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5 Essential Details About Health Insurance Schemes In A Bad Economy
1. DOES YOUR HEALTH PACKAGE COVER YOU ON AND OFF THE JOB?
Many health insurance policies have explicit exceptions that do not cover you for anything that might have been covered under Workers Compensation or similar laws. Now read that last sentence again.
COULD HAVE BEEN COVERED!?
That is correct. Many self employed people and even many small business owners do not carry Workers Comp on themselves.
There are custom made insurance policies that will cover you on and off the job - 24-hours a day, if you are not mandated by law to have Workers Compensation coverage.
2. ARE YOU WRITING IT OFF?
Independent contractors (1099's), home based business operators, professionals and other self employed people generally are not taking advantages of the tax ordinances available to them.
Many people paying 100% of their own costs are eligible to deduct their monthly insurance premiums. Just that by itself can cut your net out-of-pocket expenditures on a proper plan by as much as 40%. Ask your accountant if you are eligible and/or check out the IRS website for more information.
3. INTERNAL LIMITATIONS
All true health insurance policies use some form of internal controls to decide how much they will pay out for a certain procedure or service. There are two normal methods.
-Scheduled Benefits
Many policies, some of which are specifically marketed to self employed and independent people, have a clear schedule of what they will pay for a doctor office visit, hospital stay, or even limits on what they will pay for tests per 24-hr. period. This system is usually associated with "Indemnity Plans". If you are presented with one of these plans, be sure to see the schedule of benefits, in writing. It is essential that you understand these type of limits up front because once you reach them the plan will not pay anything above that amount.
-Usual and Customary
"Usual and Customary" refers to the rate of pay out for a doctor office visit, procedure or hospital stay that is based on what the majority of physicians and facilities charge for that exact service in that particular geographical or comparable area. "Usual and Customary" charges represent the highest amount of coverage on most health insurance policies.
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