TIPS TO HELP IDENTIFY YOUR NEEDS IN INSURANCE: For Long Term

Here are 8 tips and suggestions intended to help you identify the best choice for your exact needs and situation.

1. "Pre-Existing Condition" - Look at the Plan Wording Carefully.

Virtually all private-sector health insurance plans exclude coverage for "pre-existing conditions." A small difference in the wording can make a big difference in whether or not a medical insurance claim is actually paid . . . or not paid.

Here are two examples for illustration purposes:

1. Pre-existing condition: "Any condition which existed at or prior to the date the policy went into effect."

2. Pre-existing condition: "Any condition which was diagnosed, treated, or manifested itself in such a way as to exhibit recognizable symptoms, prior to the date that the policy went into effect."

Note that in example #1, the definition is very ambiguous. In this example, you could have a "pre-existing condition" and not even be aware of it. Examples might include slow growth cancer such as colon cancer. Another example might be any type of heart disease, which often goes undetected for years.

If you happened to have a health insurance policy with such ambiguous wording and came down with a major illness, you could be in trouble. If doctors determined that your illness existed in any form at the time your policy went into effect, even if you didn't have any noticeable symptoms, your claim would be denied.

Important: If you are over age 40, I strongly recommend that you avoid any insurance policy which contains an ambiguous definition of "pre-existing condition" as described in example #1 above. Even if you are under age 40, this may be a good idea as well.

2. A Recent Routine Check-Up Is Recommended For Ages 40+

For people over age 40, if you are in good health, then having your good health documented prior to becoming insured (or soon thereafter) could be of great value in the event of a significant medical claim later.

This documentation could be in the form of a recent routine physical exam. Or, it might be the records of one or more recent visits to a family doctor (for a cold or flu for example), where your doctor would have gathered routine medical information such as height, weight, blood pressure, etc.

If you do not have any such documentation of good health, then we recommend that you have a routine physical exam before, or soon after your insurance goes into effect.

Unless you are over age 60, having recent documentation of good health is usually not a requirement when you apply for most insurance plans. We make this recommendation because we work for you and in our experience, claims disputes are not uncommon. In the event of a dispute, your having recent documentation of good health helps us to help you.

While we strongly recommend this for people over age 40, we also believe that having recent documentation of good health is a good idea for everyone.

3. Who Regulates Your International Insurance Company?

In the USA, health insurance is primarily regulated by the individual States. If you are a USA resident traveling abroad or a visitor to the USA, we strongly recommend that you seek out insurance from companies that are registered (either "admitted" or "approved") to legally conduct business in your State.

Here is a brief look at two ways an insurance company might be registered to legally conduct business in your State. (The exact terminology may differ from State to State.)

"Admitted" - The insurance company is fully regulated under your State's "life and health" insurance laws.

"Approved" - The insurance company operates under "surplus lines" insurance laws and is not fully regulated. However, if the State obtains credible evidence of unsatisfactory claims practices or unsatisfactory financial condition, then the State may revoke the "certificate of authority" under which the insurance company legally operates in that State. Such action could influence or encourage similar action in other US States and even in other countries.

Note: We avoid insurance plans from companies that are not registered. All plans found here are backed by insurance companies which are either "admitted" or "approved" where offered.

4. When Comparing Health Insurance Plans, Check The "Exclusions."

One of the first things that experienced insurance agents look for in a health insurance brochure is the summary or list of "exclusions." Often found in smaller print, "exclusions" are not covered under the plan. Sometimes, what's NOT covered can be just as important as what IS covered.

Many exclusions are typical (i.e. acts of war, self-inflicted injuries, custodial care, etc.), while others are not and should be carefully considered when comparing health plans.

All comprehensive international insurance plans contain an exclusion for "pre-existing" medical conditions. You should carefully read and understand this exclusion.

5. The Health Questionnaire - "Medical Underwriting"

Long-Term, Annual-Renewable or "Permanent" medical plans are designed to provide comprehensive health insurance coverage for at least one year or longer. These plans are issued based on "medical underwriting" through the use of a detailed health questionnaire.

Personal medical history could be a determining factor when selecting a company to apply for insurance. Based on personal medical history, some people could be declined for insurance by one company, but accepted (or accepted with a medical "exclusion rider") by a different company.

Note: For the plans found here, if your health questionnaire is answered truthfully and accurately, and you are accepted for coverage, you cannot be cancelled or singled-out for future rate increases due to medical claims.

6. Activate Your Best Memory When Completing The Health Questionnaire.

It is important to remember that by nature, the human mind tends to forget or minimize past or present illness. A positive mental attitude can beneficial in the healing process, but failing to properly disclose a material health condition on your insurance application could jeopardize your coverage entirely.

A "medical audit" (obtaining prior medical records, researching medical information bureaus, etc.) is often done when there is a major claim. By contract, the insurance company can revoke coverage and return all premium if it can be shown that the policyholder failed to disclose a material condition on the application.

Never give the insurance company a potential way out of paying a major claim. Activate your best memory when completing the health questionnaire.

7. For A "Yes" Answer on Your Health Questionnaire - Note The Positives.

For every "yes" answer on your health questionnaire, be sure to give a clear and complete explanation.

Your completed health questionnaire becomes a part of your insurance contract, so it is important to be complete and truthful when answering all questions. When applicable, be sure to state the positives when giving an explanation to any "yes" answer.

If you have a condition that is well controlled by medication, give complete details. For example: thyroid, take 5mg (medication) daily, well controlled for (x) years.

If a previous medical outcome was good, clearly state so in writing. When appropriate, consider descriptive terms such as "full recovery," "no further symptoms," and "no further treatment or consultation required."

8. Lower Your Premium By Electing A Higher Deductible.

The "deductible" is the amount you pay in eligible expenses before your insurance begins to pay. Most plans offer a choice of deductibles, such as $250, $500, $1000, etc. Today, most plan deductibles are cumulative, i.e. one deductible per policy period (up to one year), rather than a separate deductible "per incident."

There are 2 reasons why we normally recommend that you elect a higher deductible.

1. A higher deducible lowers your premium. For long-term plans on average, the savings often exceed 10% on the next higher deductible option.

2. In the event of a medical claim, insurance companies often request copies of prior medical records. This is to show that your claim is not the result of, nor related in any way to a "pre-existing" medical condition. In the event of one or two small dollar-amount claims, the need to provide prior medical records may not be worth your time and effort.

Remember, health insurance is primarily for the big expenses. Consider saving money by electing the highest deductible with which you feel