What Is An Agent?

Tue, 29 May 2007 21:19:00 GMT

An agent is a licensed representative of an insurance company who solicits, negotiates, or effects contracts of insurance and provides service to the policyholder for the insurer.

Are There Any Tax Benefits Associated With Long-Term Care?

Tue, 29 May 2007 21:19:00 GMT

Yes. Under the Health Insurance Portability and Accountability Act of 1996, longterm care insurance policies that meet certain requirements become eligible for federal income tax advantages. These policies became known as Qualified LongTerm Care Insurance policies. Policies purchased through the end of 1996 were grand fathered under this new law which meant they automatically qualified for taxfavored treatment. Policies purchased after 1996 must be clearly identified as qualified LongTerm Care Insurance policies having met the requirements to be considered tax qualified. Consumers who have purchased a Qualified LongTerm Care Insurance Policy may deduct premiums as a medical expense for payments made in 2000, when they file their income tax return in 2001. It is recommended you contact your personal tax advisor for complete details before filing your return.

Can My Employer Make Me Wait Before Enrolling Me In The Company's Health Plan? When Is My Employer Allowed To Take Me Off Of The Plan?

Tue, 29 May 2007 21:19:00 GMT

Insurance begins when you meet the eligibility requirements of the health insurance plan. An employersponsored plan is allowed to have a waiting period, which is the time that must pass before an employee or dependent is eligible to enroll under the terms of the plan. You also may be required to work a specified number of hours a week to be eligible for enrollment. Insurance can end whenever you cease to fulfill the eligibility requirements of your plan. Generally, insurance coverage ends on the last day of work or the end of the month in which you last worked. The conditions for beginning and ending coverage must be in writing in your plan booklet or Summary Plan description. For more information about your rights in your employer`s benefit plans you can go to the U.S. Department of labor`s Website http://www.dol.gov/dol/pwba, or call their Publication Hotline at: 18009987542.

How Much Does Long-Term Care Cost?

Tue, 29 May 2007 21:19:00 GMT

Longterm care can be expensive, depending on the amount and the type of care needed and on the setting in which it is provided. For example, a year in a nursing home costs about $45,000. Skilled nursing care provided at a person`s home costs about $20,000. Personal care provided at home by a home health aide costs about $10,000.

I Am About To Lose My Health Coverage. I Have A Serious Medical Condition And Need To Get New Insurance. Is There A Health Plan Available?

Mon, 04 Jun 2007 21:51:22 GMT

If you are unable to acquire new health coverage then you may try contacting your state insurance commissioner. Some states have created health plans to specifically address this problem.

I Believe My Health-Care Professional Provided Incompetent Services. What Can I Do?

Tue, 29 May 2007 21:19:00 GMT

To make a complaint about a health professional or hospital, call your local State Department of Health. You may also use the LawInfo.com attorney directory to locate a competent attorney in your area.

I Need Medical Care But I Don't Have Enough Money To Buy Insurance. How Do I Obtain Public Health Services?

Tue, 29 May 2007 21:19:00 GMT

Your local Department of Social and Health Services manages these services. You can usually locate your local office by looking in the blue pages of your phonebook or by running an Internet search for the department in your area.

I Want To Change Jobs. Can The New Employer's Plan Deny Me Coverage Because Of A Health Condition?

Tue, 29 May 2007 21:19:00 GMT

No. Employees or dependents cannot be denied group health insurance based on their prior medical history. You cannot lose your insurance just because you get sick, or be charged more money based on your health or past insurance claims. This is the general rule. However, many exceptions do apply in different states.

If I Change Health Insurance Plans Will I Get Credit For Time Spent On My Prior Health Plan Toward My New Plan's Pre-Existing Conditions?

Tue, 29 May 2007 21:19:00 GMT

If you have a preexisting condition when you change jobs, then your new employer`s health insurance carrier must usually credit the time you were insured under your former employer`s plan toward the new plan`s preexisting condition waiting period. However, if you had a lapse in coverage, usually of more than 90 days, the new plan may impose a preexisting waiting period without crediting prior coverage. Further, health insurance carriers may still apply benefit waiting periods for certain treatments (heart transplants, for example) for new enrollees as long as they apply to all new enrollees. These waiting periods are determined by your policy`s effective date, not the date you were diagnosed with a condition.

Is A Participating Provider In A Managed Care Plan Allowed To Charge Me Amounts Greater That The Company Allows?

Tue, 29 May 2007 21:19:00 GMT

No. Participating provider agreements prohibit the providers from collecting any amount other than those contractually agreed upon by the health plan. Provider contracts usually inform providers and facilities that willful collecting or attempting to collect an amount from a covered person may constitute a felony under state law.

My Employer Says He Doesn't Have To Comply With State Laws Because His Plan Is Self-Funded. Is My Employer Correct?

Tue, 29 May 2007 21:19:00 GMT

Yes, if your employer selffunds the plan and merely contracts with an insurance company to provide administration services only, then according to the Federal Employee Retirement Income Security Act (ERISA) the employer`s plan is likely to be exempt from many state requirements. However, you have a right to appeal any decisions of the plan. Your appeal rights in your employee benefit plan are required by ERISA. Generally you have 60 days to file an appeal of any decisions of the plan administrator. The plan then has 60 days to respond in writing to your appeal.

My Primary Care Physician Won't Refer Me To The Specialist I Need To See. What Are My Rights Under A Managed Care Plan?

Tue, 29 May 2007 21:19:00 GMT

All managed care plans must have a grievance procedure for disputes involving denials of service and for dissatisfaction with care. Your benefit booklet should describe your plan`s grievance procedure. You also have a right to go outside the plan to receive services on a selfpay basis.

Should I Buy Long-Term Care Insurance?

Tue, 29 May 2007 21:19:00 GMT

Longterm care insurance is not a smart purchase for everyone. If you have significant assets you wish to protect and income that will allow you to pay premiums without financial difficulty, longterm care insurance may be right for you. However, if you have a limited income or have trouble stretching your income to meet financial obligations, such as paying for rent, utilities, food, or medicine, you should not buy a policy. People with very limited income and assets may qualify for Medicaid`s LongTerm Care Services Program. The decision to purchase longterm care insurance will depend on your health, age, overall retirement objectives, and your income. You should discuss this purchase with a family member or financial advisor.

What Are Ancillary Services Or Special Services?

Tue, 29 May 2007 21:19:00 GMT

These are expenses in connection with hospital insurance, hospital charges other than room and board, such as xrays, drugs, laboratory fees and other ancillary charges (sometimes referred to as Ancillary Charges).

What Are Benefits?

Tue, 29 May 2007 21:19:00 GMT

Benefits are the dollar amount payable by the insurance company to the claimant, assignee, or beneficiary under the policy.

What Are Covered Expenses?

Tue, 29 May 2007 21:19:00 GMT

Covered expenses are hospital, medical and other miscellaneous health care costs incurred by the insured that entitle him or her to payment of benefits under a health insurance policy. Found most often in major medical plans, the term defines the type and amount of expense that will be considered in the calculation of benefits.

What Are Exclusions And Limitations?

Tue, 29 May 2007 21:19:00 GMT

Exclusions and limitations are medical services or benefits that will not be paid for or may be paid on a limited basis. Some examples are: experimental medical treatments, selfinflicted injuries, onthejob injuries covered by Worker`s Compensation, cosmetic surgery, eye or dental care, and services that are not medically necessary. Most policies have reduced or no benefits for mental illness or substance abuse treatment. Read your outline of coverage or benefits handbook to see what benefits your insurer will NOT pay for.

What Does It Mean To Be Medically Necessary?

Tue, 29 May 2007 21:19:00 GMT

Many insurance policies will only pay for treatment that is deemed medically necessary. For instance, many policies will not cover plastic surgery for cosmetic purposes. Ask your agent whether the company or physician determines medical necessity under the policy, and ask for examples of what is and is not considered medically necessary treatment.

What Does It Mean To Lapse?

Tue, 29 May 2007 21:19:00 GMT

A lapse is a termination of a policy upon the policyholder`s failure to pay the premium when due.

What Is A Beneficiary?

Sat, 05 Apr 2008 17:48:01 GMT

A beneficiary is the person designated or provided for by the policy terms to receive the proceeds upon the death of the insured.

What Is A Claim?

Tue, 29 May 2007 21:19:00 GMT

A claim is a demand to the insurance company for payment of benefits under the insurance contract.

What Is A Co-Insurance Or Co-Payment?

Tue, 29 May 2007 21:19:00 GMT

This is your share of the bill that must be paid after you have met the deductible amount. This is usually 20% or 30% of the costs up to a specific outofpocket amount, after which the insurer will pay 100% of covered expenses.

What Is A Co-Payment?

Tue, 29 May 2007 21:19:00 GMT

A copayment is the percentage payment that you must pay for each claim. In other words, you must share in the payment of the covered expenses up to a certain limit. The most common copayment arrangement is for the company to pay 80% and you pay 20%. Copayments usually apply to each claim filed.

What Is A Deductible?

Tue, 29 May 2007 21:19:00 GMT

A deductible is the dollar amount you pay before the insurance company begins to make payments. If your policy covers you and other family members, check to see if the deductible is a flat amount for the whole family or does each family member have to meet his/her own deductible. Usually, a higher deductible means lower premiums. But be careful that you don`t buy a policy whose deductible is so high that you can`t pay the bill if you get sick and need medical care.

What Is A Grace Period?

Tue, 29 May 2007 21:19:00 GMT

A grace period is a specified period after which a premium payment is due, during which the policyholder may make the premium payment and the health insurance continues.

What Is A Health Maintenance Organization (Hmo)?

Tue, 29 May 2007 21:19:00 GMT

An HMO is an organization system for health care that provides comprehensive services directly to enrolled members for a fixed, periodic fee.

What Is A Limited Policy?

Tue, 29 May 2007 21:19:00 GMT

A limited policy is a contract that only covers certain specified diseases or accidents.

What Is A Major Medical Policy?

Tue, 29 May 2007 21:19:00 GMT

Major medical plans provide the most comprehensive coverage for medical services either in or out of the hospital. Major medical plans require you to pay a deductible and a copayment.

What Is A Policy Term?

Tue, 29 May 2007 21:19:00 GMT

A policy term is the time period that an insurance policy provides coverage.

What Is A Policy?

Tue, 29 May 2007 21:19:00 GMT

A policy is the legal document issued by the company to the policyholder that outlines the conditions and terms of the insurance. Also called the policy contract or contract.

What Is A Pre-Existing Condition?

Tue, 29 May 2007 21:19:00 GMT

A preexisting condition is an illness or other health problem that was diagnosed or treated before the policy was issued to you. Many policies will not pay immediate benefits for claims due to preexisting conditions; some will never pay. The rules are changing, though. Ask your insurance company or agent to tell you if your policy has any preexisting exclusions.

What Is A Preferred Provider Organization (Ppo)?

Tue, 29 May 2007 21:19:00 GMT

A PPO is an arrangement where an insurance company or other carrier contracts with a group of health care providers who furnish services at lower than usual fees in return for prompt payment and a greater number of patients. Under these arrangements you may have to pay less in outofpocket expenses if you use the preferred provider.

What Is A Premium?

Tue, 29 May 2007 21:19:00 GMT

A premium is the periodic dollar amount required to keep a policy in force. Premiums are usually paid on a monthly or yearly basis.

What Is A Reasonable And Customary Charge?

Tue, 29 May 2007 21:19:00 GMT

This is a charge for health care that is consistent with the ongoing rate or charge in a certain geographical area for identical or similar services.

What Is A Waiting Or Elimination Period?

Tue, 29 May 2007 21:19:00 GMT

This refers to the length of time that you must wait before benefits under your policy begin.

What Is An Application?

Tue, 29 May 2007 21:19:00 GMT

An application is a signed statement of facts requested by the insurance company on the basis of which the company decides whether or not to issue the coverage. The application becomes part of the health insurance contract when it is attached to and made a part of the contract.

What Is An Assignment?

Tue, 29 May 2007 21:19:00 GMT

An assignment is the signed authorization by the policyholder for the insurance company to pay benefits directly to the hospital, doctor, or other provider.

What Is An Open Enrollment Period?

Tue, 29 May 2007 21:19:00 GMT

This is the stipulated time during which enrollees in a group contract must select a health plan alternative. Under federal HMO regulations, HMOs must allow at least 30 days.

What Is Cobra?

Tue, 29 May 2007 21:19:00 GMT

COBRA is a federal law that regulates group health insurance. If you lose your job and you worked for an employer who has more than 20 employees, you may be able to continue your group coverage for up to 18 or 36 months under COBRA.

What Is Conversion?

Tue, 29 May 2007 21:19:00 GMT

Some insurance companies offer their policyholders conversion privileges that allow you to convert group coverage to individual coverage without showing proof of insurability. This offer to convert from group to individual coverage is made if you are no longer eligible for group coverage. Ask your insurer or agent if your policy contains this provision.

What Is Coordination Of Benefits?

Tue, 29 May 2007 21:19:00 GMT

If both you and your spouse have health insurance, or if your dependent children are covered under other health insurance, your insurance company will probably coordinate the payment of benefits with the other insurance company. This is done so that payments from both companies are not more than the actual costs of your medical care. If your outline of coverage or benefits handbook has a section on Coordination of Benefits, read it to see how expenses will be paid when two insurance companies insure you and your family.

What Is Credit Insurance?

Tue, 29 May 2007 21:19:00 GMT

Credit life insurance pays in the event of the debtor`s death. Credit accident & health (or disability) insurance covers loan payments due while the debtor is ill or disabled. The most commonly sold credit insurance is referred to as credit life or credit accident and health (or disability) insurance. Credit life insurance may be purchased by itself or in a combination policy also providing credit accident and health (or disability) coverage. Credit accident or health (or disability) insurance is not available except in combination with credit life coverage.

Credit Life and Credit Accident & Health Insurance is frequently offered to consumers financing the purchasing of an automobile. The purchase of credit life and credit accident & health insurance is strictly optional. A lender may not refuse to give a consumer the loan simply because the consumer declines to purchase credit life and credit accident & health insurance.

What Is Evidence Of Insurability?

Tue, 29 May 2007 21:19:00 GMT

Evidence of insurability is any statement or proof of a person`s physical condition and/or other factual information affecting his or her acceptance for insurance.

What Is Hospice?

Tue, 29 May 2007 21:19:00 GMT

Hospice is a health care facility that provides medical care and support services, such as counseling, to terminally ill people and their families.

What Is Individual Health Insurance?

Tue, 29 May 2007 21:19:00 GMT

Individual health insurance is health insurance that insures you in the event that you become injured or acquire an illness. Individual health insurance is a prudent investment if you are selfemployed or work for a company that does not offer health insurance. Buying an individual policy requires careful shopping because coverage and costs vary from company to company. Most individual policies allow you to choose any doctor or hospital and pay for services on a fee for service basis. This means that the health providers receive a fee for each service such as an office visit, laboratory test, or medical procedure. When you buy an individual health insurance policy, you must usually show proof of good health to the insurance company before they will agree to insure you or your family members. Some health insurance providers even require a preacceptance health exam.

What Is Medicaid?

Tue, 29 May 2007 21:19:00 GMT

Medicaid is a joint state and federal program of public assistance to eligible people, regardless of age, whose income and resources are insufficient to pay for health care.

What Is Medicare Supplemental Insurance?

Tue, 29 May 2007 21:19:00 GMT

Medicare Supplement insurance, or Medigap, is health insurance sold by insurance companies to help fill the gaps in the original Medicare feeforservice program. Medigap insurance policies pay most, if not all of the original Medicare plan coinsurance amounts, and may provide coverage for the original plan deductibles. Medigap insurance is sold in one of ten standardized policies. The ten plan types must be labeled with the letters A through J. Some of the ten standard plans pay for services not covered by Medicare, such as outpatient prescription drugs, or emergency medical care while traveling outside the United States. All standard Medigap policies are guaranteed renewable. This means that the insurance company must allow you to renew your Medigap policy unless you do not pay the premiums.

What Is Medicare?

Tue, 29 May 2007 21:19:00 GMT

Medicare is a federal program that provides health insurance benefits for people age 65 or older or to those receiving Social Security benefits for disability, and those with end stage disease.

What Is Supplemental Insurance?

Tue, 29 May 2007 21:19:00 GMT

Supplemental insurance is a policy that provides benefits in addition to those payable under basic and major medical policies. Some examples are Medicare supplement insurance, hospital indemnity insurance and specified disease insurance.

What Is The Effective Date?

Tue, 29 May 2007 21:19:00 GMT

An effective date is the date on which the health insurance coverage begins.

Who Pays For Long-Term Care?

Tue, 29 May 2007 21:19:00 GMT

Nationally, individuals and their families pay more than half of all nursing home expenses outofpocket. Somewhat less than half are paid by state Medicaid programs. Medicaid, however, does not pay until the person has spentdown his/her money on medical expenses. Medicaid will pay for a person who has less than $1,230 in monthly income and less than $2,000 in countable resources. Medicare pays a small percentage. Medicare will pay for a limited number of days of nursing home residents who require and are placed in Skilled Nursing Facilities. Neither Medicare, Medicare supplement insurance, nor the health insurance provided by employers will pay for most longterm care expenses.

Free Auto Insurance FAQs

Wed, 25 Nov 2009 17:03:23 GMT

Free Auto Insurance FAQs

Free Home Owners Insurance FAQs

Wed, 25 Nov 2009 17:03:23 GMT

Free Home Owners Insurance FAQs

Free Life Insurance FAQs

Wed, 25 Nov 2009 17:03:23 GMT

Free Life Insurance FAQs