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As the title says, is medical insurance important? Definitely. No one plans to get sick. No one want to get sick or hurt. Even when we get sick or hurt, we wish that the medical expenses won't hurt our pocket as well. That's why we need to invest on medical insurance. Why I say investment? Because we won't know when or where we will need medical care. We won't need medical care every time we get sick, but at some point we will need medical care.

Here are the reasons why you need medical insurance:

  • Protecting your finances. Health problem can cost huge money and we know that medical treatments are mostly expensive, especially certain prescription drugs. 
  • Believe it or not, medical insurance can give you a peace of mind. How? Since medical treatments are expensive having medical insurance can relieve your burden in case you need treatment. Health coverage will paid the expenses according your insurance policy.
  • Regular check-ups possibility. Some insurance company provide regular check-up in their coverage, it is include special services or hospitalization. With covered regular check-up, your health will be improved as well. 


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Insurance claim is a formal demand to insurance company for a payment based on insurance policy. Claim may be filed directly to insurance company or filed through their insurance brokers or agents. Insurance broker/agent duty including sells, solicits, and/or negotiate insurance for compensation. Marsh & McLenna, Aon Corporation, Arthur J. Gallagher & Co and Willis Group are the largest insurance brokers in the world based on revenue. 

Insurance company reviews the claim for its validity and will pay the claim to the insured or third party (broker or agent on behalf of the insured) once the insurer approved. Most insurance company claims department hire a large number of claim adjusters. Claim adjusters or claim handler will investigates insurance claims by interviewing the claimant and witnesses, consulting police, checking hospital records, and inspecting property damage to determine the extent of the insurance company's liability.

These are typically claims adjusters' duties :
  • Verify the existence of insurance policy for individual and/or property.
  • Investigates risk of loss, property damage, property loss (due to natural disaster) or body injury.
  • Evaluate the covered damages according to coverage grants after completing the above investigations.
  • Negotiate the settlement according to the law and identify the insured's coverage.

Insurance company need to balance the elements of customer satisfaction, administrative expenses, and claim overpayment leakages. The company have to manage and overcome the major business risk, fraudulent insurance practices. It may lead to a disputes between insurers and insurance company and could escalates into litigation.
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Medicare

In the United States, Medicare is a single-payer, national social insurance program administered by the US federal government since 1966, currently using about 30-50 private insurance companies across the Unites States under contract for administration. Medicare provides health insurance for Americans aged 65 and older who have worked and paid through payroll tax. It also provides health insurance for younger people with some disabilities status as determined by the Social Security Administration, as well as younger people with end stage renal disease and amyotrophic lateral sclerosis (permanent kidney failure requiring dialysis or a kidney transplant).(source: Wikipedia)

Medicare has 3 type :

1. Part A Hospital Insurance

Most people don't pay a premium for Part A because they or their spouse already paid for the premium through their working payroll taxes. Part A Hospital Insurance helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (custodial and/or long-term care are not included). This Part A also helps cover hospice care and some health care.

2. Part B Medical Insurance

People pay a monthly premium for Part B. This medical insurance helps cover doctors' services, outpatient care, some of the physical services and occupational therapists and also some home health care which are not covered by Part A Hospital Insurance.

3. Prescription Drug Coverage

Starting on January 1, 2006 new Medicare prescription drug coverage will be available to everyone with Medicare. Most people choose the drug plan and pay a monthly premium. This coverage help lower prescription drug expenses and protect against higher costs in the future. Like any other insurance, if you decides not to take a drug plan when they are first eligible, you might pay penalty if you choose to join later.


Medicaid

Medicaid is USA government insurance program for persons of all ages with low income to pay for health care, pregnant woman, elderly adults and people with disabilities. Each state currently having leniency to determine who is eligible for the program's implementation. Medicaid beneficiaries must be U.S citizens or legal permanent residents, low-income include adults and their children, and people with certain disabilities. Medicaid is administered by states, according to federal requirements. This program is funded jointly by states and the federal government.

There is mandatory Medicaid benefits, states are required to provide under federal law, and also optional benefits that states may cover. The mandatory benefits are:
  1. Impatient hospital services
  2. Outpatient hospital services 
  3. Nursing facility services
  4. Physician services
  5. Rural health services
  6. EPSDT (Early and Periodic Screening, Diagnostic, and Treatment Services
  7. Home health services
  8. Federally qualified health center services
  9. Nurser midwife services
  10. Laboratory and X-ray services
  11. Family planning services
  12. Certified Pediatric and Family Nurse Practitioner services
  13. Tobacco cessation counseling for pregnant women
  14. Freestanding Birth Center services (licensed or recognized by the state)
  15. Transportation to medical care

You can read further information about medicare and medicaid on these website below:
https://www.medicare.gov/
https://www.medicaid.gov/index.html

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What is Health Insurance?

Health insurance is a type of insurance that protect insured from medical expenses. You may choose reimbursement policy or paid the expenses directly by the insurer. Every country have their own regulations regarding providing health insurance for their citizen. Several country provide national health insurance and/or employee health insurance and require the citizens to be enrolled in it. Another country relies on private health insurance. 

Health Insurance Forms

There are several forms that often used in health insurance policy :

  1. Deductible is the amount insured have to pay out-of-pocket before the insurer pays the rest expenses.
  2. Premium is the amount policyholder have to pay according to their coverage plan.
  3. Coinsurance is a percentage of the total expenses that insured must pay. 
  4. Co-payment is the amount insured must pay out-of-pocket before the insurer pays for a certain visit or service. 
  5. Exclusions means not all services are covered.
  6. Capitation is an amount insurer pay to insurance company which agrees to treat all members of the insurer.
  7. Out-of-pocket maxima. In this case, payment obligation of the insurer ends when they reach the maximum of out-of-pocket, so the insurer will pay all further covered costs. However, out-of-pocket maxima can be limited to spesific category like prescription drugs.
  8. Coverage limits means some health insurance policies only pay for health care up to certain amount. 

Health Insurance in USA

United States has an organization work as a medical insurance group that provides health services for a fixed annual fee, which called Health Maintenance Organizations (HMO). They manage care for health insurance, self-funded health care benefit plans, individuals, and other entities in the United Stated. HMO use the term "health plan", while the commercial insurance companies use health insurance. 

According to the United Stated Census Bureau, roughly 55% obtain insurance through an employer, while about 10% purchase it directly. About 31% of Americans were enrolled in a public health insurance program: 14.5% (45 million - although that number has since risen to 48 million) had Medicare, 15.9% (49 million) had Medicaid, and 4.2% (13 million) had military health insurance (there is some overlap, causing percentages to add up to more that 100%). Employers may also provide reimbursement for health insurance purchased individually by their employees through a Defined contribution health benefits plan. Employers are allowed to pay employees cash in lieu health insurance, but this is uncommon as it is subject to strict IRS regulations. (source: Wikipedia)

There are many types of coverage in health insurance system in USA, I will explain those types in next article. In my opinion, purchasing a health insurance is like an investment. Because we won't be 100% healthy in full year, we can get mild ill or worse. It's not bad for having "backup coverage" like insurance so that our pocket won't get hurt too much. Beside, many countries have regulations for its citizen must enrolled in health insurance.
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You maybe often hear about insurance quote. What is the meaning of insurance quote? According to Cambridge Dictionary, insurance quote is a statement of the amount of money that an insurance company calculates as the cost of providing insurance for something. For example, get an immediate insurance quote for your car by calling us now or visiting our website. To put in simple, insurance quote is an estimate amount provided by the insurer regarding the price of a policy. It gives an idea of the cost of purchasing coverage to prospective policyholders. You can ask for quotes from many insurance companies to compare prices and coverage options. Keep in mind that insurance quote is not an insurance contract. Quotes can change depends on how much information you give at the time you ask for quote. If you give more detailed information, the more accurate your insurance quote.

There are plenty insurance company that provide online insurance quotes. You don't need to come to their company office when you ask for a quote. It will be easier if you want to compare several insurance companies without having to pay or make an agreement. You might look for the most suitable policy at the most affordable price you can get from multiple quotes from different insurance companies. The insurers will provide insurance quotes to disclose the costs and terms of purchasing insurance from their company. The higher risk of loss, the higher premium of insurance will be. 
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Do you love performance car? Do driving performance car gives you adrenaline rush? Or do you have your own performance car and love being an enthusiast driver? Then, you might want to purchase a performance car insurance. I have to say that performance car insurance is not cheap. Why? Because performance vehicles have more powerful engines than common vehicles which they can reach high speeds really quickly. This type of car tends to be involved in an accident.

The cost of performance car's repair is also higher than standard vehicle. The spare parts are higher spec and you may need specialist labour. Your performance car may attract thieves and vandalism often more than standard vehicle. And believe me, that is not cheap either. This is why you have to insure your performance car. 

What kind of cover do I need? 

Your cover can be arranged on the basis of third party, fire and theft (TPFT), comprehensive, or just third party with different degrees of protection. As most performance cars are expensive to buy or replace, policy holders want to benefit from the peace of mind that a comprehensive policy can bring.

Can I lower the cost of cover?

Yes, you can. You might want to learn these "tricks" :

  1. Reduce your mileage. It's odd but sadly true. The more miles you drive, the higher chance of you having an accident. The less you drive, the lower premium you will get. 
  2. Compare Insurers. There's no harm comparing premium that insurers offer before making deal.
  3. Boost security features. Adding security device such as alarm or immobilizer means you have lowered the potential risk of your vehicle being stolen. Make sure you park your car in garage or driveway.

You may think you won't need performance car insurance as long as you drive carefully or park safely. However, no one can guarantee another driver do the same as you. Preparing won't hurt you.
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The answer is definitely yes. You might be a careful person, obeying traffic laws, no speeding, and so on. But you never know that someone will do the same as you. Anything could happen on the road, whether it is other driver's fault, environment or animal. Or maybe you will be at fault. There are a lot reasons why it is important to have car insurance.

Car insurance is not only cover a collision claim but also cover weather damage, animal damage, falling tree, theft, or even vandalism. It will be really expensive if you have to pay those repairs with you own pocket. If you are concerned about the insurance's premiums, you can choose to raise your deductible so that it will lower the premiums. 

Please keep in mind you have to compare the coverage's cost verse the value of your vehicle.

The reason you need car insurance :
1. If you live in an area where crime like theft and/or vandalism occur regularly
2. If you live in an area where natural disasters such as hail, tornado, flood and so on often occur
3. An animal like deer might run in to your car when you drive
4. Someone might hit your car
5. A tree could fall on to your vehicle
6. You might crash into building, other vehicle, or railing
7. And any other cases

Some states in US require you to carry car insurance. The amount of car insurance as a minimum on each vehicle are varies on each states. It also apply on what type of insurance are required. In some states, you might have to purchase comprehensive and/or collision, while other states requires you to carry liability or more. If you fulfill your state's requirements regarding car insurance, you keep yourself legal to drive.

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During vehicle driving, it's not difficult to accidentally hit something or gotten hit. Therefore, you need collision coverage to protect your vehicle against physical damage. This type of coverage is important because anything can happen on the road. Some of the most significant damage to your vehicle can come from another vehicle, tree, pole, or guard rail. When you get into accident, you will pay your deductible then your collision coverage will help pay to repair or even replace your vehicle.

Collision coverage does not cover your vehicle if got damage from storm, flood, animal (deer), falling object, vandalism, etc. This coverage policy that distinguish between collision coverage and comprehensive coverage. You can purchase collision coverage only if you combine it with liability and comprehensive coverage. Collision coverage might expensive, so in order to lower costs people mostly choose minimum $500 deductible or higher. Raising your deductible can lower your auto insurance premiums. However, you should adjust the deductible with your ability to pay pocket if collision occur.

Purchasing both comprehensive coverage and collision coverage means your vehicle are fully protected. Comprehensive coverage usually cheaper than collision damage. Furthermore, animal and weather damages are common when it comes to vehicles. Collision coverage could cover your vehicle from your mistake or collision with other vehicle. When it comes to selecting your vehicle's coverage, you have to consider the cost of coverage with the value of your vehicle. Having both or one of these coverage type, you can have a little peace of mind.




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Comprehensive Insurance is the type of automobile insurance which cover your vehicle from physical damage caused by anything but collision. This insurance would cover your vehicle if it was destroyed by natural disaster (tornado, flood, hail etc.), dented by run-in animal (deer), vandalism (spray painted), theft and so on. Comprehensive can be used in combination with other coverage or as a standalone coverage. 

Comprehensive insurance often offers with a reasonably priced coverage with low deductible.With comprehensive insurance, you can claim for accidents you caused. It also applies if fault can't be proven. For example, your car got hit and the driver run off in the parking lot. If you don't have comprehensive cover, you have to repair your vehicle with your own pocket. Comprehensive policy gives you additional protection that you don't necessarily have to pay for expensive repairs.

The three components of automobile insurance policy are liability insurance, collision insurance and comprehensive insurance. In U.S state law requires drivers to have liability insurance, but collision and comprehensive insurance are optional. Comprehensive cover is the highest level of cover if someone take motor insurance in the United Kingdom. Comprehensive cover has gone cheaper in recent years than 'Third Party, Fire and Theft' cover. People in UK who take comprehensive cover are not only covered for third party claims after an incident, they are also covered for damage caused to their vehicle.

If you own an older vehicle or prefer to self-insure, you might not need comprehensive insurance. However, if you live in a rural area where collisions with animals are often occur, or you live in an area with unpredictable weather (stormy with much hail), in addition you live in a town where theft or other crime occur regularly, I suggest that you purchase comprehensive insurance, so you could have peace of mind. 

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People always found "Deductible" in their insurance policy. What is deductible? Deductible is an amount the insured must pay over claim before the insurance company pay the claim. Deductible can be seen as out-of-pocket expenses. Out of pocket expenses means direct cash out that could be reimbursed later. The simple way to understand deductible is through this example, let's say your deductible is $500 and your total expenses (claim) is $1500. You have to pay your $500 deductible and your insurer will pay $1000. However, if your expenses was $500, you would have to pay the entire expenses and your insurance company would pay nothing. Deductible often used to avoid a large number of claims, so the consumer could reasonably expect the cost. Insurance company restricting its coverage significantly enough to incur large costs. Because of that, the insurance company expects to pay out smaller amounts less frequently, so they can have much higher savings. Insurance premiums are typically cheaper while involving higher deductibles.

Deductibles usually provided as clauses in an insurance policy to determine how much insurance-covered expense is borne by the policyholder. Deductibles normally quoted as a fixed amount. Depending on the policy, deductible may apply per covered accident, or per year. As for health insurance, which is not easy to delimit, typically applied per year. There are several deductible reimbursement programs that provide reimbursement for automobile, home or health insurance claims. In health care financing, deductibles or out of pocket costs are typically high when it comes to prescription drugs especially in the United States. Before taking a health care plan, it is important to examine the out of pocket costs whether it's high or low.
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What is coinsurance?

coinsurance is a type of insurance which the insured shared the payment's claim with the insurer. The agreement settle in insurance policy which the insured will pay a certain percentage of the covered cost after the payment of the deductible. Coinsurance could be found in health insurance, property insurance, in title insurance and other insurance. It's commonly used in the U.S insurance market. While in Europe, coinsurance is widely used in European insurance market.

What is deductible?

Deductible is a fix amount you have to pay with your own money before the insurance company pay the claim. Deductible are used to deter huge amount of claims which consumer can be expected to bear the cost reasonably. Health insurance companies often offer insurance plans with high premiums and low deductibles, or insurance plans with low premiums and high deductibles. For example, a company have a premium $1000 a month with $5000 deductible, which means the consumer or insured have to pay $5000 in health treatment cost before the insurance company pays anything. 

Coinsurance in Health Insurance

Coinsurance is sometimes used with copayment in health insurance. The difference is copayment is really fixed while the coinsurance provide a percentage insurer pays after the insurance policy's deductible is exceeded up to the policy's stop loss. The maximum percentage of insured's responsibility is usually under 50%. Once the insured's out-of-pocket expenses equal with the stop loss, the insurer will take 100% responsibility of any additional cost. The percentage can be vary depends on each insurance company. The commonly used percentage are 70-30, 80-20 and 90-10 with stop loss limit ranged between $1000-$3000 after the insurers covers all expenses.

Coinsurance in Property Insurance

Coinsurance can be found in many property insurance policies, such as homeowners, commercial property and so on. Coinsurance in property insurance is a means for insurers to obtain rate and premium equality. Coinsurance in property insurance also could be means as a penalty to the insured by insurance company for under reporting the value of property or business income. 
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      • Is Medical Insurance Important?
      • Insurance Claim Definition
      • Between Medicare and Medicaid
      • Invest in Health Insurance
      • Learn about Insurance Quote
      • Performance Car Insurance for "Active Drivers"
      • Do I Need A Car Insurance?
      • Collision Coverage
      • What is Comprehensive Insurance?
      • Understanding Deductible
      • Coinsurance : Brief Introduction

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