Archive for March, 2006

What is the Difference Between Health Insurance Companies in California?

Whether you already know it or not California has a lot of options for health insurance. There are companies that we all heard of and there are some companies that we never heard of. With all the Health Insurance Companies out there you might be wondering what the differences are and which one is right for you.


First in state of California the health insurance companies you should be looking at are; Aetna, Assurant, Blue Cross, Blue Shield, HealthNet, Kaiser, Nationwide, PacifiCare, Celtic and new company that is going to be available in state of California is Golden Rule. These are the largest carriers that are available in the State of California. If you are looking at any other company that was not mentioned previously, use caution. With all the health insurance premiums going up there are companies that prey on people with low premiums and coverage that does not cover anything. They are just out there to make a quick buck buy collection as much premiums as they can before you cancel your coverage. Stay away from companies that you never heard of, not matter what they tell you. If you hear something like, “affordable health insurance for self-employed”, run.


Second what you have to understand that the actual cost of insurance no matter what company you go with is about the same. So how do insurance companies have so many different plans with different premiums? If it is a large insurance company and the company ran efficiently that is how you get great premium with great coverage. What creates variety of prices for coverage is the creative aspect of the insurance company designing their plans. The way they do it is by deductibles, co-pays, co-insurance, drug coverage deductibles, whether the plan covers brand name drugs or generic drugs only, maternity coverage, maximum out of pocket, deductible and co-pays for all kind of different services.


The name we all know is Blue Cross Blue Shield. Blue Cross has been around since the recession of 1929, and it used to cost only 1 cent a day. The times have changes since then, but the Blue Cross name is still around. Blue Cross has been over the years the most stable largest health insurance provider in the United States. Their strategy is to keep rates stable and have stable rate increases. While most other plans might lower their rates to get more people on their coverage and then keep increasing their rates. There fore as some plans might be more attractive in premiums at the moment over time eventually they have to catch up with the actual market health insurance cost. Sometime the company has to charge people more for health insurance in the future so they can give more affordable rates today. Blue Cross will give the one of the largest varieties of plans to choose from and you can always downgrade a plan without going through underwriting is the monthly premiums because to expensive.


The most competitive health insurance coverage you will be able to get in California today is through Aetna and once Golden Rule plans come out by United Health Care then Golden Rule plans are going to be the most completive plan. Every time most of the large insurance companies enter a new state with a new plan they make that plan more competitive just to capture the percentage of that market eventually the company will have to raise their rates to the market level. Aetna plans in California are the most competitive. This is where you can get the most coverage for your money. Keep in mind that the Aetna Individual plans in the state of California do not cover Maternity.


Assurant Health Plans is provided through Fortis Insurance Company witch is the 26th largest company in the world and Fortis Insurance Company has been around since 1892. Assurant Health Plans are the most widely accepted and flexible plans that are available on the market today. Assurant Health Plans utilizes dozens of provider networks Nationwide to give you the worlds largest selections of doctors in United States and worldwide. Assurant Health Plans are the only plans that will cover you world wide as they will cover you in the United States. There is a big difference when insurance company says that you are covered for emergencies worldwide. Insurance company can make a final decision on whether that was true emergency or not. Assurant Health Plans have no such restrictions. Assurant is the only company that will allow you to move to different state without going through underwriting process all over again. That meant that with most companies even if it is a same company if you move from one state to another you have to cancel you policy in the current state and re-apply in the state that you are moving to. The down side with Assurant in some states is that they are not the most competitive and harder to get approved for. If you considering HSA plan, Assurant Health is the best options available to individuals and families.


Blue Shield of California is great coverage especially if it is young family looking for a plan with maternity coverage and for a family where one of the adults on the plans is significantly younger than the other. Blue Shield bases their monthly premiums on the youngest primary policy holder. This can be any adult in the family. Blue Shield plans have low maximum out of pocket and wide acceptance with doctors. A lot of doctors in state of California prefer Blue Shield plans because Blue Shield reimburses them faster than most other insurance companies. Keep in mind that in some states Blue Cross and Blue Shield are the same company in state of California they are two different insurance companies competing for your business.


HealthNet of California is the insurance company available in western states. HealthNet family plans are affordable, have some of the lowest maximum out of pocket and designed for healthy individuals and families. The new line of plans form HealthNet are their popular no deductible PPO plans. Which are some of the worst plans for families. No deductible plans are not designed for families since they have extremely high maximum out of pocket witch might be a great fit for single healthy individuals. HealthNet of California also offers some of the best HMO plans available on the market. Health Net’s simple design and affordable plans are perfect match for healthy families. The way their family plans work is that once you meet your deductible HealthNet will pay 100% for all of your medical expenses after that. The down side is that their family plans do not cover regular sick doctor visits. The money that you are going to save monthly is going to be way worth no having doctor visits covered until the deductible is met. All you will get is negotiated rates that HealthNet has with doctors and hospitals. Your doctor office visits are going to cost you anywhere from $65 to $65 per visit.


Nationwide Health Plans have some of the great unique options that other plans just don’t offer. The only way you can get Nationwide health plans is by being a member of California Farm Bureau. Anyone can become a member of California Farm Bureau also know as Farmers Association. Because it is a group plans it has some options available that most individual plans do not have. You still have to qualify medically to get health insurance through Nationwide. Nationwide offers some of the most comprehensive health plans available on the market today. Nationwide health plans offer low maximum out of pocket. Some plans that they offer work similar to the way HealthNet’s plans work. Once you meet your deductible Nationwide covers everything at 100% and Nationwide plans cover doctor visit before you meet your deductible and Nationwide is the only health insurance company that has no prescription drug deductible on most of their plans. If you are looking for the most competitive HSA plans, Nationwide will be your choice.


PacifiCare is company that has been available to Californians for a long time until recently they were bought by United Health Care. PacificaCare will be replaced by Golden Rule health plans. If you have PacifiCare you might want to find out if you will have to re-qualify medically for new health insurance once they take the company of the market. Golden Rule owned by United Health Care witch known as the quality company and recommended everywhere. If you are considering PacifiCare I would wait for Golden Rule or get something else. For more great resource on Health Insurance visit www.GuideToHealthInsurance.org

Dennis Alexander – leading consultant for employer group and individual/family health insurance. Marketing consultant for major health insurance resource websites and brokerage firms online. Some of the websites consultant and/or administrator http://www.HealthCoverageQuotes.com, http://www.GuideToHealthInsurance.org

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The Lowdown on Life Insurance Medical Exams

There are three main ways a new life insurance policy is priced: Underwritten policies are those where you answer questions on your personal and family medical history and undergo a medical exam arranged by the insurance company; a simplified issue life insurance policy application asks you some medical questions but does not require a medical exam; and a guaranteed issue life insurance policy requires no questions and no medical exam. If you’re healthy, or even if you have a few medical problems, you’re likely to get the best insurance value from an underwritten policy, which is priced specifically for you. Simplified issue and guaranteed issue life insurance policies set a price that assumes risk that you may not have.

Whether you’re buying term life insurance or whole life insurance, you’ll likely be asked to undergo a medical exam. These are typically performed by licensed paramedicals who are often independent contractors hired by the insurance company. They will schedule a visit to your home for the exam and bring all the necessary supplies. The life insurance company foots the bill for the exam.

Health questions

When you submit your completed application for your life insurance policy, your agent or life insurer will call a paramedical service to let them know you require an life insurance medical exam. The service will then contact you to arrange a convenient time and place. You must have the exam or your application won’t be processed.

The life insurer may still request an attending physician’s statement (APS) from your doctor, but you cannot have the life insurance medical exam done by your own physician.

In a basic exam, the paramedical will take your medical history (even though you’ve already supplied it on your application), height and weight, blood pressure, pulse, and blood and urine samples. Beyond that, tests will vary based on your age and policy amount.

For example, MetLife will order an in-home EKG for applicants age 50 and older who are applying for face amounts of at least $1 million. For applicants age 70 and older who are applying for $2 million policies and higher, MetLife forgoes the paramedical exam and requires an exam by an M.D. chosen by MetLife (not your own doctor). The doctor will ask the same medical questions as a paramedical and get your height, weight, blood pressure and pulse, plus do a brief medical exam such as listening to your heart.

Jacki Goldstein, Vice President of Life Underwriting at MetLife, emphasizes that this is not a comprehensive medical exam and does not include sensitive issues, such as a breast exam for women. Goldstein also stresses that the M.D. life insurance exam is not a substitute for good routine medical care.

When age and face amounts get higher, a treadmill test may be required. For example, MetLife requires treadmill tests for applicants who are at least 50 and applying for over $10 million in insurance or applicants 76 and older applying for $5 million or more.

If you’re applying for a low face value policy, you may not even be asked to do a paramedical exam. For example, if you’re age 40 and applying for $50,000 of life insurance, MetLife requires no specific tests or measurements. And for some cases, MetLife asks for a “simple paramed” exam, encompassing the basic measurements and blood and urine work but without the paramedical question list. Guidelines for tests will vary among life insurers.

What are They Looking For?

The life insurance company wants to know if you have any health condition that could shorten your life which in turn affects the insurer’s risk and your policy premium. When samples of blood and urine are collected, the insurer tests for HIV, cholesterol and related lipids, liver or kidney disorder, diabetes, hepatitis, prostate specific antigen (PSA) and immune disorders. The urine sample might go through routine analysis, plus screening for certain medications, cocaine and other drugs.

Results go to the life insurer’s home office for an underwriter to review. You can usually send a written request if you want a copy of the results, and some insurers will automatically send you a copy of your lab work. If there’s anything of concern about the lab results, you would need to consult your own doctor. Goldstein says, “It’s not uncommon to have abnormalities that don’t mean anything.”

A life insurance underwriter then reviews your application and the results of your medical exam. They decide your life insurance rating, which sets your premium. If there are lingering questions about your health, they may request additional information or medical tests. In the very rare event you are unknowingly quite ill chronically or terminally your application would be declined and you would have to look for a high-risk carrier or one that offers guaranteed issue life insurance.

Don’t Let Your Life Insurance Premiums Go Up In Smoke

Smokers pay higher premiums for life insurance because of their higher mortality rate. If any nicotine shows up in your results, you’ll be considered a smoker. The test also detects nicotine from a transdermal patch.

After the Life Insurance Exam Results

If your test results correlate with the classification used for your original life insurance quote, you’ll have no problem getting that rate. If a medical problem is discovered, you might be offered a life insurance policy with a higher premium.

There are two types of risk ratings: “flat” ratings, sometimes called temporary flat extras, and “table” ratings. Underwriters assess health conditions based sophisticated table to determine how to rate certain health conditions.

For instance, an underwriter might apply a flat rating for a short period of time for a person who has just had surgery. On the other hand, a person with high-blood pressure could receive a table rating, which increases premiums by a set amount for the duration of the policy, depending on your medical condition and age. If you disagree with a rating you receive, contact your agent.

Agents can find out if the rating can be revised based on supplemental medical tests to prove you qualify for a better rating.

Even if you end up declining the life insurance policy, your test results become part of your record in MIB Group’s database (formerly the Medical Information Bureau), a clearinghouse of medical information that insurers share which stores information for seven years after you apply for a life, health, disability income, long term care or critical illness insurance policy.

MIB is jointly owned by about 470 insurance companies. So, if you go shopping around for other term or whole life insurance policies, remember that your medical information is accessible to other insurers in the near future. Note that MIB’s database does not contain actual medical records but rather codes that represent medical conditions and tests, hazardous hobbies and even your bad driving record.

If you want to check your MIB file, or dispute information in it, you can obtain one free report annually at www.mib.com.

No Way, You Say?

Life insurance medical exams are really quite routine. But if you want to avoid a medical exam at all costs, you could buy a simplified issue life insurance policy, which requires only that you answer a few medical questions, or a guaranteed issue life insurance policy, which requires neither an exam nor questions.

Keep in mind, though, that if you’re in general good health, or even with a history of some health issues, you’ll likely get a much better rate by buying a life insurance policy that requires a medical exam.

Tips for a Better Life Insurance Medical Exam

Certain health conditions simply cannot be masked, but to obtain the best possible results, here are some recommendations:

-Get a good night’s rest the night before your exam. -Don’t drink for at least eight hours before the exam.

-Avoid coffee, tea or other caffeinated drinks such as soda for at least one hour prior to the exam.

-Limit salt intake and high-cholesterol food 24 hours before your exam.

-Don’t engage in strenuous physical activities 24 hours before the exam.

Source: Exam & Profile Services, Beaver Dam, Wisconsin

Amy Danise is a staff writer for Insure.com. Visit Insure.com for a comprehensive array of comparative auto, life and health quotes, including a vast library of originally authored insurance articles and decision-making tools that are not available from any other single source. Insure.com is dedicated to providing impartial insurance information to consumers. Visitors can obtain instant insurance quotes from more than 200 leading insurers, achieve maximum savings and have the freedom to buy from any company shown.

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