Simply Junior

When it comes to insuring ones health there’s no denying the fact that this form of insurance is a must for everyone even though it’s not legally required and is purely optional. It’s hard to imagine the current healthcare system without insurance because otherwise people couldn’t afford most medical services and doctors wouldn’t get their high salaries, which are among the highest all over the world. Thanks to insurance both customers and service providers are pleased, and everyone’s getting the thing they want. Among many types of insurance available managed care plans are the most widespread, so let’s take a closer look at some of the most common forms of insurance offered by insurers:

Health Maintenance Organizations (HMO)

This is the most common form of managed care plans as it provides the lowest price and a wide range of services included. It’s main drawback is the lack of flexibility in what concerns the places you get care from. Under HMOs you are limited to a network of facilities and specialists you may get care from and covered to the full extent. If you choose to get your services from someone outside the network your costs won’t be covered at all. Moreover, you are required to choose a primary care physician who will refer you to all the required specialists, so there’s more paperwork involved with this type of plans. Yet, you usually pay lower premiums for that so it’s really worth the effort.

Preferred Provider Organizations (PPO)

Preferred Provider Organizations offer more flexibility but for a higher price if compared to HMO plans. You are still limited to a network of providers to get care from, however if you choose to go out of network there will still be some part of your bill covered only to a lesser extent compared to in-network services. And you aren’t obliged to choose a primary care physician so there’s not so many office visits to do under this type of managed care plans. If you have the additional money and want more flexibility with your health insurance this plan type will definitely appeal to you.

Point Of Service (POS)

Point Of Service plans are often referred to as a mix of HMO and PPO plans as they provide the benefits of both these forms of health insurance. You gain the flexibility of PPO in what concerns the places you get services at, yet you still have to choose a primary care physician and have a network of providers to work with. One of the greatest benefits is that you may choose your family doctor as a primary care physician even if he or she doesn’t make part of the insurer specified network, which is definitely appealing to those who have long term relations with their family doctors. PPO plans may vary in price so it’s really recommended to shop around if you want to get the best rate possible.

As you see, managed care plans come in different forms with the sole purpose of giving you exactly what you need. So it’s really important to assess your individual health insurance needs before choosing the plan type to address them adequately.

Whenever you ask a talking head paid by the insurance industry, “How do you calculate the premium rate?” the answer is always the same. There’s a big smile of sincerity and that reassuring voice says, “We look at the driver. It’s all about who you are and what you drive.” And that, of course, is how it should be. Actuaries are paid to estimate the risk of accidents and, as they keep telling us, the statistics never lie. These actuaries are like pack rats. They collect every last detail of every accident that gets reported. It doesn’t matter whether it’s a police report, a claim to the insurers from a hospital for treating accident victims, or reports in local newspapers. They have information about accidents going back to the time we were switching over from real horses to horse-powered engines. So ask how many men aged 33 have had an accident at 2 a.m. while driving a red Ford Contour in the rain with a new moon and, with the click of a mouse, you will have the answer by return. It’s the detail that’s so impressive. More importantly it shows exactly how many claims are made by male as opposed to female drivers, and what the average value of the claims is.

All around the world, the statistical evidence shows women making fewer claims and, when they are involved in accidents, the amount claimed tends to be lower.

The reason for this is that, in general, women drive within the law. They do not try to beat the lights or drive too fast on city streets so, if there is an accident, they are traveling more slowly and the impact is less damaging both to the vehicles and the people inside. Not surprisingly, this excellent safety record has been rewarded by lower premiums. Where the risk is lower, drivers pay less. Except, in Europe, this will change next year.

The European Court for Human Rights has just ruled that men and women must pay the same premiums. At the end of 2012, there must be a new system in place to calculate premiums without relying on gender as a key factor. So what’s going on? Well, ask yourself, is it fair to charge someone more to insure their vehicle just because they are male. No one asks to be born male or female so why penalize all those who have the bad luck to be born male? Keeping this real, men don’t crash because their sexual apparatus gets caught in the steering wheel. People get into accidents because they drive badly. There’s no point in forcing people to pay more because of something they are powerless to control. There’s every reason to base auto insurance quotes on actual driving records because, if the record is bad and the premium rate is high, it gives those drivers an incentive to improve their driving. Calculating premiums should be very personal, looking at how well each individual drives. Grouping everyone together on the basis of their gender for issuing auto insurance quotes is arbitrary and unfair (at least, in Europe).

There are only limited ways to have more spending money. One way is that you need to have more income. Income comes in the form of wages, salary, rentals, interest and saving. Spending money can come in the form of essential expenses as well as spending on wants and desires. There are ways however, to reduce spending in order to have more money to spend. What? Sounds gibberish…let’s take a look.

A budget will quite often help to free up cash. If you are unaware of your expenses and how it relates to your income this is the most important step of all. Completing a budget will show up your spending habits and give you an idea of just what you actually do with your money. Once you know this you’ll be surprised at how much you can save to allocate to other types of spending. Take a serious look at your power account, your telephone bills and other utilities. Phone the competitors of your usual supplier and see if they can give you a better deal. Often a provider will give you an incentive to change your services to them. This might be in the form of a deposit of say $50 on your first account or a special reduction on rates for a set period. It’s worth taking a look but make sure you are getting a better deal at the end of the day. Grab the remote and look at the cable TV channels you have. Which ones do you have access to that you never watch? Make a list of all of the channels that you can access. Mark off the ones that you watch and those that you don’t. Contact the cable company and see if you can reduce the costs by changing the package you are on. Review your life insurances. While there are certain things that require insuring there may be better options since you took the policy out. Do this with an adviser and don’t just cancel policies. Sometimes you may find premiums have come down or the amount of cover is no longer right for you. If you haven’t reviewed insurances for a long time it’s time you did. Also review your general insurance policies. If you take out vehicle insurance, contents and home cover with the same company you normally get a discount. You can also lower premiums by taking on a higher excess.

These five tips are a start to reducing your expenses so that you have more spending money.

The main thing to understand about discounts is the thinking behind them. The insurance companies want to encourage you to act in ways that favor them. If you are contrary and do the opposite, you will probably cost them money so your premium rates will be higher. Let’s take a few examples and see how it works. Obviously the point of insurance is that, if you have one of those unfortunate accidents or someone steals your vehicle, you get to claim money from the insurance company. From the insurer’s point of view, this is bad news. It wants to be able to treat all your cash as profit. The more it has to pay out, the more it should raise premiums. Except, at some point, you throw up your hands and say, “We’re not going to pay that.” So a balance has to be struck. The insurer wants all the safe drivers like you, and aims to discourage all the drivers with bad records – they are the ones who get the really big premium hikes. Although loyalty bonuses go some way in the right direction, there are more ways in which the insurer can save money. It all starts with the make and model of vehicle you are driving.

Risk assessment is done by the actuaries. These are the math wonks who collect details of every accident reported in the US. This is not just the data from claims on vehicle insurance. This is every incident reported to the police, attended by the firefighters or ambulance crews, or dealt with through claims on health insurance. Put all this together and the actuaries can tell you the probability of an accident in any make and model of vehicle, given its color, whether it was fitted with any additional features, who it was driven by, the time of day or night, whether the driver and passengers were badly injured, so on. Yes, it’s that detailed. Turning this around, if you drive a vehicle that’s statistically unlikely to be involved in an accident or stolen, your premium will be lower than average. Put a safe driver in a safe car and the chances of the insurer having to pay out are small and the profit is higher. Everyone is happy. So how do you find out which are the safest vehicles with the lowest premium rates? Well, you start with http://www.safercar.gov/, a site run by the National Highway Traffic Safety Administration. This allows you to get the safety ratings from all the tests carried out by the NHTSA. There’s a guide published at http://www.nhtsa.dot.gov/staticfiles/DOT/NHTSA/Vehicle%20Safety/Articles/Associated%20Files/2009_Insurance_Costs_Comparison.pdf which is also helpful. Finally, the Insurance Institute for Highway Safety publishes its own list of safe vehicles at http://www.iihs.org/ratings/

The safer the vehicle you drive, the greater the discount on the premium rate. So when you are filling out the questionnaire for those auto insurance quotes, aim to have a safe vehicle. If you vehicle is not safe and you cannot afford to change it, try to upgrade it by fitting safety features. Look at the questions asked in the questionnaire and talk to insurance agents to find out what features save the most money. Similarly, fit better locks and any systems making your vehicle more difficult to steal. Anything you can do to reduce the risk of a claim will be reflected in low rates in the auto insurance quotes you receive.

Perhaps this is an unnecessary statement of the obvious, but the point of insurance is to give people a financial safety net. Should an emergency or disaster strike, money you would struggle to find is paid out by your insurance company. But the squeeze has been on for the last decade as medical costs and the prices of essential drugs have been rising fast. In fact, so fast that the insurers cannot pass on all the increases to their policyholders. It was hard to raise premium rates while the economy was doing well. It became impossible to raise premiums when the recession hit without there being investigations by each state’s Commissioners for Insurance and complaints from everyone else. There comes a point when the insurer cannot get any more blood from the stone and has to sacrifice profits. This has left the medical profession, the hospitals and clinics in a winning position, while the pharmaceutical industry’s profits have continued to rise despite the recession. At the other end of the spectrum, the patients are the losers. There are some who discover the small print in their policies denies cover for the very illnesses they have. There are others whose savings are not enough to pay the deductibles and co-payments. And then there are those whose policies are cancelled when they make a claim for a chronic disease or disorder.

There is a new piece of research from the Commonwealth Fund, an independent, non-profit body. In 2007, it carried out a detailed survey among 2,600 people aged between 19 and 64. When their coverage was analysed, 20% were found significantly underinsured. Why was this happening? Because they were already spending more than 10% of their income on health coverage, whether as premiums, deductibles or both. When the underinsured were added to the uninsured, this represented 42% of adult Americans. Like the uninsured, this forces the underinsured to think twice before they have treatment with more than half either refusing treatment or struggling with debt because of treatment.

In the push for healthcare reform, the focus has been on the uninsured. But this fails to recognize the injustice suffered by the underinsured. No one should be forced to choose between refusing needed treatment and potential bankruptcy. It is therefore going to be an interesting year in prospect as the reform slowly comes into force. Both the poor and the middle class need access to cheap health insurance with reasonably comprehensive coverage. This will further squeeze the insurance industry because it will be denied the right to refuse coverage to those with pre-existing conditions and will be forced to establish group health insurance for those who have struggled to find affordable plans. In all of this, the key to success will be the ability of government and the insurers to impose more control over costs. President Obama has negotiated with the pharmaceutical industry and there is some agreement to hold down prices for those in Medicare and Medicaid. The for-profit healthcare industry also sees some self-interest in moderating its price increases and has given undertakings to the Administration. If some of the pressure is removed from the insurance industry, premium rates will stabilize and the reforms should offer a more fair system to all with a health plan. We can only hope for the best while we wait and see what happens.