Health Insurance Scams: How to protect yourself

Crime invades every spectrum of life in the United States and around the world and sadly, even people trying to protect them and their loved ones from health-related financial burden are at risk. Federal statistics show a steep rise in the number of fraudulent or unlicensed health insurance companies in recent years. The result? Hundreds of thousands of Americans spent their money on what could be worthless health care coverage that should have been worth more than a quarter billion dollars. Most of the bogus insurance is provided through employer-sponsored programs where scurrilous shysters have access to hundreds of potential victims, or to self-employed workers and small businesses that may not be able to afford or participate in a decent group plan.

It has been suggested that the high cost of health care benefits in the United States has contributed to the rising number of health insurance scams. With more than 40 million Americans living without any kind of health care insurance, fraudsters have a huge market of people who want to think they are getting a deal on a service that offers medical protection for their families. In fact, a Georgetown University study found the dramatic increase in medical care insurance scams has risen at the same time health care insurance premiums have recorded double-digit rate hikes.

Often, the scam does not reveal itself until after one of these unfortunate beneficiaries tries to use their health insurance to cover an approved medical situation. By then, depending on the family’s ability to pay for medical services without insurance, a financial crisis may already be in the works. State governments tend not to offer guarantees or financial protection when health care insurance plans are revealed as a swindle or if the insurance provider is unwilling or unable to pay for legitimate claims.

Despite the awfulness of perpetuating such a horrible crime, fraudulent health insurance companies often get away with their stolen money intact. Authorities are unable to simply swoop in and arrest the bad guys; investigations take time and organization if they are to succeed in getting enough evidence to bring about a guilty verdict in court. Unfortunately, by the time such an investigation can be mounted and authorities can make a move, fraudulent health insurers have had a chance to hide their assets or have moved on to another location under another name.

There are several things that may make you suspicious about the legitimacy of a health insurance provider. First among these is price. Fraudulent medical insurance companies tend to offer cut-rate prices as a way of luring victims to hand over their money. The truth is that health insurance can be a pricey prospect. If you think you’re getting too good of a deal, you’re probably not getting a deal at all. As the old adage goes, if something seems too good to be true it probably is.

A second indicator that the health insurance provider you are dealing with might be a scam operation is the presence of less than usual or even the absence of the regulations that govern other insurance providers. Fraudulent health insurance plan providers also try to attract potential clients by boasting about regulatory freedom at the state level. Don’t be fooled: legitimate health insurance providers are not immune from state regulation. Quite the opposite is true. Many types of insurance, including health care insurance, are regulated primarily by each state.

Additionally, while health care insurance fraud is a nation-wide problem, a survey of some of the identified medical insurance scams has revealed Texas and Florida as particular hotbeds of fraudulent insurance activity. Beware of any health care insurance providers that have recently started business. Check with your better business bureau to make sure there have been no complaints.

There are some things you can do to protect yourself against fraudulent health insurance plan scams. The first thing you can do is be aware that bogus plans are out there. The second step you take to protect yourself while still getting a reasonable health care insurance plan is to educate yourself about your available options: shop around, ask questions, request proof of licensing (operating an unlicensed insurance operation is illegal in every state), get recommendations and contact a state insurance commissioner to verify the legitimacy of a health care insurance operation before you sign anything.

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Health Insurance Plans for Your Pet

Many pet owners dread the news that Rover or Kitty are seriously ill or injured.  Too often, an anxious pet-lover is forced to make a fiscal decision when veterinary care is needed, and quite a few have had to endure the heartbreak of saying good-bye to a beloved pet that could be saved — but only at a cost prohibitive expense.  To many of us, a pet is a member of the family.  Treated sometimes like a child, the animal is companion, friend, confidante, and even dinner guest!  It is no surprise that the insurance industries realized the advantages of this widely untapped market, and fortunately for us pet lovers, health insurance for pets is no longer a wished for ideal, but a new reality!

There are some similarities to health insurance for humans; for example, be sure to read the fine print!  The most common misconception is the myth that all the distraught pet owner needs to do at the time of an emergency is to present an insurance card, and no money changes hands.  Nothing could be further from the truth!  As a matter of fact, most pet insurance plans will require the pet’s owner to make an upfront payment at the time of service.  Later on, a claim may be sent to the insurance company, and a reimbursement is made.

Many plans cost as little at $30 a month, but it is imperative that the pet owner understands the scope of coverage.  Minimum cost implies minimum coverage.  For example, one major pet health insurance plan will cover the same illnesses and emergencies at different plan levels, yet those who choose to purchase a minimum plan will receive less of a reimbursement than those who choose a more expensive plan. 

In addition to the foregoing, pet insurance is not without its complications.  For example, benefits are limited when it comes to an initial diagnosis.  While your veterinarian may charge $150 to examine Rover’s bite wound after he had a run-in with the neighbor’s Doberman, the insurance plan will only cover about $92.  If Rover needs to undergo anesthesia, the insurance is willing to pay and extra $44, but will not pay any more.  In addition to the foregoing, if the bite wound is considered a secondary diagnosis, and Rover is instead treated for a puncture wound, then the coverage for the bite wound is reduced to only $65 in its entirety.  On the other hand, if you choose to purchase the higher level plan, then a similar situation will result in the reimbursement of $154 for the examination of the bite wound, $74 for anesthesia, and $108 in case of the bite wound’s being a secondary diagnosis.

Some pet owners don’t think that such coverage is worth the money, but they had best think again!  While a pet is young, veterinary visits are few and far between, but once Rover ages, new problems crop up.  Additionally, if Kitty begins to venture into the great outdoors, the risks and potential for injury increases.  Also, it is noteworthy that pet health insurance does not only cover the catastrophic injuries, but even the mundane dental cleanings, shots, heartworm medication, flea prevention, and more. 

In closing, concerned pet owners owe it to their furry (or feathered) friends to ensure that adequate care will be available in case of an emergency.  Yet, they owe it to themselves to become well educated in the multifaceted aspects of pet insurance, and the exclusions and limitations. To this end, here are some suggestions:

1. Understand the deductible

The pet’s age and even pre-existing conditions may change the deductible the plan applies.  Additionally, a co-payment may be charged that can run as high as 20% of the veterinary fee.

2.  Understand the exclusions

Just like human insurance, pet insurance too has exclusions.  They may vary from company to company, and often deal with pre-existing conditions. Other exclusions may apply to dental care, vaccinations, etc.

3. Know the caps

The insurance plan will only pay a certain amount per covered incident.  Discuss hypothetical fees with your veterinarian and find out if these caps are realistic.  Additionally, are these caps applicable to a lifetime treatment, or to a per-occurrence charge?

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Home Security Alarm Monitoring

There are many different ways to protect your home and to minimize the risk of possible theft attempts. There is also a lot of different technological equipment created specifically for home security purposes. This article will talk about home security alarm monitoring: both alarm systems and alarm monitoring services. The installation of any alarm system greatly minimizes the chance that a burglar will be successful in his theft attempt. The alarm system with monitoring service is designed not only to prevent the possible theft attempts but also to stop the ones already in progress by notifying police department. There are a lot of different alarm security systems that are available for sale on the market. These alarm systems range from simple low-cost alarms to advanced expensive automated systems with video cameras and motion detection. The simplest alarm system is designed to detect the unlawful entry into the house and will sound the siren to notify everyone around that the theft attempt is in progress.

A lot of alarm systems will also notify the closest police unit (or other authorities like firemen or medical personnel) through the company that offers various alarm monitoring services. Many of these services are offered by companies that sell security systems. These companies will usually offer the whole package of products and services, including installation or “do it yourself” systems. Signing up for the security monitoring service is fairly low cost. There are companies that charge less then $10 per month for the monitoring service. The benefits of signing up for monitoring service are obvious. Your home security system will be watched all the time, 24 hours a day, 7 days a week, by the security service company that will notify and dispatch the police unit when your alarm goes off.

The security monitoring systems usually works by means of a standard prone line. In a case of urgent situation (when alarm goes off) the alarm system dials the company that is providing the monitoring service. The company will usually try to establish a contact with the owner of the house. In the case of the possible theft attempt, the closes police department is notified of the issue. This is a standard procedure which will probably vary from one company to another. When you do decide to sign up for the alarm monitoring service you should search for a respectful monitoring company that offers services at reasonable costs. Research each company that you find and select the best one available. It might help to research through various security guides and to review the current and past customer feedback.

Having an alarm monitoring service is especially useful when you are on vacation or out of the house most of the day. The monitoring service will usually offer additional benefits like dispatching fire and medical assistance personnel (in addition to police) when it is needed. There is even a monetary benefit from signing up for the alarm monitoring service if you have homeowners insurance. Usually your insurance company will be able to offer you a discount on your insurance payment if they know that you have an alarm monitoring system. You can save up to 20% on your insurance payments. Some insurance companies may even require the monitoring service before providing insurance to the prospective client.

With the recent spread of wireless services many companies started offering wireless alarm monitoring. The dedicated cellular link allows the alarm system do contact the monitoring company even if the regular phone lines are not working or power is out. In the event of the power down situation the system will be powered by batteries. This way, no matter what happens, the alarm system will notify the service company and your home will be safe. The alarm monitoring services also prevents false alarms. If your alarm went off for some reason, the service company will contact you and, after checking your identity, will stop the alarm. This way you are protected from false alarm fees. The last advice is to check if the security company will offer you a deal when you both buy the alarm systems and sign up for service through them. This type of deal can save you some money and will still accomplish your goals.

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Cosmetic Surgery: Costly or Covered?

How many of us have stood at the checkout counter of the local mega mart, and perused the tabloids while waiting for our turn?  A staple of many a tabloid is the guessing game: which celebrity has had cosmetic surgery or perhaps some liposuction?  Yet, what about the lady at the front of the line, has she had costly surgery? 

The term “cosmetic surgery” encompasses a wide variety of procedures, i.e. liposuction, tummy tuck, nose correction, face lift, etc.  These procedures are not cheap.  For example, a liposuction, which is essentially a fat reduction procedure in the areas of the thighs, hips, abdomen, knees, and face, may cost between $1,500 and $6,000.  A face lift, which is the tightening of the skin and facial muscles while excess skin is removed, runs from $2,500 to $8,000, and quite possibly higher. 

In general, insurance companies do not cover cosmetic surgery unless it is deemed to be medically necessary. Medical necessity is not always easy to ascertain, but as a rule of thumb, if the cosmetic surgery to be performed necessitates reconstructive surgery in the wake of trauma, tumors, infection, developmental abnormalities, or congenital disease, the patient will have the good fortune of having the insurance company foot the bill.  Conversely, if the patient is not able to establish medical necessity, the insurance company will consider the treatment to be an elective procedure and will not be obligated to pay anything.

So as to qualify as a reconstructive surgery rather than an elective cosmetic procedure, the operation must be performed in order to improve a body part’s functions, but quite often it is accepted if the surgery is merely used to give the body part a societal accepted normal appearance. Yet, the buyer must beware!  While insurance companies will quite often cover such reconstructive surgery, they may not cover it to the extent the patient wishes the surgery to go.  

One of the procedures that are quite often covered is ear surgery, also known as otoplasty. In the course of this surgery, prominent ears are set back to lie closer to the head; in some cases, the size of overly a large ear is drastically reduced.  When this surgery is done on children, the insurance companies quite often cover it; when it is done on an adult, the patient will have the obligation of proving the reconstructive aspect of the treatment as opposed to the cosmetic angle.

Another cosmetic surgery that may be covered by insurance is eyelid surgery (blepharoplasty), which corrects drooping upper eyelids, or puffy bags below the eyes.  This is accomplished by removing fat, skin, and muscle that cause the undesired drooping/puffing. This surgery may be covered if the patient can prove to the insurance company‘s satisfaction that it is deemed to be medically necessary to correct visual field defects.

Nose surgeries, also known as rhinoplasties, accomplish a wide variety of effects, such as the reduction or increase in the nose’s size by simple reshaping, the removal of a prominent hump, or the correction of a previously broken nose.  If the surgery is a reconstruction due to damage to the nose, it will most likely be covered by the insurance company.  Otherwise, the patient will need to establish that the procedure is not simply an esthetically motivated treatment, but actually offers a medical benefit, such as the relief of breathing problems.

Insurance companies in many ways still have the upper hand when deciding whether or not to cover a cosmetic surgery.  Policies are plentiful and vary from plan to plan, yet the American Medical Association and the American Society of Plastic Surgeons set a guideline that is generally followed forth.

If the aforementioned entities declare a procedure to be a reconstructive surgery, which does not necessitate a causal event but may easily apply to a simple improvement of function of the body part in question, then the insurance companies will be more likely to consider the claim for payment.  If, however, a procedure is considered devoid of medical benefits and is simply deemed elective for the sake of improving a patient’s self-esteem or body image, the insurance companies will be very hesitant to even accept the claim.

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COBRA: What You Need To Know

COBRA Insurance coverage is something many people don't understand or how it works for them and the benefits they can draw from it. COBRA might just be what you’re looking for to fill those insurance needs. But lets look at what COBRA is and if it's in your best interest to continue it or end it.

COBRA is also known as the Consolidated Ominbus Budget Reconciliation Act of 1985 or COBRA for short. COBRA is still a very useful law to many and people still use it today. COBRA makes it possible to keep health insurance coverage from their employer for up to 18 months if their employment status changes. Some of these changes could be layoff, reduced work hours or a termination of employment by either party involved.

COBRA has helped countless Americans keep insurance coverage. Now, is it good for you or not? Many times when individuals lose health coverage they have a very hard time getting coverage in the private sectors for various reasons. If they do find insurance coverage it's extremely expensive and many times not feasible for the displaced worker. For the worker to continue his insurance coverage through his employer he must pay the monthly premium, which can add up because he's not getting a discounted price anymore.

Internet access has helped many people find various health care programs. Now people can get on the Internet and do their own research and find out which company can give them the best deal and will give them the most benefits for the money. Since the Internet encompasses so much information more choices and comparison-shopping has became the buzzword.

Now one of the most important questions you need to ask yourself is whether or not to continue COBRA insurance coverage from your employer. If you have many health problems that are being treated right now you probably should strongly consider using the COBRA insurance option. Having health problems with pre-existing conditions could make it very difficult for you to get insurance coverage. If you do get health care coverage it will be so expensive it wouldn't be worth it.

If you are changing jobs and you know that your new employer doesn't offer health care coverage or if you know you won't qualify for the new company's health plan then highly consider COBRA as a viable option. It is also a good idea not to have gaps in health care coverage, as this tends to get you a better deal.

If you tend to be on the healthy side then you can choose not use COBRA as an option. There are a few reasons for that. Being healthy you should shop around as you will be able to get better coverage and at a more affordable price. Insurance companies love to insure young healthy individuals as they know it usually costs them a lot less money therefore, they will be glad to give you a good deal on your health care needs.

There are a few things you should know about COBRA so you can make a very informed decision. Once your health care coverage is lost, you are given a 60 day grace period in which time you must chose to use COBRA or not, otherwise you will lose it all together. Once the 60 days has past, it is not offered again.  COBRA also has provisions that give certain former employees, retirees and spouses the right to get temporary continuation of health care coverage at group rates.

Some of the things that COBRA will continue to cover if you decide to keep the coverage are:

Inpatient and outpatient hospital care

Physician care is also covered under COBRA

Surgery and major medical benefits

Prescription drugs are also covered but life insurance is not covered under COBRA.

COBRA has many advantages and disadvantages and just like anything else an informed decision will take some time and research. COBRA has been helpful to many employees and will continue to provide coverage when needed for many more years to come. For some COBRA just doesn't fit into their plans; each individual will have to choose whether COBRA can benefit them.

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