Posts Tagged ‘Emergency’

Emergency Room Insurance Coverage – ER Policy Supplement Shopping Guide

January 4th, 2012

Emergency room insurance supplements fall into two main categories. ER plans that cover accidental bodily injuries is the first category. The second form of ER plan is a Critical Illness Insurance plan that covers emergency room related expenses for sickness and disease such as life threatening cancer, heart attacks, and stroke.

To cover bodily injuries someone can shop around for a personal accident insurance plan. Other names for this type of injury plan include 24 hour accident coverage, accident health insurance policy, accident medical expense benefit, supplemental accident coverage, and personal injury insurance supplement. These association based plans aren’t actually insurance at all. They are indemnity insurance plans which act as a form of compensation insurance.

Accidental injury indemnity’s like this are guarantee issue with no health questions or underwriting. Plans are automatic acceptance up til age 65 or so and can be used with any doctor or hospital. Plans don’t have a strict network because injury type plans are for emergencies and trauma situations. Accident policy holders can use the ER supplement at any licensed hospital, doctor, or clinic. Plans usually have a $100 to $250 USD deductible. Deductible is what you pay before accident plan pays. Accident benefits are paid per injury and each claim is treated as a separate event which is a valuable benefit. Emergency room insurance policy only pays up to the predetermined policy face value.

Here’s a list of typical personal accident insurance plan benefit levels and the lowest rates I could find online so far:

Individual – $36.00 US dollars a month for a $10,000 policy value.
Individual – $29.00 a month for a $7,500.
Individual – $24.00 a month for a $5,000.

Family – $47.00 US dollars a month for a $10,000 policy face value.
Family – $41.00 a month for a $7,500.
Family – $35.00 a month for a $5,000.

Personal injury insurance plans only cover accidental bodily injuries and no medical conditions like strokes, heart attack, and cancer. To cover these health conditions health insurance agents in the know usually suggest Critical Illness supplements.

Critical Illness plans are also called cancer and stroke insurance plans. These policies pay plan holders a lump sum cash benefit to compensate individuals upon diagnoses of heart attacks, stroke, and cancer. These cancer heart health insurance policies are also indemnitys. The following prices are from a leading critical illness plan that covers these conditions up to $10,000 in compensation.

Husband and wife plan (2 people): $48.00 US dollars each month.
Individual person coverage: $25.00 US dollars each month.

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Patients Using Emergency Rooms As a Free Clinics Are Increasing Emergency Room Wait Times

January 4th, 2012

Many consumers are surprised to find that a trip to the emergency room is much more complicated than it used to be. Across the nation, patients are finding out that they often wait for hours to be seen. They sit in the lobby for two to three hours before they can be taken to into the main body of the emergency room. Once the patient has a room, it could be several more hours before a physician sees them. The process is frustrating for patients, staff, and hospitals. There are many different factors that affect this growing trend.

Patients are using the emergency room for more than just emergencies. Many people do not carry health insurance for a variety of reasons. Thus, they do not have a regular physician that they can go see when they are sick or injured. The emergency rooms are now filled with patients who do not need emergency care. Patients know that they cannot be turned away for any reason. So they use the emergency room as their own free health care clinic. This abuse of the systems ties up valuable bed space that is designed to handle emergencies. The advent of free standing urgent care centers helps some.

Nurses, doctors, and other hospital staff are frustrated with the abuse of the system and the inability to care for those patients that have true emergencies. Medical professionals agree that an emergency is different things to different people. But, they all agree that the emergency room has become a holding place for everything from mentally ill patients to people with things as uncomplicated as a cold. These patients take up beds that should be used for heart attacks, lacerations, and things such as accident victims. Everyone gets treated, but the wait times continue to build.

» Read more: Patients Using Emergency Rooms As a Free Clinics Are Increasing Emergency Room Wait Times

Accident Health Insurance – Plan For the Emergency Room

December 22nd, 2011

Accident health insurance supplements are being used to cover upfront injury related expenses for the ER. Plans can be used to compliment an existing health insurance policy or just as a personal injury plan to pay for any unexpected ER visits or surgeries.

Many Americans are concerned with insuring the everyday mishaps like bodily injuries and emergency room coverage. Of course, insuring things like Cancer and Heart Attacks are important, but for younger adults and especially kids, emergency room visits are far more prevalent. Unfortunately, a trip to the emergency room isn’t cheap and the healing process from a serious bodily injury can be exhausting. Damaged body parts often need to be surgically corrected and the post operation Physical Therapy sessions feel like a Sylvester Stallone Rocky Movie. I’m not going to lie, the Rocky Four soundtrack got me through my Physical Therapy workouts post ACL Knee surgery.

Health insurance for the self-employed is especially complicated when it comes to emergency room visits. To qualify for a Major Medical PPO plan one must go through underwriting and medically qualify. Assuming you get approved, you’ll need to select a deductible and plan style. The most cost effective PPO policies in the individual health insurance market are the HDHP (High Deductible Health Plan) plans. Deductible is the out of pocket expense the insured has before the health insurance policy picks up the bill. PPO stands for Preferred Provider Organization and is the type of health insurance that lets you choose any doctor. Choosing any doctor isn’t necessarily true, theirs a lot of gray area with “being in network or out of network” with PPO’s.

Deductible options for individuals in the PPO market are $1,500, $2,500, $3,500, and $5,000. Typical family deductible options are $3,000, $5,000, $7,000, and $10,000. You’ll want to choose a co-insurance of 100%. Co-insurance is the shared expense between you and the insurance company after the deductible. Most people are familiar with 80/20 % co-insurance. 100% co-insurance is popular because you won’t need to understand Calculus to figure out any future hospital bills. Insurance plan picks up 100% of the bills after deductible with this option. On a side note, it’s a good idea to set up a Health Savings Account. HSA’s have some decent tax advantages and you can set up an account equivalent to the deductible amount. So a $10,000 HDHP can have a $10,000 health savings account attached to it. The yearly max contribution to the health savings account is determined by your HDHP deductible. Ask your CPA about health savings accounts if your self-employed.

Higher deductible health insurance plans have lower monthly premiums. However, with that high deductible comes risk of having to owe that deductible amount if you use the health insurance. A $5,000 dollar deductible hospital bill is one broken bone away. Guess how a lot of Americans end up paying that HDHP $5,000 deductible? You guessed it, in the emergency room from a accidental bodily injury.

Accident health insurance supplements have been doing a good job filling this ER gap for years. Other names used for this plan include personal accident insurance, emergency room insurance supplement, accident medical coverage, personal injury insurance plan, 24 hour accident coverage, and accident supplemental benefit plan. These plans are under marketed in my opinion, and most licensed health insurance agents are doing a disservice to their clients if they don’t bring it up. I say this because so many people are shelling out a lot of money each month to insurance companies, and if they actually use the insurance could be stuck with a huge deductible bill.

Opposite the PPO health insurance industry is Guarantee Issue insurance products. Emergency room insurance supplements fall into this category and are automatic approval. Online applications have zero health questions but do need social security numbers and birth dates. This type of guarantee issue accident medical expense coverage is an indemnity. Indemnity’s compensate members with a predetermined benefit amount.

Personal injury insurance plans in this category are membership based associations. The membership organization helps individuals and families in the United States gain access to discount programs and in this case, the pound for pound most practical emergency room insurance supplement I’ve seen so far.

Each association member can choose a benefit level of accident coverage to fit their monthly budget or to match the HDHP deductible. Plans cover the HDHP deductible giving high deductible health plans a virtual zero deductible effect. Remember, a lot of HDHP’s max out deductibles from ER visits due to injuries. ER plan pays injury related expenses to pay off the PPO deductible. Again, plans only cover ER related expenses due to injury and not sickness.

Members can choose a emergency room coverage level of $2,500, $5,000, $7,500, or $10,000. Accident compensation benefits pay out per injury and have no limits on use. Typically a person will have a $100 dollar deductible per covered accident. ER policy pays up to the $2,500, $5,000, $7,500, or $10,000 per accident excluding the $100 deductible. In simple terms, you’ll owe $100 dollars for any covered injury assuming the bill doesn’t exceed the policy benefit max of $2,500, $5,000, $7,500, or $10,000.

» Read more: Accident Health Insurance – Plan For the Emergency Room