health insurance

College Student Health Plans

By the time your children toss their high school graduation caps into the air, they'll probably have already secured the college they will attend, their dorm room, and have their freshman year courses all picked out…But is their health insurance as securely in place as the rest of these issues?

Many times, a parent's medical plan will cover their children until they're 24 years old. If your health insurance plan does not cover college students, it would be beneficial to look into what college health plans are offered at your child's university.

College health insurance plans may be subsidized by tuition at some schools, though not subsidized by the student's spouses or dependents, and may ultimately save parents money. College health insurance plans are not free, and the benefits may vary from college to college. Health insurance companies meet with committees from different schools to design a plan, specifically tailored to that school's students. At times, the health insurance plans may limit preventative care, but free services may be offered at the health center.

On the average, there's no charge for office visits, but students may be charged for lab work, x-rays, physical therapy, prescriptions, and procedures such as treatment for a wound. Other services that may be covered include mental health, well-child care, newborn and infant care, routine pap and pelvic exams, routine AIDS/STD testing, as well as cholesterol screenings. Typically, benefits will pay 100% for covered services at the college health center, but for coverage outside, a deductible may be required and coverage could drop to 70%.

It should be noted that premiums and benefits vary from college to college, due to state laws and marketing factors.

Pre-existing conditions can create problems
In some states, health insurance companies can exclude pre-existing conditions from treatment. This is called "blanket disability." For example, under this law, health insurance companies won't cover asthma or any other pre-existing conditions that your college student may have. This is possible even if the state won't allow the exclusion on "group disability" products.

Many HMOs require referrals for visits to out-of-network providers. If your child chooses a college out of state, and you want them to get prompt medical care without having to call home for a physician's referral, it would be a good idea to consider the college health plan offered by their school.

Things to consider when evaluating a college health insurance policy Several factors can make a crucial difference in timely care. Be sure to find out:

• Can the student use any provider, or is the plan an HMO?
• Is prior approval required for emergency room visits?
• In the event of an emergency, what steps need to be taken?
• If the student is on vacation, what kind of coverage do they have?
• If the student is not enrolled in classes (during summer or winter break) do they still have health insurance coverage?
• Are the most efficient treatment facilities at the college easily accessible?
• What are the low-cost or free services that are offered through the campus health clinic?
• Are any pre-existing conditions included?

If you are interested in getting a health insurance quote for your college bound student, log on to Insurance.com. Here you will be able to evaluate multiple rates from best-in-class health insurance providers - helping find the best health insurance coverage for your freshman.

Long-Term Care: Choices and Options

As you grow older, you may be concerned about your housing options. Will you be able to take care of the family home, mow the grass, and rake the leaves? Will you be able to take care of your own personal needs, cook your meals, and bathe yourself? If you think you might need long-term personal care in the future, now's the time to consider your options.

In-home Care
If you need personal or health-care assistance but want to remain as independent as possible, you might consider in-home care as an alternative to nursing homes or other facilities. In-home care may include health care (nursing services), household help (homemaker services), and personal care (companion or caretaker services). You can obtain these services by hiring private individuals or contracting with a home health agency, such as the local Visiting Nurse Association. Such agencies, if they are certified, comply with Medicare and Medicaid regulations.

Continuing care retirement communities
A form of assisted living, continuing care retirement communities (CCRCs) are also known as life care communities. They offer you housing, meals, social activities, and health care ranging from minimal personal assistance to skilled nursing care. Such communities may be ideal for you if you are in good health but are worried that you may need such care in the future.

In exchange for a one-time entrance fee (which can range from $50,000 to over $300,000) and a monthly maintenance fee ($800 to over $4,000), you're guaranteed that the CCRC will provide you with housing and nursing home care for the rest of your life. Depending on your contract with the facility, the CCRC may keep your entrance fee and then assign your apartment to someone else when you die.

Make sure the CCRC offers you the level of health-care coverage that you feel you may need, and find out if the cost of that coverage is included in your basic contract or is an additional expense. You should also find out how much say you have in decisions such as determining when you must leave your apartment and move into the nursing home portion of the facility.

If you choose a CCRC as a long-term care option, be sure to read the fine print of the contract. Make sure you understand the entrance and maintenance fee requirements. You'll also want to be aware of any additional requirements that the contract might impose on you. In some cases, you may have to purchase additional insurance to cover your short-term or long-term health-care costs. Because this is a long-term commitment, you need to check the financial stability of the facility and the company that operates it. For assistance, contact the Continuing Care Accreditation Commission.

Nursing homes
Generally speaking, nursing homes take care of you when you cannot care for yourself. Such care may be short-term while you recover from an illness or injury, or long-term because either physical or mental incapacitation makes it impossible for you to care for yourself. Nursing homes offer round-the-clock medical care. This care may be:

• Skilled nursing care, which is ordered by a doctor and provided by qualified personnel such as registered nurses or professional therapists. Such care is designed to treat a medical condition from which you're expected to recover.
• Intermediate care or nursing and rehabilitative assistance provided as you need it by qualified medical personnel under a doctor's supervision.
• Custodial care or assistance with personal needs such as bathing, eating, or dressing. Such care is performed under a doctor's supervision but is provided by personnel without professional medical training.

If you're thinking of entering a nursing home, you'll have many factors to consider. If you'll need medical care (or think you might), find out if the nursing home provides the level of care you'll need. Beyond that, consider whether the facility itself is clean and well maintained, the environment is one that stimulates you, and the staff members are people whom you trust and enjoy. Take a family member or friend with you to visit the nursing home and ask for his or her honest opinion. If a nursing home is to be your home, you want it to be a place where you can feel at home. For more assistance with this search, contact your state department of elder services.

Paying for it
The choice you make from among these options may depend in part on what you can afford. Nursing homes typically charge a fixed daily rate, and the cost can vary widely, depending on the care you receive and the geographic location of the facility. You can pay the bill with private funds, the proceeds from long-term care insurance, or (if you're eligible) government assistance from Medicaid.

In most cases, you'll have to pay for a CCRC or other assisted-living option, either with your own funds or with the proceeds of a long-term care insurance policy. Medicare covers only your health-care-related expenses, and only at facilities licensed to provide medical care.

Under certain conditions, Medicare covers short-term in-home health care that's medically necessary. Most long-term care insurance policies now also cover in-home care. In many cases, you might elect to pay for in-home health care with your own funds; be aware that you may be able to deduct the expense on your tax returns.

Although long-term care isn't a topic most people are eager to consider, don't put off doing so until the last moment. The longer you wait to make a plan, the more likely you won't be able to afford one.

Why You Need Disability Insurance

Typically, people buy property and casualty insurance to protect their possessions (houses, cars, and furniture) and life insurance to provide income for their survivors. However, many people don't think about protecting their income with disability insurance. But how well could you live if you weren't able to work? Disability is an unpredictable event, and if you become disabled, your ability to make a living could be restricted. Although you may have enough money in the bank to meet your short-term needs, what would happen if you were unable to work for months, or even years? The real value of disability insurance lies in its ability to protect you over the long haul.

A look at the odds
Statistically, your risk of being disabled is great. In a given year, the following events occur with the following frequency:

Event	Frequency
Home fire	1 out of every 88 homes
Serious auto accident	1 out of every 70 autos
Death	1 out of every 106 people
Disability	1 out of every 8 people

A further look at disability statistics reveals the following:

• A 30-year-old man has a one in five chance of suffering a long-term disability before his planned retirement.
• A 30-year-old woman has a one in three chance of suffering a long-term disability before her planned retirement.
• Roughly 50 percent of people who suffer disabilities lasting longer than six months remain disabled after five years.
• Heart disease and back problems are the two most common causes of disability.
• More people lose their homes through disability than through fire or death.
• One in seven employees will be disabled for five years or more before retirement

As these statistics show, your chances of being disabled for longer than three months are much greater than your chances of dying prematurely. One reason for this is that medicine has found ways of treating many illnesses and injuries that previously would have been fatal. Although this is good news, it increases your need to protect your income with disability insurance.

Of course, statistics can be misleading. You might never become disabled, especially if you're healthy and work in a low-risk occupation. But then again, how many people do you know who have had cancer or have suffered a heart attack? How many of your friends and family members have been in car accidents or have had back problems? Illness, as well as injury, is disabling. If you were hurt or got sick, how would you support yourself or your family?

What would happen if you became disabled?
What would happen if you suffered an injury or illness and couldn't work for days, months, or even years? If you're single, you may have no other means of support. If you're married, you may be able to rely on your spouse for income, but you probably also have many financial obligations, such as supporting your children and paying your mortgage. Could your spouse really support you and your family? In addition, remember that you don't have to be working in a hazardous occupation to need disability insurance; accidents happen not only on the job but also at home, and illness can strike anyone. For these reasons, everyone who works and earns a living should consider purchasing disability insurance.

But isn't disability coverage through an employer or the government enough?
You might think that you are adequately insured against disability because you have coverage through your employer or through government programs such as Social Security and workers' compensation. However, only 50 percent of employers cover short-term disability, and only 40 percent cover long-term disability. Government programs may pay you benefits, but only if you meet a strict definition of disability. Here's an idea of the benefits you may already have, as well as their limitations:

• Social Security
  Although you shouldn't overlook the disability benefits you may be eligible to receive from Social Security, you shouldn't rely on them either. Social Security denies more than 50 percent of the claims submitted, in part due to its strict definition of disability. Even if you are deemed eligible for benefits, you still won't begin receiving them until at least six months after you become disabled because Social Security imposes a waiting period. In addition, your benefit may replace only a fraction of your pre-disability income.
  
• Workers' compensation
  If you're injured at work or get sick from job-related causes, you may receive some disability benefits from workers' compensation insurance. How much you receive depends on the state you live in. However, when you review your disability insurance needs, remember that workers' compensation only pays benefits if your disability is work-related, so it offers only limited disability protection. Some states also cover only the diseases or disabilities outlined in that state's workers' compensation laws.
  
• Pension plans
  Some government and private pension plans pay disability benefits. Often these plans pay benefits based on total, permanent disability, or reduce your retirement benefit in proportion to what you have already received for a disability. In addition, remember that these benefits are usually integrated with Social Security or workers' compensation, so your benefit may be less than you expect if you also receive disability income from these government sources.

Short-Term Health Insurance

You've just graduated from college or moved out on your own, and you're no longer covered under your parents' health insurance plan. Or perhaps you've flown the coop on your cubicle job and you're looking for the next big thing. Maybe you've found a new job, but your new employer's group health insurance plan won't kick in until you've been with the company for three months. These are good reasons to look into short-term health insurance if it's available in your state.

What's in a name . . .
As the name implies, short-term health insurance typically offers coverage for 30 to 180 days, although some plans will cover you initially for up to 12 months. If your short-term need runs longer than the coverage, you may be able to renew the plan, but don't count on anything beyond a year.

Most short-term plans will cover you in the event of an accident or a sudden illness. As you might expect with almost any health insurance plan, short-term plans may have benefit limits, and you'll be required to cover an initial deductible and to make co-payments. You'll be allowed to pick your own doctors, hospitals, or other health-care providers. You'll get coverage for inpatient and outpatient services, hospital room (including intensive care unit) and board charges, lab examinations, and X rays. These plans rarely require a physical exam, and coverage often begins as soon as the insurer receives your application and first premium payment. Applications may be mailed in or submitted over the Internet, and payments may be made by check or credit card. Check with the provider for complete information on coverage and the application process.

. . . And what's not
To keep the premiums down, short-term health insurance plans don't offer all of the benefits of permanent plans. Most won't cover treatment of a pre-existing condition (i.e. an illness or injury that has produced signs or symptoms, or for which you've received treatment, in the past five years). In addition, these plans don't cover routine medical exams, preventive care, dental or optical care, or pregnancy and childbirth expenses.

Short-term health insurance policies are exempt from the Health Insurance Portability and Accountability Act of 1996. Insurance carriers issuing these policies don't have to guarantee their renewability, and most don't. They also don't have to waive any pre-existing condition limitations for individuals otherwise eligible for those waivers.

But despite their limitations, short-term health insurance plans can help you fill the gaps in your health insurance coverage. And that's just what the doctor ordered!