Florida Health Insurance Guide
Florida Health Insurance Short Attention Span Buyer’s Guide
This guide will give you the basics in less than 5 minutes. Call me to fill in the blanks.
Three Terms You Must Know
Here are the three terms you must know to understand health insurance:
Deductible – this is what you pay before the insurance company pays out anything. Most of you have deductibles on your car or home insurance. It’s the same thing. Keep in mind that office visits and prescriptions are usually not part of the deductible.
Coinsurance – this is the 80/20 thing you hear about. Once you meet your deductible, the health insurance company shares some expenses with you. Usually, after the deductible you are responsible for 20% of the next $10,000, which of course is $2,000. So, if the deductible was $2,500 and after the deductible you had to pay 20% of the next $10,000, the total out of pocket would be $4,500. It does not matter if your bill from the hospital was $20,000 or $2 million. Your maximum share is $4,500.
Co-pay – a co-pay is the amount you pay for a visit to the doctor or a prescription. You no not have to meet any deductible first. Let me say it again because nobody ever really listens to me when I say this.
If your co-pay for a doctor visit is $35 and your deductible is $5,000, how much do you have to pay before you can go to the doctor for the $35 co-pay? If you said "nothing", then you are smarter than 90% of the people I talk to. I just said the co-pays do not have anything to do with the deductible. By the way, not all plans have co-pays.
Alright, you now know the basics. If you understand the three terms you are already a pretty savvy shopper. Since, I have a few minutes left of the 5 minutes it takes to read this guide; I want to give you a few more tips.
Buy High and Pay Low
High deductible plans are almost always the smart choice. Stop worrying about what happens if you go into the hospital. A $1,000 deductible is too damn expensive. The odds are that you will not reach any deductible. Besides, the deductible has nothing to do with doctor or prescription co-pays. Just do the math when you compare premiums. Do not spend $1,200 a year to lower your deductible by $1,500. It is not worth it.
Do Not Associate with Association Plans
Some plans are not controlled by Florida. They are association plans and will kill you on rate hikes after a few years. They are not bad companies; they just found a way to circumvent rules that are there to protect you. Ask me about which plans are pure health insurance and which plans are association plans. You would be surprised to find that some big name companies are association based.
This is all going to change with the new healthcare bill. Companies are only allowed a certain amount of profit and cannot discriminate with rates. So this will change in the future.
PPO versus HMO
This is easy. In Florida HMO’s are very unpopular. For the most part, you can only find them in Dade, Broward and Palm Beach counties. Contrary to popular belief, HMO plans are not less money than a PPO. Tell your know-it-all friend that they do not know what they are talking about. For my money, I like the flexibility and protection of a PPO plan.
Pre-existing Conditions
Folks, if you have a pre-existing condition and see the doctor every three months and your prescriptions cost you a few hundred a month, do you really think a health insurance company is going to cover all of it? They might cover some of your prescriptions with a rate up in premium (that means they charge you more).
Yes, I do have some companies that will cover your pre-existing conditions. Coverage depends on the condition and how much your medications cost. This is something you need to talk to me about.
However, don’t be dumb. You still need health insurance for the “big stuff”. Do not get bent out of shape because the plan does not pay for your blood pressure medication. You want the health insurance to pay for the quadruple bypass or the liver transplant.
Shopping For Florida Health Insurance
I am looking to lease a car. I go from dealership to dealership trying to get the best price and avoid the moronic head games the dealers play. Florida health insurance is a lot easier to buy. Each carrier submits their rates to Florida (those plans that are controlled by Florida) and each and every salesperson charges the same rate for the same plan (all other things being equal like age, location, etc.). You cannot bargain or shop around.
Ideally, you want to use an agent who represents many different companies, knows what he or she is talking about and does not want to come to your house to get a check and a signature (keep them out of your house, the same way you should never give the keys to your trade-in at an auto showroom until after the price is set).
Ideally, you will call us for your health insurance needs.
If you would like a personal quote, give me a call. My name is Martin and I am here from 9 AM to about 8 PM. You can reach me at 800-272-0512.
Thanks for taking
the time to read this,
FLQUOTE.COM - A Full Service Insurance
Florida agency
Coral Springs, Florida 33076
1-800-272-0512
1-954-757-0033
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