Health Insurance FAQs
Your annual deductible can vary significantly from one health insurance plan to another. THe higher the deductible the lower your monthly payment
In an example of 80/20, 80 is paid by the insurance company and 20 by the insured.
Copayment or Copay
Maximum Out of Pocket
Health Insurance FAQ
A monthly payment you make to have health insurance. Like a gym membership, you pay the premium each month, even if you don’t use it, or else lose coverage. If you’re fortunate enough to have employer-provided insurance, the company typically picks up part of the premium.
A predetermined rate you pay for health care services at the time of care. For example, you may have a $25 copay every time you see your primary care physician, a $10 copay for each monthly medication and a $250 copay for an emergency room visit.
The deductible is how much you pay before your health insurance starts to cover a larger portion of your bills. In general, if you have a $1,000 deductible, you must pay $1,000 for your own care out-of-pocket before your insurer starts covering a higher portion of costs. The deductible resets yearly.
Coinsurance is a percentage of a medical charge that you pay, with the rest paid by your health insurance plan, that typically applies after your deductible has been met. For example, if you have a 20% coinsurance, you pay 20% of each medical bill, and your health insurance will cover 80%.
The most you could have to pay in one year, out of pocket, for your health care before your insurance covers 100% of the bill.
How they all work together
Health insurance policies can have a variety of cost-sharing options. Some policies have low premiums and high deductibles and out-of-pocket maximum limits, while others have high monthly rates and lower deductibles and out-of-pocket limits.
In general, it works like this: You pay a monthly premium just to have health insurance. When you go to the doctor or the hospital, you pay either full cost for the services, or copays as outlined in your policy. Once the total amount you pay for services, not including copays, adds up to your deductible amount in a year, your insurer starts paying a larger chunk of your medical bills, typically 60% to 90%. The remaining percentage that you pay is called coinsurance.
You’ll continue to pay copays or coinsurance until you’ve reached the out-of-pocket maximum for your policy. At that time, your insurer will start paying 100% of your medical bills until the policy year ends or you switch insurance plans, whichever is first.
Dental Insurance FAQ
How does dental insurance work? What do I pay for?
Can I buy dental insurance without having health insurance?
What do most dental insurance plans cover?
Is there a waiting period for dental insurance once I'm covered?
What is the difference between in-network and out-of-network care?
Finally, when you stay in-network, you usually do not have to submit claims yourself. The dental office will handle the paperwork, saving you the cost of your time.
It’s a good idea to check on the number of dentists near you who are in-network before you buy a dental plan. If you already have a dentist, be sure to confirm if he or she is in-network. By choosing an in-network provider, you are making dental care more affordable for yourself.
Life Insurance FAQ
How can I determine whether I need life insurance?
What kind of things does life insurance cover?
Mortgages, College expenses for the kids, Living expenses for your family, Stay-at-home labor expenses (cooking, cleaning, etc.), Burial expenses, Loans from family members, Estate taxes that your heirs must pay for other assets
What is a beneficiary?
Your insurer will automatically disburse the death benefit if you die, but it’s still a good idea to tell any beneficiary about the policy so they will be prepared to take action should a problem arise. For this same reason, it’s also a good idea to provide the beneficiary with access to the contract.
Does a beneficiary need to do anything to receive the death benefit?
The insurer will require proof of death and a copy of the contract in order to disburse the benefit.
Is the life insurance my employer provides enough?
Life insurance is more expensive for those who are older or in poor health, so employer-offered life insurance can be a great way to obtain coverage if you can’t otherwise afford it.
Are my life insurance premiums tax-deductible?
What’s the difference between an agent and a broker?
In some cases, an agent may actually be employed by the insurance company, although there are also agents who are self-employed.
If you’re looking for details about a specific insurer’s products, an agent may be the best person to talk to. However, if you’re trying to comparison shop across multiple insurers, you may want to contact a broker.
Agents and brokers always provide their services for free and earn commissions off of the policies they sell.
What happens to the money I pay into a policy if I outlive the coverage term?
What happens if I can’t pay my policy premiums?
Mortgage Protection FAQ
Whos owns the insurance?
Owned by you. You can control what happens to your life insurance coverage.
Who determines who will get the benefits?
The lender receiving the proceeds, generally applies it to pay off the mortgage.
You decide who will be named beneficiary and receive the proceeds.
Who determines who wCan my coverage be canceled by someone other than myself?ill get the benefits?
No. Although your coverage offers mortgage protection it is not tied to a specific mortgage or need. When your mortgage is finished your coverage may remain in force, except in the event of non-payment of your life insurance premiums.
Can I continue the coverage if I change companies or move?
Yes. Coverage is portable and you can use it to cover another mortgage, if desired.
Is the benefit amount level?
Yes. Amount of benefit can remain level even though the mortgage balance reduces.
Can I apply for more coverage than the mortgage amount?
Yes. Coverage can be higher than the amount of the mortgage to cover other needs.
Can the plan be designed to build cash values?
Yes. Depending on the life insurance coverage you choose you may be able to take advantage of tax-deferred cash accumulation options.
Can my plan be customized to meet my individual needs?
Yes. Other benefits and features can often be added through optional riders.