Top 10 Misconceptions in
contributed by californiainsurancefinder.com
do you think are the 10 biggest misconceptions
or misunderstood aspects in health insurance?
are the Top Ten most common misunderstood and
mistakes people either do or think as it relates
to health insurance in California.
- Insurance Carriers just don't want to pay
claims or they can pick and choose which claims
By law the carrier must pay all claims that
are filed and coded correctly or have been pre-approved.
- The insurance company raised my rates and
I didn't even have any claims.
Fact- Rates are increased based on age brackets
and zip codes. Individuals' claims histories
have no bearing on rate increases.
- Can I shop and get a better deal from different
agents or by going direct to the carriers?
price and benefits are the same via agents.
They have a wholesale relationship with the
carriers. The service they offer is non-biased
as they do not work for the insurance companies
and thus should not be "selling" one brand over
- All Health Insurance includes maternity benefits.
I do not need maternity benefits and thus I
am wasting my money with health insurance.
California there is non-maternity plans which
cover all services except maternity. These plans
are 30-40% lower in premium
- Does my co-pay apply after or before my deductible?
you see a CO-pay in your plan benefits this
equates to your deductible being waived.
- The word "COVERED".
Very few things are ever "covered" 100%. One
example that is covered in plans is a check-up.
The word coverage is more appropriate and means
that you have benefits and the insurance company
will pay part of the bill.
- I have a PPO plan and I can go to any doctor.
you can go to any doctor. However, every carrier
has a network of providers. If you stay in this
network called "in network" providers your benefits
are much better. If you go out of network you
still have coverage. However, at a lower tier.
- I have a deductible (example $750) and then
I have co-insurance of 30%: Does that mean I
pay 30% of the entire bill? That could mean
a lot of money out of my pocket.
definition all insurance plans have an out of
pocket maximum for you the subscriber. This
is also referred to as "stop loss". Once you
hit this next threshold your plans pay 100%.
9 - My Emergency CO-Pay is $100. So, I just
pay $100 to go to the ER.
The CO-pay of $100 is like your office CO-pay
of $30. This just processes you into the room.
Once the x-ray, stitches or surgery occurs to
fix what is wrong your deductible will apply.
It will cost you more than $100 to go to the
ER. One alternative to help reduce out of pocket
expense is the urgent care. These services are
typically billed as an office CO-pay and this
is a viable alternative for basic services.
- What is the difference between and HMO and
has a primary care physician that you need to
see 1st before getting a referral. A PPO plan
you can self refer. However, HMO benefits are
typically more comprehensive and offer better
covered. They lack the flexibility that a PPO
offers. The PPO plan typically have a deductible
where HMO do not have deductibles.
submitted by CaliforniaInsuranceFinder.com
At www.californiainsurancefinder.com they are
here to help. They can answer your questions
and help you find the right plan that meets
your expectations. The process of finding insurance
can and most of the time is a frustrating and
time consuming process. They offer patient and
understanding help to minimize the time you
need to spend to find the right plan. They also
have a wholesales relationship with all the
major carriers in California including Blue
Cross, Blue Shield, Aetna, Kaiser, PacifiCare,
HealthNet and others. You can also reach them
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