How to be a Smart Shopper:

Be Prepared!  Before you embark on your ‘shopping adventure’, we’ve listed 6 key points you should keep in mind so you can be a Smart Shopper.  Our key points pertain to individuals and business owners (owners pay key attention to point #5!).  If you want some very detailed information, go to the bottom of this page. 


#1 – Health insurance rates FOR ALL CARRIERS will continue to go up - even under the ACA!  The quotes you see today are a ‘snap shot’ which could change next month.  You could buy plan B today because it is cheaper than your plan A.  Six months from now your new plan B has a rate increase and now A is cheaper. The carriers call this 'chasing rates' and it results in turnover that costs everyone, including you the insured, in the long run. There is a ‘reward’ that you should figure into your cost for staying with a carrier and that is smoother claims. The longer you are with one carrier, the more health history they have and therefore the less need to research claims when they occur.

 

#2 – The quotes you will get are almost always the “Best” rates available.  These carriers are fighting to be the lowest so you’ll apply with them.  This is especially true with life insurance quotes.  Depending on your health history, height and weight and other facts you’ll list on your application, you may not get the “Best” rate.  If you are an individual, you could get declined (NOT for health insurance though as the ACA finally helped get rid of that situation).  The carrier can also load the premium 20%, 25%, 50%, 75%, even 100% are examples.  Also, one carrier may load your premium 50% because you take a certain drug where another carrier would decline you and a third carrier would only load 20%.

 

#3 – Provider Networks. Ensure your doctor and more importantly, your local hospital is contracted with the carrier you are considering.  A plan may be real cheap because the nearest hospital is 100 miles away.  It also pays to call your specific doctor and verify they are in the network.  If you do this, we highly advise asking their opinion if you are considering two different carriers.  You may find the carrier you are favoring is notoriously late in paying claims – which may lead to your doctor dropping the plan 3 months after you sign up. BE DILIGENT when asking your doctors if they take your SPECIFIC Plan. Many carriers now have different networks for different types of plans.  Example:  One carrier might have 1 to 3 networks for their group plans, another totally different network for their individual plans, and then another different network for their individual plans purchased through an exchange, like Covered CA.  

 

#4 – Know your maximum exposure!  The annual Out of Pocket (OOP) limit is the most crucial part of your policy.  What are you liable for when the ‘BIG BILL” hits.  EXAMPLE: Two carriers have ‘identical’ $1000 Deductible plans but plan 1 is $100 less than plan 2.  The ‘catch’ is, if you have a $100,000 bill with plan 1 you are responsible for $20,000 versus $7500 with plan 2!  Know your individual AND your family maximum exposure.

 

#5 – Do the math and pay your own small bills with your premium savings!  AFFORDABLE Deductibles are large and here to stay.  Don’t be ‘afraid’ of them.  EXAMPLE: You can pay $400/month for a plan with a $1500 deductible or $250/month for a plan with a $2500 deductible.  Save the $150/month or $1800/year and use this money to pay your ‘small bills’.  Also, when the next 10% rate increase occurs, your rate will not go up $40 (10% of $400) but only $25 (10% of $250).  If you are a business owner, we can help you design a plan where you take the savings from each employee and set up an HRA plan that usually results in lower premiums and better coverage.  That’s not a typo!  Lower premiums AND better coverage!

 

#6 – What insurance do you want to be ‘stuck’ with? Consider your ‘sleep factor’.  You need to be able to sleep at night and this isn’t easy when you aren’t confident in your insurance carrier.  Insurance is to pay the big bills so you don’t lose your car, home, and other worldly possessions.  Ask yourself - If you just found out you have an illness which will be with you the rest of your life how are you going to feel about your insurance?  When the hospital or surgeon asks who your insurance carrier is, are you going to confidently say, “It’s Company XYZ”!? 

 

There are numerous other considerations depending on each person or groups specific situation.  The 6 we’ve listed above are what we feel are the ‘Essential 6” items to keep in mind when you are shopping for coverage.  We would be happy to discuss all your concerns if you want to call or email us. 

 

MORE DETAILED INFORMATION AVAILABLE AT THE LINK BELOW

 

You may have a lot of questions, be a ‘first time shopper of health insurance’, or have a very specific need.  We didn’t want to ‘recreate the wheel’ or give you information that you may feel is biased.  In our ‘surfing’, we’ve found a great website at Health Insurance Marketplace. This link will take you directly to their site where you can get many of your questions answered:

  

Excuse the Disclaimer but we all have to protect ourselves - If you go to the above link, you will be leaving this site and you assume total responsibility and risk for your use of the site(s) you are linking to.  The information is being provided strictly as a courtesy.  Finch and Pirkle Insurance & Financial Affairs does not make any representation as to the completeness or accuracy of information that is provided in these sites.  We are not liable for any direct or indirect technical or systems issues or any consequences arising out of your access to or your use of third-party technologies, sites, information and programs made available through their site(s).