1. If your employer offers health insurance, find out how much it will cost per month to add your new baby to your employers plan. If you only have one or two children, you may be able to save money by purchasing an individual health insurance policy.  Unlike your employer’s plan these plans can be customized to fit your family’s needs and budget.  You can purchase a very good plan for a healthy baby for around $125.
2. If you decide that and individual plan is best for your baby you should apply for coverage just as soon as possible after birth.   This will help ensure that your baby is protected and that you receive the best possible rate.
3. Look for plans that have a low copay.   Newborn babies require numerous  doctor visits so it may be wise to have a higher premium in exchange for a lower copay during the first couple of years.
4. Before you buy a policy on your baby make sure that the insurance company has an adequate network in your area.  Most companies have a search tool that allows you to search to determine that your doctor and local hospital are part of their “in network” services.
5. All health insurance rates are regulated by the NC Department of Insurance so you will get the same price for a specific policy no matter where  you buy from it.  By working with a broker like us, you get personal service and an experienced team who understand the needs of new and expecting parents.  Click here to request a quote today or call us at 866-788-9591.

1. Confirm that the delivery and new baby care are covered.
2. Verify that well-baby visits, check ups and immunizations are covered.
3. If you have a preference for a physician for your child, whether it be a pediatrician, family practice physician or other type of physician, make sure that this physician is part of your health plan’s network (if HMO, PPO or POS).
4. Verify the coverage of a specialist in case one is needed.

When your new baby is born, make sure you add your child to your health plan within the first 30 days of birth (check with your health plan to confirm the number of days you have to do this.)  Usually, a health plan may cover the care of a new baby for the first days of their life, usually 30 days, but will deny coverage after this period unless the parents add the child to the plan.  There have been instances when parents forgot to add their child to their plan or they assumed that their child would be automatically added to their plan, and then, unfortunately found out that there was no coverage for their child.

If you would like to receive a health insurance quote for your baby click here.

A Suze Orman exclusive

Look, I know we’ve gotten ourselves into a horrible national crisis here, and a great many Americans are going without health insurance coverage because of the cost or are being forced to cough up more of their own money to pay for coverage previously offered as an employee benefit.

But folks, this is one area where you simply can’t afford to be underinsured if there’s any way at all you can help it. Remember, insurance is all about planning for the worst (which, of course, doesn’t prevent you from also hoping for the best). And if you or anyone in your family were to ever develop a severe illness, you would want to make sure you could afford the best care for them.

So please, if you don’t currently have any coverage, make this your main financial priority as of this moment. If you are a recent college grad who has yet to start work or are unemployed without coverage, you can buy short-term policies that will cover you for up to six months or so. (A great tip for college seniors: If you don’t have coverage or are currently covered by your parents’ insurance, buy a health plan of your own while you are still in school—one that will allow you to continue with the policy after graduation. Student policies are often a great deal, and being able to extend your coverage past your school years gives you plenty of flexibility while you job hunt.)

A key tactic for keeping your premium down is to choose a plan with a high deductible. Stick with me for a sec and you’ll see the wisdom of this. A low deductible, say one of just $500 a year, can actually end up costing you more than one with a $2,000 deductible. That’s because the lower the deductible, the higher the premium. Moreover, when you have a low deductible and make a ton of claims, your insurer might get ornery and jack up your premium when your policy comes up for renewal.

That’s why the smarter thing to do—if you are generally healthy—is to choose a policy with the highest deductible you can afford. Since your deductible is the annual out-of-pocket money you are required to kick in before your insurer covers your health costs, base your choice on what you can afford to pay out from either an emergency cash fund or a low-rate credit card with a line of credit you intend to tap only for emergencies.

If you are totally strapped for money, at least get a policy that provides you with catastrophic coverage. The annual premium can be a lot lower since these policies basically only kick in after you meet a sizeable deductible of $5,000 or more. The idea here is that you are healthy enough so that you don’t expect to need to use the policy for routine health care costs. At the same time, you’ll have the peace of mind of knowing that if you become severely ill you (or your family) will not have to pay monstrous health care bills out-of-pocket.

1 – Is the policy guaranteed renewable? Some smaller health insurance companies can choose not to renew your policy if your child were to become ill.    This is how they can afford to offer extremely low rates.  As with anything else – you get what you pay for.   Make sure you read the fine print.

2 – Check the network of doctors and hospitals. Make sure the company you buy from has doctors and hospitals in your area.  You may also want to ask your current doctor what companies they accept.

3 – Buy from a broker when possible. Health insurance agents can be valuable in helping you determine what kind of plan you need.  More importantly – they are there to assist you should you have trouble with a claim or payment.   Since the premium rates are set by the state – their expertise is available at no cost to you.   They are your advocate and work for your best interest.

Why do I need health care insurance and what are its limitations?

Health insurance helps protect you against high medical costs that could arise if you get sick or experience an accident. Though you may not be sick now, paying for health insurance protects you later if you or a member of your family get sick. There is no way to completely predict who will get sick, when they will need care, and how much that care will cost. Health insurance works by pooling large numbers of people together and then spreading the risk for high costs among everyone. That way, if you pay some money now, you can get benefits later if you need them.

Of course, health insurance can have major limitations. Most policies cover a defined range of treatments, tests, and doctors’ visits. If you need a treatment or drug that is not covered, you could pay for it yourself. Most insurance also charges you more than just the premium. For example, you are likely to be required to pay copayments (fixed per-visit or per-prescription costs), deductibles (dollar thresholds you must pay before coverage kicks in), or other payments.

Policies may also limit the amount of covered care you can receive, the number of times you can go to a doctor in a year, or the total dollar amount for care. They may require you to pay a large portion of costs even after you’ve paid your premiums.

What is a health maintenance organization (HMO)?

An HMO is the type of insurance that often has the lowest out-of-pocket costs to you, the patient. You may pay a small deductible along with copays for visiting the doctor or filling a prescription. HMOs keep costs lower by limiting the network of health providers you can see. Generally you must stick to the primary care physicians and specialists in the closed network. That means if a particular doctor is not in the HMO’s network, you may have to pay extra to see him or her, or not be allowed to use their services at all.

What is a preferred provider organization (PPO)?

A preferred provider organization has a network like an HMO, but you are allowed to go outside the network if you pay higher fees. Out-of-pocket costs of the insurance are usually greater because of this expanded choice. PPOs offer a lot of choice of doctors and hospitals, but they usually cost you more.

What is a point-of-service plan (POS)?

A point-of-service plan combines an HMO-like network with the freedom to see any doctor outside the network. If you stay inside the network, you pay regular HMO copays and co-insurance (Paying a certain percentage of costs up to a capped level). If you go outside the network, you likely won’t have any co-insurance, but you will have a higher deductible. For instance, you could be required to pay the first $1,000 for any care you receive, in addition to your premiums.

What is an indemnity plan?

An indemnity plan has no provider network. Instead it pays for care regardless of which hospital or doctor you go to. There is a lot of freedom with an indemnity plan, but because there are no closed networks, it is harder for the insurance company to negotiate to control costs. That means that premiums and deductibles may be very high, to help the plan cover high health care costs if you get sick.

What is a health savings account?

Health savings accounts are accounts that allow you to save a certain amount of money tax-free as long as you spend it on health costs. Current law limits yearly HSA contributions to $2,650 for individuals and $5,250 for families. HSAs are used in conjunction with low-premium, high-deductible plans that cost less up-front but require you to spend more of your own money if you need care. Employers may also contribute to these accounts.

What is a flexible spending account?

A flexible spending account may be set up by your employer to help cover medical expenses. The account allows an employee to deduct a set amount of money from their paycheck, tax-free, that can be set aside to pay for medical costs such as out-of-pocket costs or uncovered care. Employers may also contribute to these accounts.

Companies may place a limit on how much money can be set aside in such an account. In addition, the employee will lose the money if they don’t spend it by the end of the year.

How can I protect my private medical information?

Most doctors, nurses, clinics, hospitals, health plans, and insurers are required to follow the rules of the Health Insurance Portability and Accountability Act. That law gives you the right to:
o Ask to see your health records
o Have corrections added to your records
o Receive notice that tells you how your health information can be used or shared
o Decide if you want to give your permission BEFORE your health information is used or shared for certain purposes like marketing.
o Get a report on when and why your health information was shared
o File a complaint with your health insurer, health provider, or the federal government if you feel your privacy rights were violated

What is the difference between group and individual insurance?

Group insurance is typically offered through an employer. It insures a group of people, i.e., the company’s employees, all together. Individual insurance is what you buy if you are self-employed or if you choose not to take insurance through your job. Individual insurance is almost always more expensive because you don’t have the advantage of collective buying or negotiating with the insurance company. But one advantage of individual insurance is that you may deduct your premiums from your taxes.

What is a pre-existing condition? How does it affect my current insurance?

A pre-existing condition is a medical condition, such as diabetes, that you already have when applying for new insurance. Insurance plans may try to exclude coverage of your pre-existing condition before insuring you. But generally they may not exclude illnesses that occur after insurance starts. Usually you take a physical at the start of a new policy so that the plan can determine if you have any pre-existing conditions.
How does it affect getting a new insurance policy?

As stated above, insurance plans may try to exclude coverage for pre-existing conditions before insuring you. They may offer insurance only at a higher cost in the form of deductibles, copayments, and coinsurance, or they may choose not to offer you coverage at all.

What is the Health Insurance Portability and Accountability Act (HIPAA) and its impact on my having insurance?

Passed in 1996, HIPAA is designed to protect health insurance coverage for workers and their families when they change or lose their jobs. HIPAA prevents group health insurance plans from singling any one person out for higher premiums based on age, sex, health status, or other factors. HIPAA also limits how plans can exclude covering you for pre-existing conditions. In effect, HIPAA lets you “carry over” coverage of a pre-existing condition to a new insurance policy if you had roughly equal coverage before.

Why should I worry about a “coverage gap,” not having insurance for 63 days or more?

The “carry over” of coverage mentioned above only applies if your previous coverage ended less than 63 days before your new coverage begins. That means that for your new plan to cover a pre-existing condition, or limit exclusions for a pre-existing condition based on previous coverage, that coverage must have ended no more than 63 days ago. That’s why you may hear 63 days quoted as a HIPAA definition of “continuous coverage.”

By Todd Zwillich
Researched by Michele Foust
WebMD Special Report Reviewed by Louise Chang, MD

NEW YORK (CNNMoney.com) — If your kid is heading off to college this Fall, make sure they have enough insurance coverage. Here’s what you need to know.

It’s a good idea to check into your child’s health coverage as they go off to college. Full-time students between the ages of 18-23 are usually covered under their parents’ health plan.

But keep in mind that some plans have younger age cutoffs. If your health plan has a network, you’ll want to scout out a doctor near where your child is going to be living. Then you’ll need a referral from your local physician.

And if your child is no longer on your plan, most colleges offer limited health insurance plans for students. And don’t forget that many colleges offer emergency health-care or infirmary hours on campus too.

Basically insurance companies reward you if you don’t drive.

Case in point: your son or daughter can get a discount on their insurance if they leave their car at home while attending school. And the school has to be at least 100 miles away.

You’ll also want to notify your insurance company that the car will be garaged in a different location. Your premium could go down depending on where the college is located.

And if you must bring your car to campus – don’t let other people drive your car. No matter who’s driving, your kid is still responsible for what happens.

If you have a kid that’ll be living on campus, chances are, your homeowners’ policy will cover most of their possessions.

In most cases, your homeowners insurance will cover about 10% of property that’s outside the home. That means if you have $75,000 worth of contents coverage at home, it will cover about $7500 worth of stuff that’s in a dorm room.

Of course, you’ll want to get in touch with your insurance company since not all insurers have this same limit. And if your kid is going to be living off-campus at an apartment, your homeowners’ policy won’t be helpful. In this case, you’ll want to look into renters insurance.

Rates run about $250 a year for contents of about $15,000 according to the Independent Insurance Agents & Brokers Association.

Get a Quote on Health Insurance for Student

By TOM MURPHY – Jul 13, 2008
Associated Press

Low health insurance caps leave patients stranded

By TOM MURPHY – Jul 13, 2008

Mary Wusterbarth thought her toddler was struggling with an ear infection when she seemed sluggish. Instead, a virus had attacked the little girl’s heart, damaging it beyond repair. Brea needed a transplant.

Within three weeks of a 2007 doctor visit, the 20-month-old had exhausted the $1 million lifetime maximum on her health insurance. Her parents have scrambled ever since for ways to cover thousands of dollars in monthly medical costs.

“We have no idea what kind of financial future we have,” said Wusterbarth, of Wake Forest, N.C. “The medical bills come almost daily. There’s never an end.”

Insurers set lifetime limits to keep rates low on some policies, but holders are learning that individual caps that seemed large quickly max out as health care costs soar. Several patient advocacy groups are prodding insurers to raise the caps, which generally don’t adjust for inflation. Congress also is considering two bills that would do that.

Only 1 percent of employer-offered group plans — the largest health insurance segment — had caps as low as $1 million last year, according to a survey by The Henry J. Kaiser Family Foundation. But 22 percent had caps of less than $2 million, and some want to see all these relatively low maximums eliminated.

Insurers, however, say most health coverage already offers either a comfortable maximum of several million dollars or unlimited coverage. They note that more government regulation could lead to higher coverage costs, and low lifetime caps help them offer a greater variety of coverages.

“I think the discussion needs to move into why do some health care services cost hundreds of thousands of dollars and what can we do to address those issues,” said Robert Zirkelbach of America’s Health Insurance Plans, a trade association representing nearly 1,300 insurers.

Kelly and Tom Treinen used to think the $1 million individual cap that came with the insurance they had for seven years offered plenty of protection. In fact, they chose that plan, which Kelly received through her job as an elementary school principal, over a higher-priced option through Tom’s business. That one offered a $5 million cap.

Then doctors diagnosed their teenage son, Michael, with an aggressive form of leukemia in May 2007. His treatment called for 10 doses of a chemotherapy drug that cost $10,000 per dose. A 56-day stay in an intensive care unit cost about $400,000.

Michael reached his $1 million lifetime maximum in less than a year. The Noblesville, Ind., family had to issue a public plea for help after a hospital told them it needed either $600,000 in certified insurance or a $500,000 deposit to continue preparing for a critical bone marrow transplant.

The Treinens raised $865,000 in six days. Money came from all over the United States and as far away as Germany. But Michael’s cancer had stopped responding to chemotherapy, and he died May 25 before he could receive the transplant.

The family had no idea how fast costs were piling up. Some initial bills didn’t arrive until months after treatment started. Then they would receive multiple mailings for each treatment, each listing a different amount — the hospital cost, the insurance discount, the amount they owed.

“When you’re dealing with constant care of your child, you’re not going home with a calculator and adding up to see where you’re at,” Kelly Treinen said.

Insurance can shield patients from the true cost of health care, said Jerry Flanagan, health care policy director for California-based Consumer Watchdog. He noted that most people have no idea how quickly $1 million “can evaporate,” unless they’ve been seriously ill before.

“You can eat through a million-dollar lifetime cap in two or three surgeries,” he said.

Low lifetime maximums are found more often in small-employer group plans, Flanagan said, noting that those businesses generally have less insurance buying power. He said employers often give their workers a choice on plans or premiums but not on lifetime maximums.

The Kaiser Family Foundation study says a greater percentage of employer-offered group plans are providing lifetime caps of at least $2 million, and the percentage that offers caps below $2 million has declined slightly.

But medical costs for employer-sponsored health plans should increase 9.9 and 9.6 percent this year and next, according to PricewaterhouseCoopers Health Research Institute.

“The nature of caps is that over time it becomes easier and easier to hit (them) because the cost of health care services keeps going up,” said Mike Thompson, a health care and employee benefits expert with the firm.

A coverage cap of $1 million in the 1970s would have had to grow to more than $10 million today to keep pace with rising costs, said Glenn Mones of the National Hemophilia Foundation.

The foundation’s vice president for public policy says he’s seen more patients approach their lifetime caps in recent years. People with hemophilia can spend more than $200,000 a year just on drugs that prevent internal bleeding.

His foundation renewed a lobbying push in Congress this year for higher lifetime caps because it sees a better political climate for one.

U.S. Rep. Anna Eshoo, D-Calif., unsuccessfully pitched a bill on lifetime caps in 1996. She will try again this summer because she sees better odds with a Democrat majority in the House of Representatives. Sen. Byron Dorgan, D-N.D., introduced a similar bill in March in the Senate.

Mary Wusterbarth, a stay-at-home mother with two other children, thinks legislation on minimum lifetime caps is an excellent idea. Her daughter, Brea, is 3 now and doing well. But family finances aren’t as healthy.

The Wusterbarths spent more than $20,000 to adopt Brea from China in 2006. Then her heart began to fail, just months after she arrived at their Louisiana home.

She qualified for Medicaid while hospitalized for the transplant, but that coverage ended once she was released. The family has since moved to North Carolina, where Brea’s father, Danny, works as an operations manager for a distribution center.

They drained their savings and spent more than $60,000 out of pocket on medical bills in the past year. Church donations have helped, and they negotiated some discounts to wind up with $50,000 in insurance coverage for Brea they hope will last the next six months.

But Danny Wusterbarth makes too much money for Brea to receive Medicaid coverage. Insurers won’t cover Brea because of the medical history, a common problem with people who reach caps.

Brea’s anti-rejection drugs run about $3,000 a month. The biopsies she needs every few months to check for rejection can cost $40,000. She’ll also need another transplant in about 10 years. Her mother isn’t sure where all the money will come from.

“We were actually told that if we would get a divorce or if he would quit his job, then she could get all the help she needed,” Wusterbarth said. “But that’s not the way we do things, so we just take it day by day.”

Children are generally dropped from their parents’ health insurance when they turn 18 or 19 or graduate from college. But 16 states now require insurers to cover dependent children on their parents’ policies until the children are in their mid-twenties — and sometimes up to age 30.

The new rules can help cover adult children who don’t have health insurance through their jobs or don’t have jobs. To qualify, grown children must be unmarried and live in the same state as their parents. But they don’t need to live with their parents or even be considered dependents for tax purposes.

This can be an attractive option for adult children who have health problems and could have trouble qualifying for affordable insurance on their own. But other young adults might be better off declining the deal. In many states, healthy people in their twenties can purchase insurance on their own for less than $100 per month.  That could be less than the cost of keeping a child on your family policy.

In most states (other than New Jersey), insurers don’t charge extra specifically to keep older children on your policy. But your rate might drop if you remove your child, especially if you’re insuring only one child and can switch from family coverage to rates for a single person or a couple. You’d have to compare the price with what it would cost for your child to purchase individual insurance.

If you still have other children on your policy, you may be able to insure older ones at no extra charge (as long as your insurer doesn’t base premiums on the number of children). That would be the best deal.

For a list of each state’s age requirements for dependent coverage, see the National Conference of State Legislatures’ Web site. Note that these laws don’t apply to employers who self-insure.

Washington Post

Get a Quote on Health Insurance for Child in NC

NEW YORK (Reuters Health) – Infants cared for by someone other than mom or dad are more apt to be exposed to “unfavorable” feeding practices and to gain more weight during their first year of life, a new study shows, which could contribute to childhood weight problems.

“Parents may want to have enough communication with child care providers about when, what and how to feed their babies during their stay in day care, which is important to avoid potential risk of overfeeding or underfeeding at home,” Dr. Juhee Kim of the University of Illinois at Urbana-Champaign, told Reuters Health.

Kim and co-investigator Dr. Karen E. Peterson of Harvard School of Public Health, Boston, analyzed data on child care arrangements, feeding practices, and weight gain collected for 8,150 infants who were 9 months old. More than half of these children received regular child care from someone other than a parent.

The researchers found that the roughly 40 percent of infants placed in child care when they were younger than 3 months of age were less likely to have been breastfed and were more likely to begin to eat solid foods earlier than infants cared for by their parents.

There is evidence from other studies to suggest that breastfeeding may lower a child’s risk of becoming overweight and that the early introduction of solid foods may increase the risk.

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