Brian Gruss Licensed Insurance Planner

Know What to Look for When Buying Individual Health Insurance

Most Americans who have health insurance are covered through an employer’s plan. However, some employers do not offer health insurance coverage. If you work for one of these companies, you will need to purchase private individual health insurance.

There are certain advantages to purchasing health coverage in the private market. Instead of choosing from plans pre-selected by an employer, you decide which plan features you want, and pick a plan accordingly. For example, by choosing a plan with a higher deductible, or one that doesn’t cover certain services, you may realize a substantial premium savings each month.

Instead of having your coverage tied to a place of employment, coverage through a private health plan is yours to keep no matter where you work. A health insurer can’t drop you as long as you pay your premiums on time.

But along with these advantages come some potential disadvantages-

• Employer plans provide considerably more coverage than individual plans, even when you are paying the same premium rate. That’s because with an individual policy, a larger percentage of the premium goes to pay for such operational costs as marketing and paying claims.

• A group plan generally must insure all employees and family members, while individual plans can reject applicants who aren’t in perfect health. They can also offer plans that exclude coverage for certain pre-existing conditions.

• In most states, private health insurance plan premiums increase as you age. Initially, you can avoid these rate increases by periodically changing plans, because new rates tend to be lower than renewals. However, as you get older, it will become more difficult to find a company to insure you and individual policies will get more expensive.

If you do need to shop in the private health insurance market, you first need to find a competent insurance agent.  Determining what kind of insurance you need and how much coverage to buy are complex issues. A good agent will help you assess your situation, and work with you to find the right coverage for your specific needs. The key to a successful working relationship with an insurance agent is trust. You should be able to trust your agent’s knowledge, experience and professional judgment, and you should always feel secure that your agent is acting in your best interest. But keep in mind that trust is a two-way street: Your agent also needs to trust you to provide information that is truthful and complete.

If you are comparing several plans, you need to know what to look for before making a decision. When choosing a health plan ask your health insurance agent the following questions:

·   Will the plan cover me for the specific doctor or hospital I would like to use?

·   How does the referral system work?

·   What pre-existing conditions would affect coverage?

·   How will the plan handle care if I (or a family member) am away from home?

·   What is the plan’s monthly premium, and what deductible and coinsurance am I required to pay?

·   Are there other fees, such as copayments and any additional charges if I use providers that are out-of-network?

·   Is there a maximum amount the plan will pay over a year or a lifetime?

·   What types of benefits are specific to this plan?

The purchase of individual health insurance in the private market can seem confusing. Approach its purchase like you would that of any important item-research your options and compare prices, and get the best advice and assistance you can, in this case, the services of Brian Gruss a qualified insurance agent.

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Four Solutions to Medical Bill Problems

There’s just something a little scary about receiving a medical bill or a letter from your insurance company claiming you owe money. These tiny sheets of paper have the power to send many of us into full-on panic mode.

As soon as you receive a medical bill or explanation of benefits (EOB) from your insurance provider, do you immediately whip out your checkbook and mail in your payment? Are you terrified you’ll be turned over to a collection agency if you don’t pay the bill right away?

Not so fast! Before you cough up the cash for that medical bill or EOB, it’s important to do a little homework. Don’t simply assume that you have to pay the bill. First of all, it could be a mistake. Secondly, the doctor’s office or hospital will not send your bill to collections right away. And most importantly, if you pay the bill only to realize later that it was covered by your insurance, it can be extremely difficult to get a refund.

So, put away that checkbook and read on to learn the solutions to four common medical bill problems:

Common Problem #1:  You receive a bill for a covered service.

Let’s your medical provider sends you a bill for a service or procedure that your insurance has always covered in the past. Don’t assume your insurance provider has simply changed their coverage. More often than not, this just means that the insurance company hasn’t had a chance to pay the bill.

If you receive a bill for commonly covered service, let it sit for 30 days. This should give your insurance provider plenty of time to pay off the bill. However, if you receive another bill from the medical provider, give your insurance company a call to find out what’s going on. You should also call the medical provider to let them know that you’re working with the insurance company to make sure they pay.

Common Problem #2: You see the word “DENIED.”

You go to the doctor or dentist for a standard service that’s usually covered by your insurance company. However, a few weeks later, you receive a claim stamped with the menacing word, “DENIED” in bright red letters.

Don’t freak out because it’s probably just a mistake. The medical provider may have incorrectly coded the treatment. Call your insurance company and make sure the claim matches the actually service you received. If not, let them know what happened, and find out the proper code for your treatment. You may need to follow up with the medical provider, as well.

Common Problem #3: You have a jumbled pile of EOBs and bills and no idea what you owe.

If you have a whole mess of EOBs and medical bills, it can be difficult to figure out what goes with what and how much you need to pay. That’s why it’s important to keep all of your medical records as organized as possible. A little bit of organization could save you a whole lot of time, money and frustration down the road.

When you receive a bill from your medical provider, staple it to the coordinating EOB from your insurance company. Keep all of your bills in a folder so you can easily and quickly access them. If you call your insurance company or medical provider to discuss a particular claim, write notes on the EOB or bill to keep track of who you talked to and what you discussed.

Common Problem #4: Only a portion of your claim was paid.

Let’s say you received a standard medical treatment that’s typically covered in full by your insurer. But a few weeks later, you discover your insurance company covered only a portion of the claim. It could be a slip-up on the insurer’s end or the medical provider could have coded the treatment incorrectly. But more often than not, this happens when you go to an out-of-network provider.

If that’s the case, you’ll probably have to pay this claim. When you go to a provider that is not part of your insurer’s network, you often have to pay more out of pocket. However, if you receive this kind of bill and you’re certain you saw a network provider, give your insurance company a call. It could simply be a mistake.

Of course, this is just a handful of medical billing problems. Patients deal with these and countless other medical billing issues day in and day out. So, the next time you receive a bill or EOB in the mail, don’t panic. When in doubt, call your insurance company and/or the medical provider to discuss your concerns.

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Going Back to Work? Looking at Popular Post-Retirement Jobs

When you think about retirement, you may imagine clocking out for the final time and telling your boss to take this job and shove it. You may dream about a carefree days at the beach or on the golf course and plenty of long visits with your grandchildren. However, many of today’s seniors are envisioning an entirely different type of retirement: one that involves more work.

A growing trend in the U.S. shows that an increasing number of seniors are working well into their retirement years, taking on new jobs after their “official” retirement. Whether it’s because they need the cash or simply because they’re bored, some of these seniors are staying on the clock for many years after their 65^th birthday.

According to the U.S. Department of Labor, the number of employed Americans between the ages of 65 and 90 has skyrocketed in recent years. As a matter of fact, 6.4 percent of Americans age 75 or older (more than 1 million seniors) were still working in 2006. That was up from 4.7 percent just ten years earlier.

But what kind of jobs are these seniors taking on so late in life? Here are a few of the most popular post-retirement jobs:

The Same Ol’ Job:

Many retirees are simply staying put in the same job they’ve held for years. After all, it’s often easier to stick with what you know. Some ask their employers if they can work fewer hours and take on a smaller workload for a reduced salary. For many retirees, this option gives them the best of both worlds: they continue to earn some income, but they also win some extra time to take on new hobbies, travel and relax at home.

Consultant

Many seniors who were an expert in their field during their working years end up selling their expertise to other companies after they retire. For example, let’s say you are the most practiced technical guru in your company. After you retire, you could offer your tech services to other businesses—or even your old company.

Caterer

Many seniors dream of cooking and baking their days away after retirement. So, why not make it into a post-retirement career?

If you’re a regular Martha Stewart in the kitchen, you should consider starting your own catering businesses. If you aren’t quite willing to run an entire business on your own, you could always look for job openings with a local catering company. That way, you can cook and bake to your heart’s content without having to deal with business headaches.

Store greeter

Okay, so it may seem a little cliché, but these welcome wagon positions are still extremely popular with retirees. Not only is greeting a low-stress way to earn some extra income, but it’s also the perfect prescription for bored retirees who want to get out and socialize. Store-greeter positions aren’t just limited to supermarkets anymore. These days, businesses from car dealerships to electronics stores are hiring happy greeters to welcome customers.

Tour guide

You’ve been around long enough to know every historical detail of your hometown. So, why not share some of that knowledge as a tour guide?

If you’re a history buff, you may want to look into job openings at the local museum, a nearby historical monument or a sight-seeing tour. Not only are these part-time tour guide positions flexible and fun, but they’ll also give you an opportunity to socialize with interesting tourists from around the world.

Of course, these are just a few of the countless jobs seniors are taking on after their “official” retirement. From temp work to customer service positions and everything in between, there’s an abundance of jobs available for retirees.

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