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Education

I have a major gripe about writing a section on health insurance education in Florida right now.  We are only a month away from the Supreme Court decision and a few short months away from the huge election. Both of these events are likely to have a huge effect on health insurance nationwide, and in Florida.

What is unlikely to change (at least until 2014), is that all of us that go to the individual health insurance market to shop for plans, will need to go through an underwriting process and be judged on our health and prescription history. So if you have either medical issues or are financially challenged when it comes to paying premiums, East Coast Health Insurance will help turn you on to the various programs available based on your issues.

For those that are healthy enough or financially able to afford individual health insurance, the best way to go is to run a health insurance quote on our site.  Once the quote is run you will be looking at about 120 plans that you can choose from (depending on your zip code) and I am sure you will be confused by the options.

The first thing you will need to understand is how a deductible works.  I’m sure many of you already know, but for those that don’t, a deductible is the first part of a medical insurance claims that you are supposed to cover.  So for instance if you have a $10,000 medical claim and have a $2,500 deductible, you will be expected to cover the first $2,500 of the claim.  The good news is that you don’t have to come up with $2,500 deductible on the spot and can usually arrange a payment schedule with the hospital or provider. The higher the deductible the lower the premium.

So now you are looking at a bunch of plans from different companies so you will want to pick deductibles that are the same amount in order to figure out which carrier is the most competitive.  Sadly, you still have more math to do, because after the deductible there is something called coinsurance.  And unless your coinsurance is 0% or 100% (means the same thing), you have coinsurance.  Most plans offer choices of 20%, 25%, or 50% coinsurance. The higher the coinsurance the lower premium.  Coinsurance refers to the portion of the medical claim that you are expected to pay after the deductible is exhausted.  Be sure your coinsurance is defined as well.  Meaning that the coinsurance needs to end at some point!  Usually most coinsurance exhausts at a total to you of $3,000.  There are usually 2 sets of coinsurance to meet if you have a family, regardless of the amount of family members.

An example of coinsurance on a $10,000 claims would go like this; assuming 80/20 coinsurance to 3,000.

You have a $2,500 deductible so you will pay the first $2,500 of the $10k.  That leaves $7,500 at 20% to pay.  That equal $1,500. Thus on the first 10k medical claim of the year you will pay a total of $4,000.  The next time you have a claim in that calender year, you will only have to meet another $1,500 in coinsurance as you have already satisfied half of your coinsurance and 100% of your annual deductible.

Now that you understand how health insurance works, it is time to figure out which plan is the most affordable.  The first step now is to figure out if you want office visit copayments or you would sooner have the doctor visits go to your deductible which will make your plan more affordable.  You will also need to figure out if you need prescription coverage and if so, if generic coverage is enough.  Remember, the more sacrifices you make, the cheaper the plan.

So pick all the plans that have the same deductible and coinsurance and be sure that the plans either cover office visits and prescriptions or not.  Just be consistent!  Now you should be able to back into figuring out which company has the best priced plans for you and your family.  Once you figure this out, it is time to pick the plan and you are done.