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Frequently Asked Questions on Individual Health Insurance

Below are some answers to frequently asked questions, to assist you in making informed decisions in individual and family health insurance.

•             Is it true of false that the health insurance exchanges soon to be introduced be cheaper than my options now? The answer to this is uncertain for now because of many factors that have to be considered. For example, we are yet to define whether the health exchanges will allow all the insurance carriers to participate or they will opt for insurance plans that will meet a certain criteria. Also, factors like the number of people willing to take up such insurance, the market trends at the time the exchanges start operating, whether insurers will want in on the action and many more, will affect the health insurance prices and the extent, is just a matter of anticipation.

•             What is a network in relation to health insurance? In the medical and health sector, a network is defined as a list of hospitals, clinics, pharmacies, doctors, surgeons, medical specialists and all medical product and services providers that have made agreements with health insurance carriers to give health care services for their clients. They have a pre-defined agreement which is usually lower than the actual amount paid by other patients. This will save you, and your insurer much needed money. Using the services of facilities or specialists outside the network will be costly and even if your insurer pays for part of the expense, it will still be quite expensive for you.

•             Can my Individual or family health insurance policy last for a lifetime? Terms and conditions vary from policy to policy including the renewal of insurance coverage. There are guaranteed renewable policies which can be owned forever on some conditions. The primary one is your ability to pay for the premiums on time regardless whether the insurer adjusts the premium upwards. However, on some instances, the insurer can end the insurance coverage if you resign from your job while you were in a group health plan.

•             How affordable is health insurance if I have a pre-existing condition? It is astonishing to see how people have come to treat the issue of getting health insurance coverage if you have a pre-existing condition. It has been made an issue so stigmatized that individuals with pre-existing conditions don’t care to find out what the options are. The answer is straightforward – it is available and it is affordable. If you are unable to get such insurance due to low income, then the government will take care of you under the Affordable Care Act. Individuals who are old enough can qualify for Medicaid and have state-funded insurance without discrimination by pre-existing conditions. The law in some states e.g. Maryland has prohibited denial of health insurance coverage on the grounds of pre-existing conditions.

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