Underwriting:
When you apply for individual health insurance, the health insurance company uses a process called medical underwriting to identify applicant's age, sex, and health history to decide whether it will cover you and how much it will cost to provide you coverage. Based on this history, insurers may charge higher premiums or restrict or deny coverage.

1. Do all health insurance companies have the same underwriting guidelines for offering insurance?

No.  Each insurance company has its own underwriting guidelines, which are usually not made public. 

2. How is your current health?
As an experienced advisor, I can direct you to companies that will look upon your health background more favorably.

Remember!
Don't let your medical background discourage you from applying for individual health insurance.   Many pre-existing health conditions are accepted by insurance companies, once they review medical records.   I can help you with your application so that it will be easier for the insurance company underwriter to understand your health background and application. 

3. Do you have a favorite doctor that you would like to keep?

Call your doctor's office and ask for the individual or group health plans the doctor is contracted with.  Make sure to state "individual" or "group" depending on your needs because some doctors work only with group plans but not with individual plans that are offered by the same insurance company.

You can also call us and we will check a computer listing or current directory.   If you are new to California-- please ask us for our advice.

4. What type of health plan do you want: HMO vs. PPO?
The plans are divided between HMO's (Health Maintenance Organizations) and PPO's (Preferred Provider Organizations).

The HMO plan requires "PRE-APPROVAL" for medical services.  You will always see one doctor (Primary Care Doctor) and HMO covers almost everything in full

with very little out of pocket costs.  Many HMO plans are allowing the patient to go directly to a specialist without a referral from the Primary Care Doctor.  Sometimes, we can design the plan to sallow a specialty office visit without a referral.

The PPO plans give you a choice of many doctors and allows you to see anyone of them at anytime.  You will still need to make sure your insurance company approves your necessary procedures for coverage.  You will have more out of pocket costs when you see these doctors and hospitals, but more flexibility and freedom with healthcare.

5. What will your "maximum out of pocket" expenses be? 
When selecting a health insurance plan, it is important to understand what your "maximum out of pocket" expenses will be for a serious hospital stay or for a series of doctor visits and tests outside of the hospital.

HMO Plans - (you must choose one primary care doctor)

HMO health plans usually cover the hospital bill at 100% but some of the plans have deductibles that you must pay for before the insurance companies will begin paying for your hospital medical bills at 100%. The deductibles or "maximum out of pocket" expenses can range from $500, $750, $1000, and up to $2000 for a hospital stay.

PPO Plans- (you have the freedom to choose many doctors)

When selecting a PPO health plan your "maximum out of pocket" expenses are even more important to understand. PPO plans have deductibles or co-payments or percentage (%) payments that must be paid by you before the insurance company will begin paying for some of your medical expenses.

For more details and information, contact us at (818) 881-8887 .