http://money.msn.com/health-and-life-insurance/7-costly-health-insurance-mistakes-insure.aspx?page=0

7 costly health insurance mistakes

1. Your doctor isn’t in the network

You’ll pay more to use health care providers who aren’t in your health plan’s network, so check to see if the doctors and other professionals you want are included.

A plan that tightly restricts you to a local network might be sufficient if you need care only in your area, but it won’t benefit a kid away at college or meet all your needs if you spend a lot of time on the road, says Pete Villemain, the president of Employee Benefit Services, which manages employer benefits plans.

Make sure any specialists you need are also covered by the plan, Rosen says. Don’t assume a specialist is in the network just because your primary care doctor gave you the name.

2. You pay huge insurance premiums to save a few bucks on the co-pay

“The mistake I see individuals make so many times is they focus so much on getting a low co-pay and they fail to look at how much extra premium they pay for it,” says Villemain.

He suggests evaluating how you’ll use your plan and comparing the costs accordingly. If you go to the doctor only a couple of times a year, is it worth hundreds of dollars extra on the premium just to get a lower co-pay?

3. The drugs you take aren’t covered

Some states require individual plans to offer prescription drug coverage, but in other states, many individual health insurance plans don’t cover drugs, says benefits consultant Michael Goodheim of Farsighted Strategies in Seattle.

If the plan provides prescription-drug coverage, check to see if your medications are included on its formulary, which lists the preferred drugs for coverage, Goodheim says. Expect to pay more if you take a drug that is not listed.

4. You’re overinsured

In addition to comprehensive health plans, many employers offer supplemental insurance policies, such as cancer or critical illness insurance, that pay a lump sum of cash after diagnosis. Such policies can provide valuable protection, but they might be unnecessary if you already have broad coverage under your medical insurance and short-term and long-term disability insurance, Goodheim says.

5. You can’t afford your share of the medical bills

Low premiums are an attractive feature of high-deductible health plans, but make sure you’re prepared to pay all the out-of-pocket medical expenses, Goodheim says.

Besides the deductible, check the maximum out-of-pocket expenses you pay. After you pay the deductible, many plans pay only a portion, such as 70%, of covered medical expenses. Your 30% share is called co-insurance, which you must fork over until you reach the cap on out-of-pocket expenses.

“Those dollars can really add up,” Goodheim says.

6. You’re expecting, but your policy doesn’t cover maternity care

Most employer-sponsored plans cover maternity and prenatal care, thanks to the federal Pregnancy Discrimination Act of 1978 and the Health Insurance Portability and Accountability Act of 1996, as well as many state health insurance mandates for group coverage. Some states also require individual health insurance plans to include maternity coverage, but in states where there is no such mandate, many individual health plans pay only a small portion of the costs or don’t cover maternity at all. Even if the plan includes maternity coverage, read the fine print to know exactly what is covered and whether there’s a monetary cap.

Starting in 2014, individual and small-group plans sold through state health insurance exchanges must include pregnancy and newborn care, along with other essential benefits.

7. You don’t check your health plan for changes

Scrutinize group health plan offerings from employers each year during open enrollment, Rosen says. Don’t assume the plan is still the same. Coverage levels, costs and networks could change from one year to the next, even if the plan is offered by the same insurer.

“If you’re not sure about something and it raises a flag in your mind, then check it out,” Rosen says.

Ladies, it’s a fact that our health needs are different than those of men.  Due to our genetic make-up, there are many other health concerns that we must consider when choosing our health insurance plan.  The future is unpredictable, so it is important that we get coverage for all our current and potential future conditions.

Questions all women should ask about their health insurance coverage

1. Does my health insurance plan cover health screenings recommended annually for women?

It is recommended that women have annual mammograms, cervical cancer screenings, and osteoporosis screenings beginning at a certain age.  There are others important annual tests, but these tests are specific to women. The law requires that health insurance companies offer coverage for one annual mammogram for women 40 and older to prevent breast cancer.  Most states mandate that insurance companies cover an annual cervical cancer screening, such as pap smears.  Also, health insurance companies are required to offer coverage for annual osteoporosis screenings since they are necessary for health maintenance.  Osteoporosis tests begin around age 60.

2. Does my health insurance company cover specialty doctor visits?

Most health insurance companies cover for your OB/GYN services.  But it is important to check your health insurance plan to see what costs and treatments are covered because some are excluded from insurance.  For example, sterilization is rarely covered by health insurance companies.

3. Will my pregnancy be covered by health insurance?

Today, the average cost of having a baby is over $6000. Health insurance companies will most often cover doctors office and hospital visit expenses (with a small co-payment).  But there’s a catch: you must have health insurance before you get pregnant! Women who are already pregnant are considered “high-risk” candidates and it will be much more difficult to get coverage.  Other things you may want to check with the insurance company is if they offer coverage for services during your pregnancy (associated with the pregnancy but not the typical office visits) and prescriptions for possible depression. Even if you don’t needs these, better safe than sorry!

4. What if I need infertility treatments? Is that covered?

Infertility insurance is limited, but you’re not out of luck.  There are 14 states with mandates for health insurance coverage of infertility treatments.  If infertility treatments are not specifically excluded form your insurance plan, you can get coverage.  If needed, get a copy of your plan from your health insurance provider.  Otherwise, infertility treatment coverage is also offered by private insurance companies.

5.  Does my health insurance cover all of my prescription drugs?

There are many prescription pills specifically for women, such as contraceptive pills.  Generally, contraceptives have not been covered by health insurance companies in their plan. But, each insurer is different.  It is important to ask your provider because they may offer contraceptive coverage.

6. Is there coverage for treatment against diseases common to women?

Women are at a higher risk for osteoporosis, breast cancer, cervical cancer, and many others.  It is important for women to take preventative measures in their healthcare as well as have insurance for their expenses.  Vaccines are common preventative measures, such as Gardasil, a vaccine to prevent HPV and cervical cancer.  Many insurance companies cover this preventative vaccine because it reduces the chance of future medical conditions. However, check with the health insurance provider you are considering before making the final decision.

It is important to get coverage before you become ill.  Difficulty arises with health insurance coverage if you are already ill because the insurers many consider it a pre-existing condition.  Or some companies may offer coverage for office visits and pharmacy charges, but have you on a waiting list for any other treatment coverage you may need.

Price Waterhouse Coopers annual medical costs trends report suggests that a 9 percent increase in health insurance coverage will occur in 2010. This 9 percent increase is primarily for businesses and their employer sponsored health plans. Though employers may suffer a 9 percent cost increase in health insurance coverage, employees might have to cope with an even larger increase in coverage.

PWC implies that some of the reasons for this increase in costs is due to employees being concerned about losing their jobs therefore using their health insurance as much as possible while it is still available to them. Another reason for this increase is increasing medical costs as employment rises. More and more uninsured people are turning to Medicaid causing health coverage costs to rise.

A survey done by PWC that involved over 500 employers concluded that 42 percent will increase health care costs for employees in the form of higher premiums, deductibles, and copays.

“As the economy recovers, employers will refocus on more sustainable longer term approaches to medical cost containment based on an increasingly shared interest between employers and their workers,” says Price Waterhouse Coopers Principal Michael Thompson.

Check out the U.S. News article at http://health.usnews.com/articles/health/healthday/2009/06/18/health-highlights-june–18–2009.html

This is the choice more and more small businesses are facing

According to a recent survey by the National Small Business Association, about 10% of small businesses are eliminating health insurance coverage over the next year. It’s either health insurance or jobs.

This isn’t the first decline in health insurance coverage over the past year. Only 38% of small businesses are providing health insurance coverage, down from 61% in 1993. About 19% of small businesses are planning on stopping coverage within the next 5 years.

Sheryl Weldon, owner of Texas-based Commerce Welding & Manufacturing Co. dropped coverage in December after seeing health insurance premiums for her employees increase by more than $600 a month in the last five years. Five years ago, Weldon was paying $200 per employee per month and this year premiums skyrocketed to more than $800. Premiums typically increase 8% to 16% a year for small businesses.

Kelly Reeves, president of KLR Communications, canceled health insurance for her three employees. Reeves said she had to choose between cancelling health insurance coverage and laying off an employee after losing a client that accounted for 50% of revenue.

Due to small businesses canceling health insurance coverage, more and more people are becoming uninsured. According to a report released by Families USA this year, approximately 86.7 million Americans were uninsured between 2007 and 2008. The report also found that nearly 75% of those uninsured were without health insurance for at least 6 months and almost two-thirds were uninsured for more than 9 months.