FAQ'S FOR MEDICAL AND LIFE MEDICAL

  1. What are my choices for medical coverage?
    Generally speaking medical coverage breaks down into three categories, Traditional, Preferred Provider Organization (PPO), Health Maintenance Organization (HMO). Traditional plans are plans that do not restrict doctors or hospitals. The selections of services are based upon the patient. These plans tend to be less restrictive and provide total access to the healthcare system. Preferred Provider Organization (PPO) plans are designed to include doctors and hospitals in a network at a reduced cost to the patient. Not all doctors are listed in the network and those that are not included in the network would be paid at a lower benefit than those within the network. Health Maintenance Organization (HMO) plans are established for a very fine and defined geographical area, i.e. by town, county, large employer. Only doctors listed in the HMO network will be paid benefits, those outside the network will have no benefits at all.

  2. If I have a doctor already which plan will work for me?
    This depends on if your doctor is part of a Preferred Provider Organization (PPO) or Health Maintenance Organization (HMO). If they are, either plan will work for you. If your doctor is not listed in the PPO or HMO then a Traditional plan will work the best for you.

  3. What is a pre-existing condition?
    A pre-existing condition is evaluated by insurance carriers for both individual and family plans when writing coverage in the first 24 months of a policy. This limitation usually applies to any condition that is present, or has been treated within the last 6 months prior to the effective date. In order for a pre-existing condition to be covered an individual will have to be covered under a medical program for 12 or 24 months before any benefit is paid on that condition.

  4. If I am covered under my employers plan do I need an individual plan?
    No. As long as you are a full time employee and meet the eligibility requirements of the plan there is no need for additional coverage on an individual basis. If however you want to supplement a group medical plan you may do so by purchasing a "wrap plan" which would be used to satisfy deductibles and or coinsurance percentages that would be paid by the individual.

  5. If I have a family does my deductible apply to all family members?
    The deductible shown on most medical plans are per person. Usually the deductible is limited for families so that only three people need to satisfy the deductible.

  6. How does a prescription card deductible work?
    Prescription Drug deductibles vary by insurance company. Insurance companies that offer prescription drug benefits most often offer small deductibles for generic drugs, i.e. $5, $10 or $15 per prescription and larger deductibles for brand name drugs, i.e. $25, $30 or $50 per prescription. Injectables and other formulary drugs may have larger deductibles such as $50 or $75. One change that is starting to appear in the prescription drug market is the use of a front-end deductible of $100 or $250. What this means is that over $100 or $250 of prescriptions would need to be paid by the individual before any prescription drug co-pay would be made.
LIFE

  1. I have an old "whole life" policy can I change to a different plan.
    Life insurance has changed dramatically in the past few years. The introduction of interest sensitive policies and lower insurance premium costs has made life insurance a greater value today than in the past. Old "whole life" policies, although very stable, usually have very conservative pricing assumptions making them somewhat expensive and inflexible. By looking at newer products older policies may be converted into either a universal life or variable universal life program without sacrificing safety of principal or flexibility.

  2. What are my options when buying life insurance?
    The options available are term, whole life, universal life, and variable universal life insurance products. Each have their own unique features and are great tools to use for many financial planning situations.

  3. How do I know how much life insurance to purchase?
    That depends on what you would like to protect. Many individuals chose to cover their mortgage, college funding, retirement, debts or income lost to their family due to premature death. Each year individuals should complete a financial assessment with a qualified financial professional. This assessment updates any benefits accruing under social security or other retirement programs. Any financial burdens can be planned for and solved a fraction of the cost.

  4. Should I have a life insurance plan even if I have life insurance through my employer?
    As with anything provided by outside sources an individual "base plan" should be established so that a sudden change in employment does not leave you vulnerable at a time when you can least afford it.

  5. Should I cover my children with life insurance?
    The loss of a child is always an emotional time. Worst yet, having the loss of a child become a financial burden to a family is a painful reminder of the loss. We strongly suggest children be covered for at least the cost of a burial, usually $15,000. There are a variety of inexpensive options to cover this need in which parents are often unaware are available to them.

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