Health Insurance Basics

If you are self-employed, or otherwise in need of individual health insurance coverage, how do you go about finding the best plan?

1. Learn the language:

HMO – Health Maintenance Organization. This is a very structured plan where you pick a PCP (Primary Care Physician), the doctor you see first for everything. The PCP refers you to a specialist.

PPO – Preferred Provider Organization. This is less restrictive than an HMO. You self-refer to any physician in the network for care.

Indemnity Plan – The old traditional plan before managed care. You go to any doctor or hospital. There are not many of these left, and they cost the most.

Hospital/Surgical Plan – These plans cover the basics with few bells and whistles. Some provide riders to make them look like major medical plans.

MSA – Medical Savings Plan – These plans were designed by Congress. You have a high deductible health plan coupled with a tax-deductible savings plan.

Temporary Health Insurance – A great low cost alternative for those needing coverage for one to twelve months or who cannot qualify for long term coverage.

The above ary very general descriptions to help explain the different options. Not all plans are available in all states.

2. Select the best type of plan for you:

This will depend on the length of time you need the coverage; how much money you have in savings or are willing to risk; your plans for having children; the doctors your prefer; cost; and most importantly your health.

If you are planning a family – Having maternity coverage is a must. An HMO will almost always provide the lowest cost, as maternity is built into the cost.

If you are between jobs – A temporary plan is the best way to go.

If you prefer a particular doctor or hospital – A PPO may be the best way to go.

If money is tight – A Hospital/Surgical Plan, HMO, Temporary Plan, or high deductible PPO may be options for you.

If you want complete freedom – and money is no factor, then an Indemnity Plan is best.

If you hardly ever use your plan – and you wish you had all the money back, then an MSA may be best for you.

If you have minor problems – that would be pre-existing conditions with most plans, an HMO might not consider these as problems.

If an HMO will not take you – a PPO, Indemnity, Hospital/Surgical or MSA may take you, but rider the condition.

3. Find out what it will cost:

To find out what it will cost, contact an agent in your state.

To avoid any surprises at claim time, it is important to provide accurate information. Do not give an insurance company an excuse not to pay!

SOURCE: DivorceNet

8 Roadblocks to Settling Your Divorce

From our neighbor to the north, this post is by Jeffrey Behrendt on his Ottawa Divorce Blog. In my next post, I will share his suggestions for overcoming these 8 roadblocks:

Many times in my practice, once I am familiar with all the facts of a case (including both my client’s version and the version of my client’s spouse) I can predict a range of outcomes that’s normally very accurate. Despite this, it can be difficult to settle a divorce case, raising legal fees tremendously and causing both parties a lot of stress. Here are 8 of the reasons why this happens.

1. The other divorce lawyer. I do agree with the common perception that lawyers can make things more difficult than need be. The reasons for this are somewhat complex. Some lawyers are overly aggressive. This isn’t solely the lawyer’s fault – clients going through a divorce often want their lawyer to be aggressive. Aggression isn’t the only problem – an inexperienced lawyer may not be reasonable simply because they don’t know what a local judge may decide.

2. Unreasonable clients. One thing about being a divorce lawyer is that even though you’ve dealt with a situation many times before, a client knows more about it because a friend of a friend said something. Whether you like what the law has to say or not, for most middle-class couples in fairly average situations, the law is pretty clear. But it can be difficult to resolve a case if one spouse doesn’t agree with what the law is. (As a side note, I agree that in a lot of cases, the result isn’t fair, but that’s a political, not a legal, issue).

3. Child Custody Disputes. In most cases, you can say it’s just money, and move on. With the children, you can’t do this. Custody disputes are one of the most difficult types of case to settle.

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