Find the Best Insurance Value

We all would like to have an employer who offers non-contributory health insurance. Unfortunately, that usually does not happen often.

The search for affordable, adequate health care coverage can be an enormous problem. Without a policy that either pays all or a part of prescription costs you will not have access to reduced rates for necessary medications. This is an important consideration. Currently many conditions are treated with medications that were not available even a few years in the past. Hospital stays and surgeries have been reduced by the use of medications.

Usually when someone considers a change in employment, they are looking at the job description, salary, working conditions, opportunities for advancement, but may not carefully examine the health insurance portion of the employee benefits package. This is a critical part of your benefits and nearly as important as your salary level. Many people forego changes in employment because they have good coverage for a family member with a serious or chronic illness. Your prospective employer includes the cost of the benefits package as part of his total employment cost for the job.

Young singles are at a stage in life where they may change their marital status and may start families. It is critical that any health insurance policy allow for coverage of a spouse and dependents. Likewise, the middle aged worker needs to review a policy to ensure that there is dependent coverage available for his children while they attend post secondary school. Therefore, it is necessary to project what your future situation might be and plan accordingly.

The self-employed are one of the most overlooked groups for insurance in our society. The cost for individual coverage may extremely high, depending on age, pre-existing conditions and dependent requirements. One avenue for the small business owner is to consider joining a local association or some other type of organization that offers a group insurance policy.

Many fraternal organizations, unions and clubs may offer access to group rates and in fact some organizations have been formed mainly for that purpose. Many of these organizations offer access to health care that might otherwise be prohibitive on an individual basis. The small cost for the annual dues may far outweigh the potential savings in premiums with the group plan. Sometimes the health care packages are often one of the most attractive options these organizations or clubs have to attract new members. Research all the local and national organizations that you are qualified to join with regard to obtaining access to their group health insurance.

If you are not in a “low income” category that would qualify you for access to social health care benefits, you can plan on paying high premiums. Pre-existing conditions may preclude access to any coverage. Here are some things that you can do:

Know and understand some of the options available and how widely diversified policies can be; then shop carefully to find a policy adequate for your needs?


Don’t assume anything, always read the fine print so you know what is included and what is excluded.

Do not buy a policy that covers a single disease.

What are the deductibles and if so, how much?

Is major medical included?

Is there a maximum annual or lifetime limit?

Is there a maximum out of pocket expense you will be expected to pay?

When does coverage begin?

Does the coverage include prescriptions?

Are lab fees and x-rays included?

Are you allowed to choose your own doctor or must you select from a list of providers?

Do you mind being assessed by a nurse practitioner or some other health provider before being referred to a physician?

Do you mind the requirement for a referral to a specialist in an HMO plan?

Does the coverage include dental, vision, maternity, well-baby care, preventative screening and etc?

Is your coverage limited to a specific geographic area?

Does the policy require prior approval for ambulance, medical or surgical procedures and if so how much notice required for approval?

Does the policy limit coverage for a particular surgical procedure to the going rate in the area or some other amount? This is important because you may need to comparison shop for doctors willing to accept the amount the insurer is willing to pay for the procedure?

If you do not yet qualify for Medicare, Medicaid or other social programs and are too old for individual coverage in that “no mans land”, take a look at AARP. It can provide stop gap coverage while you are waiting to qualify for assistance.

Single or low income parents should investigate any subsidized program that might be available in their states. Many states have programs that will provide care for your children if not for yourself, but unfortunately they often do not publicize these programs.

These social programs are generally based on a sliding scale based on your income level and in many cases visits and prescriptions for your children might be free of charge.

Never feel embarrassed about shopping for health insurance assistance. Your family’s health requirements are more important that any feelings you might have about contacting various agencies for help. There are many federal and state programs and research is the key to finding help when it is needed.

For instance, dental schools often provide free dental care as practice for their students. This dental care is carefully supervised so is generally safe.

Often associations for various diseases may be a source of information regarding availability of benefits.

Additionally, don't forget that many doctors will not charge fees or will substantially lower their fees if you can convince them that your need is great and medical attention is urgent or vital.  If your need is great, don't put pride ahead of your family's health.

It’s important for society to ensure that the needs of the most vulnerable members health needs are met, namely our children and our elderly.

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