AboutLinda Woolsteen Expertise I can help you with questions about health insurance. If you feel your insurance company is mistreating you. Are they telling you they are checking eligibity, pre-existing, etc. Or you just don`t understand how your insurance works or don`t understand what a PPO is.. I can help you.
Experience
Past/Present clients One company I worked for I was the underwriter for the Academy of Medicine of Cleveland and the Ohio Bar Association. I was also a supervisor of our customer service department.
Question Hi Linda, I have a 23 year old son in college who is no longer covered by our health insurance - United Health Care I need to either renew his existing policy with Gerber Life Health Insurance (through American College Student Assoc.) or find a better policy. Since he is healthy and rarely has to go to the doctor, my goal is to cover him in the event of an accident or catastrophic illness. I do not want to find my self going bankrupt, trying to save his life.
What should I be looking for in a policy? Thank you
Answer Hi,
I tried to take a look at some of those policies through American College Student Assoc. But, it did not provide me with rates and just gave some of the benefits.
Well, it certainly wouldn't hurt to benefit & rate shop. I personally have a $2500 ded with Medical Mutual of Ohio, have office copays and routine coverage and my premium is like $260/month or so, but I am also 45 yrs old.
I personally figured that I could always handle or if I had to throw the $2500 onto a credit card I could, but what I like about mine is then it pays at 100% and I don't have to worry about the coinsurance (typically 20% of the rest of any bills).
A lot of people have deductibles like $5,000 & $10,000 nowdays. It isn't unusual.
Seeing that he probably is in the prime of his life and doesn't have any issues I would look at benefits in a policy such as, like you said, that may have an additional accident benefit. Sometimes, they have like $500 accident benefit added, so you know, if he does some crazy small things & are accident related they are pd at 100% and usually not subject to deductible/coinsurance.
The Insurance Company that I last worked for watched closely for accident related claims due to alcohol, drugs and would deny those as illegal behavior of course if the alcohol blood limit in the medical records exceeded your states and if the drugs were illegal.
But, we would see a lot of claims with younger people riding ATV's, skiing, snowmobiles and running into fences and stuff. Also, accident benefits usually cover things like poison ivy, animal bites..one time a lady called us stating her neighbory's cat bite her and it was pretty bad for a cat, lol.
Some benefits that are usually limited benefits and people don't think about but then have claims & they really rack up are: Physical Therapy, Mental/Nervous, Spinal Sublaxation (chiropractors). A lot of the younger people like to go to Chiropractors. I have seen, so many times, where people never thought they would have to use Physical therapy, then something happens and the benefit usually only pays like $50/per visit up to 25 visits per cal yr.
A nice feature is Deductible Carryover. Which means if anything is applied toward your deductible the last 3 months of the year (October, November, December) that amount that was applied will also carryover to your new deducible when it starts all over again in January. So, say you wanted to go for counseling & it is all going to be applied to deductible... if you have a choice and can wait go in the last 3 months and at least it will help you with some of next yrs deductible.
Student plans usually tend to be very limited benefit wise. Like what is the maximum payable per lifetime per covered person? Regular individual policies are usually like $2,500,000. Hospital claims can be in the hundred's of thousands nowdays.
PPO network's: Does he go to college out of state? Some PPO networks are National now, like First Health.
