Health Insurance: Plans for Secured Healthcare

Submitted by Anonymous (not verified) on Tue, 12/01/2009 - 08:17
Our health is precious and we do all sorts of things to keep ourselves healthy. We know how it feels to fall sick and if it is something serious, how expensive treatment can get. So that we are able to afford the right treatment and not worry about the costs getting health insurance is a good idea.

The rising cost of treatment is a matter of worry for a lot of us. If we have health insurance, it helps us plan ahead and also save for future treatment costs. We do not have to worry about bearing the expenses out of our pockets. Your need for insurance may be different from the needs of others. Hence, there are different health insurance plans to suit different needs.

Health Insurance Plans

Health insurance plans are primarily of 2 types -
  1. Indemnity Plans (fee-for-service)
    According to this plan, the insurance holder can choose the doctor he wants to be examined by. The doctor/medical professional receives a fee-for-service. This claim is made either by the doctor or the patient himself. Indemnity health insurance has several other types.
    • Indemnity health plans: As a policy holder you may go to any doctor, hospital or any other medical provider for a fixed monthly premium. You may choose the health care provider you want and the plan will reimburse you or your doctor for the service rendered. There may be a certain portion of deductible that you need to pay or simply bear a portion of the fee. Certain expensive services or hospital care or any covered services may require you to have prior authorization for them in order to be covered. To know if indemnity plans are better than HMOs or PPOs click here.

    • Flexible spending plans: This is also known as cafeteria plan and is sponsored by the employer allowing the employees to design their own package. There are several benefits for this plan like pre-tax conversion plan, multiple option pre-tax conversion plan, flexible spending accounts, medical plan and employer credit cafeteria plans.

    • Basic health plan: This is a low cost health insurance plan that provides limited benefits. These plans do not cover certain basic treatments and it is advisable that you should go through the policy document before purchasing. Premiums for such affordable health insurance plans are community rated and are based on gender, age, occupation, geographic location or health status.

    • Health Savings Accounts (HSA): This plan is designed to help you pay for your present health treatment costs and also save for future costs on a tax-free basis. You do not have to pay a premium here. Instead this tax-free account covers your out-of-pocket medical expenditure. What types of investment you should make, which third party or insurer you should rely on is completely your own decision. Generally, HSA requires you to buy a High Deductible Health Plan too.

    • High deductible health plan (HDHP): This inexpensive health plan is active only after a high deductible of a minimum $1000 is paid for an individual or $2000 is paid for a family.

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  3. Managed Care Plan
    Managed care helps minimize unnecessary costs for healthcare. The policy holders receive extensive medical coverage while also giving financial incentives to the policy holders who opt for the medical providers listed in the policy. There are several types of managed care:
    • Health Maintenance Organization (HMO): There is an already existing network of participating physicians, hospitals as well as other health care professionals and facilities that you can choose from. The doctor you choose from the given list will then provide you with the required health treatment. If you need to go to a specialist your primary care doctor will refer. Generally there is a fee or a co-payment that you need to pay in HMP plan. Your out-of-pocket are fewer here.

    • Point-of-service (POS): In this plan the primary care doctors usually have the freedom to refer other medical providers listed in the plan. If the referral is not from amongst the listed doctors, it will still be covered but then you need to pay a certain co-insurance. If the doctor is listed in the plan, then the plan provides coverage for the same.

    • Preferred Provider Organization (PPO) : In this plan the listed doctors, hospitals and health care providers are paid by the insuring company. Often these payments are discounted and hence the costs will be lower if you choose a doctor from the network of doctors provided by the insurer. However, you may still go for a doctor outside the network but you will have to pay the difference between the medical provider's fees and what the plan pays.
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    Other health insurance options

    Two of your other health insurance options may include:
    1. Self-insured health plans
      A self-insured health plan or self-funded plan is one where the employer assumes responsibility (with pre-conditions) to provide health care benefits for its employees. This plan is designed such that the employers pay for the out-of-pocket claim as and when they occur instead of depositing a fixed premium to an insurance providing company. Such a self insured plan is subject to all Federal laws and Budget Reconciliation Act.

    2. Medicare
      Medicare is a federal government program designed to insure senior citizens. You can avail the benefits provided by Medicare to secure your future.
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    How insurance companies determine your coverage & rates?

    When you apply for a health insurance, your application has to undergo the insurance underwriting process. The underwriters evaluate how much of a risk you pose for the insurance company and accordingly approve or reject your application. Your rates and coverage limits are also determined if the application is approved.

    The following factors influence the health insurance rates of an individual:

    1. Age and gender of the person to be insured.
    2. Pre-existing conditions after a thorough check-up of the individual's medical history.
    3. Medical history of the family (whether or not the parents had heart disease, cancer etc.)
    4. Smoking habits of the individual.
    5. Previous records of mental health (whether the person had undergone counseling or used anti-depressants).
    6. Occupation.
    7. Choice of deductible, coverage and benefit limits, exclusions etc.
    8. Past records of health insurance applications.
    To know how the above mentioned factors have an effect on your health insurance costs, click here.
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    Tips to buy affordable health insurance

    The premiums for medical insurance seem to be increasing every year. This leaves us with the question that how we can find affordable health insurance coverage that suits our pocket. It may seem very difficult but with a little research you can still look for a suitable health insurance plan. You may follow the 6 easy tips to choose a health policy which not only suits your needs, but also matches your pocket.
    1. Know your state rules: Be familiar with the rules that your state follows. This way you can make rational and mature decisions about your health insurance. Pay special attention to rules about pre-existing conditions (if any) and also about what coverage you will get.
    2. Find out your insurance needs: Knowing what type of health insurance coverage you need is important. You may need short term health insurance policy or a regular one depending on the status of your job and your family planning. Getting a cheap health insurance policy may not be the solution to all your problems. You will have to keep in mind the requirement that you have.
    3. Calculate the overall costs: Prepare a budget for yourself. Buying health insurance doesn't just mean paying premiums. There are co-payments, deductibles and also sometimes co-insurance. Keep all of these in mind when planning for your insurance.
    4. Compare your options: To be able to find an affordable health insurance you must have an idea of all what is available in the market. After you have shopped enough get hold of a broker who can help you in comparing the policies. A comparison between few different companies and their products will help you settle better with a policy.
    5. Do your insurance homework: You need to be acquainted with the jargons of the industry if you must find yourself a policy that suits you best. Do your homework; get your research done properly to be able to buy a suitable policy.
    6. Never conceal information: While doing the paper works you may have to answer a lot of questions. Don't be tempted to lie or hide facts. This will only create problems in the future for you, and raise your costs for health insurance.
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    Individual Health Insurance vs. Employer Sponsored Insurance

    Most of you may have employer sponsored health insurance. But the number of people opting for individual health insurance is also increasing. This increase is due to the advantage that individual policies have over employer sponsored programs. They are:
    • Tailor-made coverage: Everyone has different health needs and individual health insurance recognizes it and provides policies to suit individual needs. Since the employer sponsored program is 'one-size-fits-all type, you may end up paying for coverage you don't need or not get a particular coverage that you may need.

    • Mobility of coverage: Unlike the employer sponsored insurance, you can still carry individual health insurance with you even if you are changing jobs.
    For more information click here.

    You must plan ahead to secure your future. With health insurance you can certainly prepare to face an undesirable situation arising from a medical condition.

    Related Readings:

    Useful letter

    Like temporary life insurance do we have any temporary health insurance options too?

    Posted: 02 Dec 2009 10:24 Post Subject:

    Most health insurance policies are annual. you could look at a shorter term policy but you'd have to negotiate this with your insurer.

    Travel insurance provides short term medical insurance cover, but i don't think the cover incepts until you leave the country. how long did you want cover for, and why only a short time?

    Posted: 03 Dec 2009 06:12 Post Subject:

    It could be different in other states, but here in California, many insurers offer special policies to cover short term health insurance needs to bridge a potential gap between two employments or similar situations.

    Posted: 03 Dec 2009 10:03 Post Subject:

    Yes, I'm about to quit my current job. I'm a sales professional and I'd opted for a group health insurance plan.

    Posted: 04 Dec 2009 02:47 Post Subject:

    DeliaCC . . .

    If you are currently covered by a group plan, then you will have the right to continue the group plan at the group rate for up to 18 months under the provisions of COBRA. You'll have at least 60 days from termination to choose to continue. Currently, your employer must pay 65% of the premium, and you pay the balance. Your employer will get a payroll tax credit for the amount it pays for your COBRA continuation, so it's only an out of pocket expense for the employer for up to 3 months at a time.

    Depending on the state in which you reside, you should have the option to elect individual coverage with the same insurer as the group plan with no proof of insurability. The benefits will be different (lesser, usually) and the cost will be different (probably less, too).

    Alternatively, if you apply for new medical insurance under HIPAA within 63 days of the last day your group medical insurance was effective, you can obtain a Guaranteed Issue policy with any other HMO/PPO or other indemnity medical insurance plan. It's important that you not goof and pass the 63 day limit, otherwise you will lose your entitlement under HIPAA. Most insurers have special GI plans with lesser benefits than some of their other plans.

    And many carriers have "bridge" plans to help you with any temporary insurance needs while you're in between employers, if that's the case.


    Your present group insurer/employer is required by law to provide you with a HIPAA Certification of Group Coverage following your termination of employment. If you don't get it on your last day of employment, don't let more than a week go by without receiving it. You'll need it to obtain the GI coverage from another insurer.

    Posted: 05 Dec 2009 06:12 Post Subject:

    Good info!

    Your present group insurer/employer is required by law to provide you with a HIPAA Certification of Group Coverage following your termination of employment.


    In that case I think it's better to approach the employer. But who's gonna issue the Hipaa certificate? Is it the state dept. of insurance?

    Posted: 05 Dec 2009 09:10 Post Subject:

    Your employer is required by (federal) law to provide you with the HIPAA certification. The health insurer normally agrees to do that for the employer.

    The certificate will show your date of hire, date of eligibility for coverage, and date coverage began, and length of any preexisting condition exclusion/probationary period in the coverage.

    The latter two are most important because they serve to show how many months of continuous coverage you have had. If you have prior coverage for a period longer than the "preexisting condition exclusion/probationary period" of the new coverage (the period of time that preexisting conditions/new illnesses would not be covered -- commonly 6 months), then you must be fully covered from Day 1 -- no exclusions. If you don't have as many months as necessary, you must be credited with a month-for-month reduction in the exclusion period (Example: old group policy covered you for 5 months, new policy has a 12 month exclusion -- you would be credited with 5 of the 12 months, and only need to wait 7 more before full coverage applied to you).

    Again, don't let more than a week go by without getting that certificate after you terminate. If you've give them 2 weeks' notice of your term date, that's plenty of time for them to prepare/get the certificate for you.

    For more information on COBRA and HIPAA, go to www.dol.gov (US Dept. of Labor). You will find all their current resources and publications on COBRA, HIPAA, and ERISA there.

    Posted: 07 Dec 2009 05:31 Post Subject:

    My friend, in case you have a pre-existing condition your coverage application may be denied of short-term health insurance. Otherwise, this coverage is pretty much like policies that cover surgeries, x-rays and other emergency services. The deductible is expected to be low and you could be free to choose your hospital and doctor.

    Posted: 07 Dec 2009 07:53 Post Subject:

    Guaranteed issue (GI) policies under a HIPAA certificate of creditable coverage will not have preexisting condition exclusions unless something is excluded in general by the policy itself (such as maternity coverage, elective cosmetic surgery, etc.), as long as your former group coverage has been in place at least as long as the GI policy's probationary period (typically only 6 months).

    New applications for insurance not guaranteed by HIPAA are always subject to medical underwriting, and may contain preexisting condition exclusions, or applications may be declined on the basis of health status.

    That's why it's important to be sure to get the Certificate, and leverage your rights under HIPAA.

    Posted: 08 Dec 2009 12:01 Post Subject:

    One good thing about short-term coverage is that it is usually quick-issue (if approved).


    Post edited and link deactivated as per forum rules, thanks. Ohio Short Term Health Insurance plans are only 5-8 questions and are issued within 24 hours (if approved, of course). I assume most states are similar.

    Posted: 08 Dec 2009 05:49 Post Subject:

    It's very important that we don't overlook the disadvantages of carrying a temporary health policy. In order to avail certain medical services you may need prior certification. You must clarify that the deductible that you're needed to pay should occur only once ( and not for each occurrence of accident and illness).

    Some times the use of an illness coverage may be referred to as a "pre-existing condition" when its applicable for a separate temporary policy. This might cause further loss of insurance.

    Posted: 09 Dec 2009 05:28 Post Subject:

    Please don't forget to opt for more coverage with your temporary insurance. Also check if your coverage offers protection for catastrophic health problems.

    Posted: 10 Dec 2009 06:58 Post Subject:

    I think the best way to deal with this is to continue with the same policy through COBRA. Short term insurance would be a good option for you if you don't find other coverage options once the COBRA period comes to an end.

    Posted: 11 Dec 2009 01:48 Post Subject: insurance

    I've been looking into COBRA, myself. Can ya'll please give me your positive/negative experiences with them?

    Posted: 11 Dec 2009 06:38 Post Subject:

    BIG (but common) MISCONCEPTION HERE! There is no such thing as "COBRA Insurance." COBRA is an acronym for . . . get ready . . . Consolidated Omnibus Budget Reconciliation Act of 1986. In passing that Act, Congress declared that employers with 20 or more full time employees (or equivalent) who also provide their employees with health insurance must continue to provide the insurance at the group rate to an employee or their spouse or dependents (all are "qualified beneficiaries") when one of six "qualifying events" occurs (termination of employment, reduction in hours [disqualifying from insurance eligibility], death of the employee, separation/divorce of employee and spouse, dependent child who loses dependency through age (19 or 23 is still a student) or marriage (becomes someone else's problem :P ). In declaring this, Congress also said that the employee can be required to pay 100% of the cost of the insurance (plus up to 2% for admin expenses). And COBRA sets the period of time that coverage may be continued (18 months for the first two contingencies, 36 months for the remaining 4).

    Up until this current economic crunch, Congress never provided any funding mechanism to assist the employees/dependents to pay the cost of insurance, which for some families has gone from $0/month to $1,000/month out of pocket. Temporarily, however, employers are required to fund 65% of the employee's/spouse's/dependent's cost (and then receive an equal employment tax credit on each quarterly tax return). The way the Obama Admin & Congress are printing and spending phantom money, it could be extended well into or beyond 2010.

    So what "COBRA" is is NOT an insurance company but a right to continuation of the same group insurance at the current group rate. But it's very common to hear people say something like, "I got laid off and I had to get that COBRA insurance, but it's really expensive, and I couldn't afford it."

    So you don't buy COBRA, you don't get COBRA, you continue courtesy of COBRA. If you can afford to.

    When continuation under COBRA expires at the end of 18 or 36 months (29 months for certain disabled beneficiaries), HIPAA provides for the employee's eligibility to obtain a Guaranteed Issue individual/family health policy from any insurer of their choosing, as long as they apply within 63 days of the expiration of COBRA continuation.

    Posted: 11 Dec 2009 07:12 Post Subject:

    Great info everybody! Just wished to add that these short term policies would cover for 30-365 days in general.

    They're hard on you if you have pre-exisiting conditions and even when you have one, please go through the conditions and exclusions carefully.

    Posted: 12 Dec 2009 01:39 Post Subject: health insurance choices for diabetic

    I'm single diabetic 47 yr old female not kids, in OC California, want to retire, but the health care choices are atroious.

    My CA company Cobra payments are $660/month. will last 36 months due to Cal - Cobra. After that HIPPA premiums are not much lower.

    I'm engaged to be married, and he (55) is self employed has health insurance that costs ~ $700/month.

    Is there any hope for me to get reasonable health insurance? or should I just wait until I am 55 and take advantage of my company's retiree health insurance plan, of $375/month

    Posted: 12 Dec 2009 06:16 Post Subject:

    If you're currently insured under the Cal-COBRA continuation privilege, at the time it ends, you'll be eligible for a Guaranteed Issue policy from any insurer still doing business in California, despite your otherwise unfavorable diabetic condition. You don't mention how many more months you have left on your continuation privilege.

    When you mention "health insurance" and premiums of $660 or $700, you don't indicate whether the coverage is for HMO or PPO, what the deductible is (if any), what the office copay is, or what the maximum out-of-pocket expense is, just to name a few. I can show you and your fiance OC rates for PPO coverage from Blue Shield/CA as low as $236 per month or as high as $705 for a person his age -- but that's unfair without knowing what he already has and being able to make an apples-to-apples quote for comparison.

    Also, if you were able to go to work for his business, the two of you would probably qualify for a Guaranteed Issue small group coverage (minimum of 2, maximum of 50).

    8 years is a long time to have to wait for a retiree benefit plan (and you can bet it won't be just $375/mo at that time). There is good coverage at reasonable cost to choose among from Blue Shield, PacifiCare, HealthNet, CIGNA, and Aetna (the companies I currently represent). HMOs, PPOs, and HSA-compatible High Deductible Health Plans. It's not as awful as you may believe.

    Your diabetic condition (and any other health challenges) is the primary obstacle. But if your height and weight are within normal range, you're not on an insulin pump, and you don't have high blood pressure, you would not be likely to be turned down, although you could expect to be rated "substandard" and pay a higher than standard premium.

    I'm in Pomona, very close to OC. Send me a private message and I will be happy to give you more information. You don't want to broadcast your health information on a bulletin board.

    Posted: 22 Jan 2010 03:49 Post Subject: pre existing conditions

    cal me today 860 447 9040 any health insurance companies in conn that deal with pre existing bulging disks and space narrowing canal jan falk 860 447 9040

    Posted: 24 Jan 2010 11:45 Post Subject: CANCELLATION OF POLICY

    I WILL BE GOING ON MEDICARE APRIL 1, 2010, HOW DO I GO ABOUT CANCELLING MY POLICY WITH CINGERY AND GET THE BANK DEDUCTION STOPPED

    Posted: 27 Jan 2010 09:20 Post Subject: picked wrong coverage

    We picked wrong health insurance coverage, we can't afford what we picked (by mistake) can it be changed?

    Posted: 28 Jan 2010 08:26 Post Subject: hi

    thanks for all the interesting inputs


    link deleted per terms of use

    Posted: 30 Jan 2010 10:37 Post Subject:

    Just buy a regular health plan and cancel it when you are finished.

    Posted: 03 Feb 2010 10:44 Post Subject: Cancellation of policy

    You can terminate the present policy and look for another affordable one. Generally there is no provision against cancellation of a policy except in case of a Medicare where you need to apply to the Health care Financing Administration (HCFA) if you choose to get private insurance.

    Posted: 22 Mar 2010 07:54 Post Subject: Call Center and Telemarketing Services

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    Posted: 10 Apr 2010 04:33 Post Subject: JOB SEARCH

    I AM CURRENTLY WORKING IN DAMAN HEALTH INSURANCE IN UAE AND WANT TO JOIN SIACO AT SAUDIA ARABIA , COULD YOU SEND ME THE VALID EMAIL OF HUMAN RESOURCE DEPARTMENT

    Posted: 15 Apr 2010 07:02 Post Subject:

    I wonder what will happen to COBRA in 4 years when health reform does change. By the time this bill passes come to think of it, our entire health care system is most likely going to be only affordable to the most elite in this country. We are beginning to resemble a failed third world nation!

    Health Insurance Quote | Florida Public Adjuster

    Posted: 16 Apr 2010 11:04 Post Subject: helth insurance

    How many health insurance policies should you have? Should you have mediclaim policies at all if you do not have any medical problems?
    Which are the best health insurance policies available for you today in India How can one claim money after hospitalisation if you do not have a cashless mediclaim facility?

    Posted: 26 Apr 2010 02:37 Post Subject: How to Healty Eating Recipes

    how to healty eating recipes? Which recipe goog

    Posted: 14 Jun 2010 07:16 Post Subject: Health Insurance

    Does anybody know of any companies who offer health insurance to people over the age of 80? I am looking for cover for my parents. hey do not qualify for medicare/medicaid.

    Thank you

    Posted: 11 Jul 2010 04:39 Post Subject:

    Hi angelab

    HCC Medical Insurance Services & Seven Corners do offer health insurance for quotes for 80+ year old person but it only limited to 10-15 K.

    So take a online quote from these companies (either of them) and then take wise decision.

    DIMG786

    Posted: 12 Jul 2010 06:32 Post Subject:

    I am looking for cover for my parents. hey do not qualify for medicare/medicaid.



    Unless your parents are illegal aliens, your statement is not correct. All persons who are US Citizens or legal resident aliens age 65 and older are "qualified" for Medicare. If they do not have the required 40 credits for "fully insured" status, which currently makes Medicare Part A premium-free, then they pay a premium for Medicare Part A in addition to the premiums everyone must pay for Medicare Part B. For those not "fully insured", the Part A premium in 2010 can be as much as $430 per month (per person).

    Medicaid is a different program for "medically-indigent" persons, regardless of age. There are specific income/asset requirements that must be met to qualify for benefits (benefits vary from state to state). Many Medicare beneficiaries are also receiving benefits under Medicaid to cover expenses excluded under Medicare, such as routine physician visits, hearing aids, eyeglasses. Persons age 55 and older who receive benefits under Medicaid subject their estate to "asset recovery" after death, for up to 100% of benefits provided.

    Posted: 23 Jul 2010 01:57 Post Subject: Dropped Health Insurance by Employer

    Can an agent drop a whole company and not give thirty days notice of its intention?

    Posted: 24 Jul 2010 06:56 Post Subject:

    Since slavery was eliminated in the US in the 1860s, no agent has ever been forced to remain with any insurance company against his or her free will. They are not required to give any prior notice to companies or clients that they are not going to represent any particular insurance company after a certain date.

    Beyond that, I'm not certain I answered your question.

    Posted: 03 Aug 2010 03:58 Post Subject: New laws

    I have a sneaky feeling that there will be a revolt once people see how the new health ins. laws work!

    Posted: 18 Aug 2010 07:25 Post Subject: NEED HEALTH COVERAGE

    WILL SOMEONE FROM YOUR COMPANY PLEASE CONTACT ME TO TALK ABOUT COVERAGE FOR MY FAMILY MEMBER?

    Posted: 15 Sep 2010 02:44 Post Subject: Cancellation

    I have been added to my wife's health insurance through her employer effective as of the first of September, and I just found out that I can get insurance through my employer with the same provider, but cheaper. (TX) Can we cancel my insurance through her employer, so I can get my own through my employer????

    Posted: 16 Sep 2010 04:23 Post Subject:

    You can, but you had better make sure that your coverage through your employer is in place before you terminate your coverage through your wife's plan. Otherwise, you might just find yourself without any coverage at all, in which case your moniker, Krazy, would be most appropriate.

    Check with your employer's HR dept or benefits coordinator about how to do this right the first time. Whatever you end up doing with coverage through your wife's employer must happen second.

    Posted: 27 Sep 2010 08:19 Post Subject: Expatriates Health Insurance - pls advise

    Hi there, I've asked this before but no one bothered answering. Hope you will notice me here. I'm an expat, planning on spending most of my life in HongKong.
    I want to get health insurance that isn't too expensive but will still cover me if I go traveling or whatever.
    Right now, I've been recommended to go for global health Asia...do these packages look reasonable to you?


    I'm looking to work on a temporary basis so I don't think I can get it through my employer.
    So if anyone knows a good expat health insurance company that is somewhat comprehensive,
    please send the information my way. I only have to cover myself and I have my own business.

    Thanks :)

    Posted: 27 Sep 2010 04:39 Post Subject:

    Global Health Asia appears to be legitimate, and claims financial backing from Chartis and Liberty International (a subsidiary of Libery Mutual).

    You'll have to inquire about their plans and costs and coverages, to be able to determine if your needs will be met. But it does not appear to be a scam of any type.

    Posted: 12 Nov 2010 04:51 Post Subject: two HDHPs and COB

    I need more information on how having two HDHPs that coordinate benefits works. My family would be covered under both plan A and plan B. Here is a scenario:

    Plan A – has a $5k deductible.
    Plan B – has a $3k deductible.

    (This is how I think it would work, please correct me if I am wrong):
    My husband has services and Plan A denies for deductible.
    The balance is billed to Plan B.
    Plan B also denies for deductible.
    The balance is billed to us.

    Questions:
    1. Once we meet the $3k deductible for plan B, will plan B start to make paymentst?
    2. Or do we have to meet plan A’s deductible BEFORE plan B can even be billed? In which case we have to meet BOTH plan deductibles ($8k) before EITHER insurance kicks in?

    Posted: 12 Nov 2010 11:09 Post Subject:

    What exactly is the purpose of having two HDHPs? Most of them cover expenses 100% after the deductible has been satisfied. If one HDHP provides better coverage than the other, drop the one that offers less coverage.

    Having two HDHPs would generally require satisfying two deductibles. That's why you don't need two.

    Posted: 15 Nov 2010 05:26 Post Subject:

    My employer requires that if my husbands job even offers insurance, he cannot be primary on my insurance. His insurance is through a carrier that is out of network for our family's current physicians so our out-of-pocket would be doubled. Also, I was advised that HDPD's do NOT coordinate with a PPO insurance. So I was thinking our only option to having less OOP would be to have 2 HDHP's, since:
    1) a HDHP will not coordinate with a PPO plan
    2) MY employer will require my husband take HIS employer's insurance as primary (therefore doubling our OOP expenses)

    Are you confirming that I would have to satisfy $8k in deductibles as I outlined in my scenario?

    Do you know about whether or not the information I received regarding the COB between a HDHP and a PPO plan is accurate?

    Posted: 16 Nov 2010 09:48 Post Subject:

    His insurance is through a carrier that is out of network for our family's current physicians



    You have it backwards. The physician is not in the insurer's network. Have you asked the physician why he doesn't join the other network?

    To avoid the higher out of pocket expense, your husband needs to find a physician in his employer's plan's network. Learn to use the insurance appropriately.

    HDHPs do not coordinate with anything. You pay the deductible amount and they cover the balance for the year. What is so hard about that? Generally, you have to use network physicians to avoid a higher deductible. What's so hard about that?

    You don't seem to be very cooperative when it comes to using your health insurance.

    Posted: 16 Nov 2010 02:43 Post Subject:

    My questions were in regards to whether or not the HDHP coordinated with anything and if so, how it worked. We are not being uncooperative, we have just established relationships with our physicians and do not want to change them if we don't have to. Thank you for taking the time to answer my questions. I'm sorry you found the need to be a jerk about it though.

    Posted: 17 Nov 2010 03:55 Post Subject:

    Sorry if you took my comments in the wrong manner. I understand that you may have established relationships with physicians that you would prefer to maintain, but may not be able to do so. People all across America who have employer-sponsored health insurance face this dilemma all the time when the plan changes from one year to the next. It does not make husbands and, especially, wives happy to have to look for a new physician every year.

    You started out by stating that your insurance won't allow your husband to use your employer-sponsored plan as his primary insurance, which is accurate if he's covered by an employer-sponsored plan of his own. It seemed as if you thought you had the right to choose which plan is primary for him. But you don't.

    On the other hand, a person cannot be forced to join their employer's health plan, unless it is a "non-contributory" plan (the employer pays the employee's full cost of the plan). I doubt that your state's insurance law requires a person to enroll in their employer's-sponsored plan if there is a fee, and if their spouse's employer-sponsored plan is less costly or offer better benefits, they have the freedom to only be covered by their spouse's plan. Obamacare, however, may change that in the future.

    As explained, an HDHP is intended to be the only health plan that covers a person as an individual, or a person and their dependents. There is no point to having more than one HDHP covering the same persons. Doesn't mean you can't have an HDHP for yourself, and your husband has an HDHP for himself, and neither plan covers the other. The limitations on contributions to the required HSA do not change when there are two separate individual HDHPs involved, and you could end up not being able to contribute the entire individual amounts to two HSAs.

    Posted: 09 Dec 2010 03:33 Post Subject:

    hi Sil Anderson.

    actually i have a second thought on getting an insurance for my dad. seems like it's not working any more because our system on health care has been change. i need some advice.....if i will continue or not...

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