Tag Archives: Medicaid

What is a Supplemental Accident Policy?

MILLIONS of people have accidents every year.

Rate of Nonfatal, Medically Consulted Fall Injury Episodes, by Age Group
Graphic source: MMWR Quickstats, 02/03/2012
In 2010, the overall rate of nonfatal fall injury episodes for which a health-care professional was contacted was 43 per 1,000 population. Persons aged ≥75 years had the highest rate (115).
Will you or your family be affected?

Accidents and disabilities can create serious financial worries. A supplemental accident plan can help protect you and your loved ones from those concerns by providing additional assurance that major medical plans can’t.

In addition to the routine expenses that medical insurance covers, there are additional costs that you must pay yourself – not to mention the possibility of lost wages.

Protect your most valuable asset . . . your income!

With a supplemental accident plan, you get these assurances:

  • Your benefits are paid directly to you or to whomever you choose, unless otherwise required.
  • Your benefits have no lifetime maximum limits, and are renewable as long as premiums are paid.*
  • Your benefits are paid regardless of any other insurance you carry.
  • Your rates cannot be increased unless all rates of that kind are raised in your state.

*Some disability benefits/rider may only be guaranteed renewable to the age of 70

Did You Know?

Worker’s compensation only covers injuries that occur on the job.

Major medical plans may cover only routine medical expenses for accidents or disability, leaving uncovered costs such as copays, transportation, physical therapy, emergency room and a host of other expenses for you to pay out of your own pocket.

Loss of income due to a disability can strip you of your wealth-and the lifestyle to which you’re accustomed.

An accident plan is a great supplement to a high-deductible health plan.

According to the National Safety Council

  • 66% of all accidents occur off-the-job.
  • More than 23.8 million injuries required medical attention in 2003.
  • In 2004, over 82% of all costs due to accidental injuries were non-medical costs and expenses.

How would YOU pay for unexpected costs?

  • Spend your savings
  • Sell off assets
  • Preserve your resources with supplemental accident insurance.
National Safety Council, Injury Facts, 2005-2006 Edition, p2, p23
The above facts represent the U.S. population, are for information only and do not imply coverage under the policy or endorsement of the company or the policy by the cited sources

Click here for a quote on Supplemental Accident Insurance

Frequently Asked Questions

Q: What is Supplemental Insurance?

A: Supplemental insurance is extra or additional insurance that helps you pay for out-of-pocket costs that your major medical insurance doesn’t cover. Things such as loss of income, co-pays and co-insurance, travel and lodging, etc. The benefits are paid in cash directly to you so you can use the money however you choose to pay for those unexpected expenses due to illness or injury.

Q: Do I really need supplemental insurance?

Unexpected accidents and illnesses happen. When they do, it can leave you and your family vulnerable to out-of-pocket expenses that major medical insurance does not cover. Supplemental insurance benefits give you piece of mind and reduce the worry about how you will pay for those unexpected expenses. With less worry, you can focus on getting well rather than how you will get the money to pay your light bill.

Q: I am on Medicare, retired, or don’t have any income; can I still get accident insurance?

Of course!  Falls and broken hips are major concerns with people on Medicare.  As you can see by the chart above, our chances of a fall increase dramatically the older we get.  Eventhough you may have a plan that pays for the hospital and doctor bills, you may need extra money for someone to come help take care of you during that time. Supplemental insurance benefits give you piece of mind and reduce the worry about how you will pay for those unexpected expenses. With less worry, you can focus on getting well.  You don’t have to be employed to purchase an accident plan, however it will not pay in addition to Medicaid

Q: What happens when I have an accident?

A: Filing a claim is easy. You will simply visit our web site to download your claim forms, or call us at 1-877-740-8683 to have them mailed to you.

Q: How can I get supplemental insurance?

A: We make it easy as 1-2-3. 1. Just call us toll-free at 1-877-740-8683. 2. We take the application over the phone in less than 10 minutes. 3. You get your policy in the mail in 1-2 weeks. It’s that easy! Our knowledgable representatives will work with you to identify your protection needs, so you have the coverage you need to help meet those needs.

Q: How do I qualify; do I have to complete a physical?

A: Almost anyone can qualify for an accident policy even if they cannot get major medical. There are very few health questions, and no physical is required. Generally, as long as you can answer “No” to the health questions, the coverage is issued and can become effective within 15 days from the date of the application.

Q: What services are covered?

A: Most plans pay cash for things such as:

Admission to a hospital
Dislocations, fractures, eye injuries, broken teeth, paralysis, burns, lacerations, concussions, and others
Emergency transportation in an ambulance
Family lodging for a member of the immediate family
Emergency treatment in a hospital emergency room or even a physician’s office
Confinement in an intensive care unit
Physical therapy

Q: What is generally not covered on an accident plan?

A: Most plans will not pay benefits for the following:

Operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven.
Engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot-air ballooning.
Participating or attempting to participate in an illegal activity.
Intentionally causing a self-inflicted injury.
Having any sickness, illness or bodily infirmity.
Committing or trying to commit suicide, whether sane or insane.
Dental care or treatment due to accidental injury to natural teeth.
War or any act of war (whether declared or undeclared) or participating in a riot or felony.
Alcoholism or drug addiction.
Injury originating prior to the effective date of the policy.
Injury to a covered person while practicing or being a part of organized or competitive football or rodeo, sky diving, or scuba diving.

Exclusions and limitations vary by policies by state, so always refer to your policy or outline for applicable exclusions and limitations.

View other supplemental coverages:

Critical Illness
Heart Disease / Heart Attack / Stroke
Hospital Indemnity

Consumer Healthcare Guide to the Reform

There is much debate over if this Reform is good, bad or ugly.  What is clear, is that it is going to impact every one of us; consumers, employers, insurance companies, hospitals and doctors.

While everything doesn’t really get “kicked in” until 2014, people are already getting prepared, and things are changing.

Here are some things as it is now, and what is to come.  Since change is constant … please visit us often to keep up!!!

I don’t have health insurance. Will I have to buy it and what if I don’t?

Today, you are ok if you don’t have health insurance (well you won’t be fined that is). Starting in 2014, depending on your income and possibly other factors, you will have to have it or pay a fine (or tax – not sure what they are calling it).  This tax may be able to be waived for several reasons, including financial hardship or religious beliefs.

They are estimating millions of people will qualify for Medicaid or federal subsidies and will be able to buy insurance that way.

I have group coverage at my job, will I be able to keep that? Will my benefits change?

If your company provides insurance, it will probably stay that way. Your employer is not obligated to keep the current plan, so they can change premiums, deductibles, co-pays and/or the network coverage.   We have seen a lot of small employers under 50 making a lot of changes because of the reform.  In addition, you may have already seen some companies making dependant changes; what already took effect was the fact that the plans had to guarantee that an adult child up to age 26 who can’t get health insurance at a job could stay on their parents’ health plan.

I can’t afford health insurance, but I want it. What do I do?

The federal government’s plan is, depending on your income, you can apply for Medicaid. Currently, in most states nonelderly adults without minor children don’t qualify for Medicaid. But beginning in 2014, the federal government is offering to pay the cost of an expansion in the programs so that anyone with an income at or lower than 133 percent of the federal poverty level,  will be eligible for Medicaid.   What if you don’t qualify for Medicaid and still can’t afford health insurance?

Then there are the government subsidies that you may be eligible for.  They help you pay for insurance bought through the exchanges, which should be available October 2014. This will be private insurance from insurance companies offered to individuals and small businesses. We plan to be one of the agencies offering these plans to you as well.

What if I have a pre-existing condition, will it be harder for me to get coverage?

After 2014, Insurers will not be able to decline an applicant based on health status.  That is good and bad.  If you are healthy, you want to get insurance NOW, and possibly lock in a lower rate while you can be underwritten.  Once all plans are treated the same, the rates are anticipated to be much higher and a healthly person will be paying much more.

I am a small employer. Do I have to buy health insurance for my employees?

You are not required to provide insurance. Starting in 2014, employers with 50 or more employees that don’t provide health care coverage and have at least one full-time worker who receives subsidized coverage in the health insurance exchange will have to pay a fee of $2,000 per full-time employee. The firm’s first 30 workers would be excluded from the fee.

Small employers with 50 or fewer people won’t face any penalties.

In addition, if you own a small business, the health law offers a tax credit to help cover the cost. Employers with 25 or fewer full-time workers who earn an average yearly salary of $50,000 or less today can get tax credits of up 35 percent of the cost of premiums. The credit increases to 50 percent in 2014.

We offer many solutions to help you work through the law and get all the credits and eliminate the penalties.  Click for more info.

I’m over 65. Is it going to affect my Medicare?

The law has made a lot of good and bad things happen for beneficiaries.  With the changes, more and more doctors are not taking Medicare, which is the main negative.  The reason why is because they are basically not getting paid as much.  This is more and more reason to have additional coverages to Medicare.  Click to see more.

The good things the law did was it expanded Medicare’s coverage of preventive services, such as screenings for colon, prostate and breast cancer, which are now free to beneficiaries. They pay for an annual wellness visits to the doctor. Preventative care is so important in keeping healthy, so use these FREE services!   Because the law reduced the payments to Medicare Advantage plans, some say these cuts could mean the Advantage plans may not offer many extra benefits, such as free eyeglasses, hearing aids and gym memberships, that they now provide. The reason for the cuts was because Medicare Advantage costs more per beneficiary than traditional Medicare.

Will I have to pay more for my health care because of the law?

That is a million dollar question and an argument no one knows the answer to.

That said, there are some new taxes and fees. For example, starting in 2013, individuals with earnings above $200,000 and married couples making more than $250,000 will pay a Medicare payroll tax of 2.35 percent, up from the current 1.45 percent, on income over those thresholds. In addition, higher-income people will face a 3.8 percent tax on unearned income, such as dividends and interest.

Starting in 2018, the law also will impose a 40 percent excise tax on the portion of most employer-sponsored health coverage (excluding dental and vision) that exceeds $10,200 a year and $27,500 for families. The tax has been dubbed a “Cadillac” tax because it hits the most generous plans.

In addition, the law also imposes taxes and fees on several major health industries. Beginning in 2013, medical device manufacturers and importers must pay a 2.3 percent tax on the sale of any taxable medical device to raise $29 billion over 10 years. An annual fee for health insurers is expected to raise more than $100 billion over 10 years, while a fee for brand name drugs will bring in another $34 billion.

Those fees will likely be passed onto consumers in the form of higher premiums.

In our opinion, being in the insurance industry for over 30 years, we feel very sure people under 30 will pay more after 2014 than what they would pay right now for the same plan.  People over 55 will pay a little less than what they might pay now.  Overall, premiums are going to go up for everyone we estimate 12%-20% across the board maybe more, sadly we do not feel they will be going down at all because of the reform.

Other parts of the law now in place:

You are likely to be eligible for preventive services with no out-of-pocket costs, such as breast cancer screenings and cholesterol tests.   Health plans can’t cancel your coverage once you get sick – a practice known as “rescission” – unless you committed fraud when you applied for coverage.

Children cannot be denied coverage even if they have pre-existing conditions, however the companies can rate up for that condition; some up to 800% of the premiums.  FYI – This has adversely cause the companies to stop offering child-only policies.  This will apply to adults in 2014.

Insurers will have to provide rebates to consumers if they spend less than 80 to 85 percent of premium dollars on medical care.  You may have already gotten some money back from the insurance company on your policy and wondered what it was for.

Some existing plans, if they haven’t changed significantly since passage of the law, do not have to abide by certain parts of the law. For example, these “grandfathered” plans can still charge beneficiaries part of the cost of preventive services.

If you’re currently in one of these plans, and your employer makes significant changes, such as raising your out-of-pocket costs, the plan would then have to abide by all aspects of the health law.

The law has already hit some obstacles:

For example, the law created high-risk insurance pool (PCIP) to help people purchase health insurance. But enrollment in the pool has been less than expected. As of Aug. 31, 86,072 people had signed up for the high-risk pools, but the program, which began in June 2010, was initially expected to enroll between 200,000 and  400,000 people. The cost and the requirements have been difficult for some to meet.   Applicants must be uninsured for six months because of a pre-existing medical condition before they can join a pool. And because participants are sicker than the general population, the premiums are higher.  (What does this tell you?  If in 2014 nobody can be declined by an insurance company, then wouldn’t insurance be more expensive?)

Enrollment has increased since the summer, after the premiums were lowered in some states by as much as 40 percent and some states stepped up advertising.

As always visit our blog, subscribe to our newsletter, become a fan, however you wish … stay up to speed on the HealthCare Reform with us.  We will make sure we keep you up-to-date with the most accurate information we have.

If you need a health quote go to www.FreedomFreeQuote.com
If you need a medicare supplement quote go to www.eMedigap411.com
If you need life insurance go to www.HelpMeBuyLifeInsurance.com

Or just call us 877-740-8683 we will be happy to help you!