make sure you read the questions yourself on the medical application. You can't get a true comparison without being honest about previous health issues. You will have to include them in your policy application, so include them now in order to get the best price comparison. Most carriers can take the policy away and not pay any benefits during the first two years if the policyholder misrepresented his or her health. Eliminate that risk by reading and disclosing everything you can remember at application time

Understand the exclusions

Actually, you should put great focus on the exclusions. There might be ancillary expenses for excluded illnesses or there might be illnesses that aren't covered at all. Or, they might not be covered for a specific period after signing (like for pregnancy or pre-existing conditions). Remember, once you have signed, you have agreed to any and all provisions of the policy.

Don't overlook even the smallest clause

Be cautious of clauses like "expenses that are reasonably incurred." Ask for exact numbers. "Reasonably incurred" may be much less that what the actual charge ends up being. You might get stuck paying the difference. Ask about caps on individual services like in vs. out-patient surgery charges and pharmacy costs. The last thing you need is a health insurance claim denial that forces you to hire a health insurance lawyer to get what you rightfully deserve.

"Be a smart shopper and ask for right insurance help if you need it," cautions Darras.