If you are looking for NC dental insurance there is a new player in town. Cigna North Carolina is now offering a comprensive dental plan that can be added on when you purchase one of their health plans. This is not a stand alone plan - meaning that you cannot buy their dental coverage by itselt...you have to have one of the medical plans as well. However this is a pretty good plan that will stand toe to toe with the others available, actually will out perform them in many others. Here are how the benefits stack up (in network):
Calendar Year Deductible per Person $50
Calendar Year Maximum per Person $1,000
Preventive/Diagnostic Services (no waiting period) Cigna Pays 100% (no deductible)
Oral Exams
Routine Cleanings
Routine X-rays
Fluoride Application
Sealants
Space Maintainers (non-orthodontic)
Basic Services (6 Month Waiting Period) Cigna pays 80%
Fillings
Non-Routine X-rays
Emergency Services to Relieve Pain
Oral Surgery, Simple Extractions
Major Services (12 Month waiting Period) Cigna pays 50%
Crowns/Inlays/Onlays
Root canal Therapy/Endondontics
Minor Periodontics
Major Periodontics
Oral Surgery, All Except Simple Extractions
Surgical Extraction of Impacted Teeth
Relines, Rebases, and Adjustments
Repairs - Bridges, Crowns, and Inlays
Repairs - Dentures
Anesthetics
Dentures
Bridges
There you have it. Comprehensive Coverage at an affordable price. Here are the rates for 2011 in Mecklenburg County (prices vary by area):
Everyone that is looking for health insurance in North Carolina should also be looking for the BEST health insurance. There is no one size fits all. What is right for you may not be right for your neighbor. Here are some tips to assist you in what you are looking for.
The primary tip you should look at is how often your family uses healthcare related services on an average year. Some folks may visit their physician each month. Whereas others might only see their physician annually for their preventative physical. These two types of individuals would need completely different plans. For those that use medical services on a regular basis you may want to pay a little more for full comprehensive coverage so that you have copays to cover your routine visits and prescriptions. Whereas if you are generally healthy and only want to see the doctor when you have to you may look for a less comprehensive coverage like an HSA plan to cover you for the catastrophic scenario. However, in each case you still have to weigh the price vs benefits ratio.
The next suggestion in getting the best health insurance in North Carolina is refelective upon your budget. Health insurance is expensive.. Nevertheless, there are plans available that can save you a lot of money. You could take a plan that has a higher deductible each year and this will greatly affect you monthly premiums. As mentioned above, a high deductible health plan (HDHP) paired with a health savings account is now a very comom choice for affordable health insurance.
The last tip for securing the best health insurance in North Carolina your family is to utilize the services of a good health insurance broker. Most people think that they will pay more when using a broker.This IS NOT the case. In North Carolina, insurance companies cannot charge more for insurance policies that are bought through a broker. By taking advantage of the knowledge of a qualified broker you will likely save much more money that you would trying to do this on your own.
North Carolina, like many other states, is still struggling with high unemployement. Most individuals in our state have relied on their employer for the NC health insurance benefits. Now that so many people are still out of work many are finding that they cannot afford their COBRA health insurance premiums...especially if they have recently lost the COBRA subsidy that was put in place in 2009 with an extension in 2010.
So, where does that leave you? Well there really are better choices than COBRA to begin with. Because COBRA only last for up to 18 months it really is only a temporary solution, albeit an expensive one.
What type of coverage is best for you and your family? I can't really answer that here as it really is dependent on your current situation. More times than not I find that a high deductible health plan works the best for folks that are generally healthy and are looking to save on their premiums but still have full catastrophic coverage for hospitalizations and prescriptions.
Sometimes you can save even further with a "Basic" type plan. These typically limit the number of office visits anywhere from 2-4 times per year depending on the carrier, limit prescription coverage to only generic drugs, but will still offer you great coverage in the event you are hospitalized. (Note, due to the generic only drug coverage, I personally have a lot of reservations about these. Some prescriptions can cost $2000-$4000 per month if you happen to be the unlucky one that has to take them you wont be real happy with this plan).
Another option is a short term policy. These are often very inexpensive and they do not cover office visits, prescription drugs or preexisting conditions. The only time I find these to be a useful option is if you have guaranteed issue coveage (like an employer plan) starting in the next 3-6 months and you use this as "gap coverage".
You can always give me a call at 704-560-8972 to discuss your options. This is a free service and I will explain to you all your option or rates. Or if you would like to just see some of your options, click this link for your North Carolina health insurance quote.
As you can see from a lot of my blog posts and my website, I am a pretty big advocation of having a health plan that qualifies for a North Carolina health savings account.
Starting January 1, 2012 for High Deductible Health Plans (HDHP) the annual contribution limit for health savings account will increase. Currently for individuals with self-only coverage enrolled in an HDHP, the maximum annual contribution amount will increase from $3,050 to $3,100. For individuals with family coverage (2 or more on plan) the contribution limit will increase from $6,150 to $6,250.
No changes are being made as to what defines a HDHP. Currently and into 2012 an HDHP is defined as having an annual dedcutible for self-only coveraeg of at least $1,200 and a $2,400 deductible for family coverage. In addition, for self-only coverage the annual out of pocket (OOP) maximum cannot exceed $6,050 (most carriers cap self-only OOP at $5,000) and $12,100 for family coverage (most carriers cap family OOP at $10,000).
Please review your options for North Carolina health plans and contact us to assist in determining which plan is right for you.
Well I bet the title got your attention! You must be asking "please tell me more about these zero premium NC health insurance plans!" Obviously, there is no such thing as a zero premium insurance plan...after all these companies have to bring in revenue to pay for claims. But for some there is a way that you can take advantage of the laws to work for your benefit and pay nothing or have a very reduced rate overall once everything is said and done. Let me explain by example.
I recently had a prospect call that was looking to change plans and was inquiring about the pros and cons of a North Carolina health savings account. After explaining to him how all this works he decided that this made the most sense for his situation and we applied with a carrier for a $5000 deductible individual HSA qualified plan. Due to excellent health he was awarded best case rates and his monthly premium was $81 per month ($972 Annually). I know you are saying to yourself (and me) this is not a zero premium health plan. Keep reading....
Lets look at the numbers and some things this guy has working for him. First, he is self employed so he gets to write off 100% of his health insurance premiums on his taxes. Because he is a relatively high income earner lets say for this illustration he is in the 25% federal tax bracket. Also the NC tax bracket would be 7%. In addition, he has also set up his Health Savings Account (HSA) where he plans to contribute the annual maximum of $3,050. This too is 100% tax deductible. Here's how his numbers break down:
$972 x 32% = $311 in additional tax refund
$3,050 HSA contribution x 32% = $976 in additional tax refund
$1,287 in additional tax refunds
As you can see he is paying out $972 in annual health premiums but due to the tax laws he is able to increase his tax refund by $1,287. In this situation he is making money. In addition, he has $3,050 set aside in a health savings account to pay for over 60% of his annual deductible IF he needed to use it.
This was an example for a single individual. It's important to note that in 2011 if it were a family plan they can contribute up to $6,150 annually to the HSA.
Obviously not everyone will fall under this scenario and be approved at rates like these. However, this is an example of some of the insights that you can get by working with a qualified NC health insurance agent to make sure that you are aware of all the opportunities out there.
Disclaimer: I am not an accountant or a CPA. Please consult with your CPA in regards to your particular situation.
Most of the times when people are shopping for NC health insurance they are looking to reduce their premiums. Whether these premiums are for COBRA, a portion of their group, or individual coverage that they already have. Sometimes I am able to help them find a better solution and sometimes I cannot. However, if you are on COBRA then most likely we will find you a better alternative.
What I call the "No Brainer" solution to changing your policy is when your annual premium savings with the new plan will cover your out of pocket exposure of the new plan. Let me explain through an example of a recent client.
The Jones' (not really their name!) came to me looking to save money on their current COBRA premiums. In disussing their current plan they told me they were paying $1,500/month for COBRA...holy cow that is more than most peoples mortgage! Well the plan has a $0 deductible, 80/20 coinsurance (max individual exposure of $4K and family exposure of $8K). Having a $0 deductible (almost unheard of anymore) is great but you are paying for this in premium. After a discussion of everyones health status and determining the appropriate carrier we moved forward wiht the application.
After a several days the underwriting process was complete and final rates were determined. After explaining to them the benefits of having a high deductible health plan (HDHP) paired with a North Carolina health savings account and the premium savings they were convinced this made the most financial sense. Well how much was it? For a $10,000 family deductible the monthly premium was roughly $500/month. $10,000 deductible you say! Who in their right mind would want that? Let's look at the math.
Current premium savings of $1,000 per month equals $12,000 annually which is $2,000 more than they would have to spend on claims with the new plan. Therefore they cannot lose money...they will either save $12K annually or worst case they will save $2K. It is a win-win situation and why I call this a No Brainer.
Let's look at some examples:
Example 1
COBRA
New Plan
Annual Premium
$18,000
$6,000
Annual Individual Claim
$10,000
$10,000
Amount of Claim Owed
$2,000
$10,000
Total Annual Cost
$20,000
$16,000
Annual Savings
$4,000
In this example you can see that in this type of scenario they still saved $4,000. Not only that but now the ENTIRE family is covered for the rest of the calander year because they have met their family deductilbe. Still not convinced. Let's look at one more Scenario.
Example 2
COBRA
New Plan
Annual Premium
$18,000
$6,000
Claim 1 - Husband
$40,000
$40,000
Claim 2 - Wife
$20,000
$20,000
Claim 3 - Child
$8,000
$8,000
Amount Owed Claim 1
$4,000
$10,000
Amouth Owed Claim 2
$4,000
$0
Amount Owed Claim 3
$0
$0
Total Annual Costs (including premiums)
$26,000
$16,000
Annual Savings
$10,000
As you can see in this situation they CANNOT lose money. We looked at two examples...the first being more common scenario and the second a more extreme but very real scenario.
Granted not everyone is paying this much in COBRA premiums but they usually are quite high. This situation was a great example of why someone shopping for NC health insurance needs to work with a broker so that they can insure they are getting the best plan for their money.
Which carrier offers the best individual health insurance North Carolina? This is a question that seems to get searched for a lot according to my analytics. The answer to this is there isn't one BEST company for everyone. What may be the best option for you may or may not be the best option for your brother or neighbor.
Let me explain a little further. Many people search the internet for health insurance quotes all the time. These quotes really mean very little unless you are healthy as a horse. These rates are quoted best case scenario but this is a start. Now lets say you have sleep apnea. Do you think you will get the rate that you are quoted. Well you won't because of the high risk involved with this condition. Most carriers will infact deny you coverage whereas some will rate you up as much as 300% and others will place a rider on this condition (meaning they won't cover it nor will they cover any complications that arise from it). Other common conditions that many individual have include anxiety/depression, migrains, high blood pressure, high cholesterol, acid reflux, and obesity. All of these are viewed differently by the various carriers and will be rated differently which will have a major effect on your final premium.
That touches a bit on the underwriting variotions of different health insurance companies. But what about plan variations amongst them. Here are some common terms that you should be familar with and compare between plans:
Deductibles - How many deductibles per family?
Coinsurance - What is the maximum amount of coinsurance for the individual and family?
Prescription Drugs - Does the plan cover brand name drugs?
Copays - Are there limits on the number of times you can see your doctor? What does the copay
These are just some of the important features of plans that you need to look. When it comes down to determining which carrier or plan offers the best individual health insurance North Carolina you really should work directly with a professional that can answer all these questions for you. There is no cost associated with working through an agent so it is a win win for everyone.
When you find yourself shopping for North Carolina family health insurance, the great thing is that you have options! Unlike when you are working for someone usually your only plan choice is the one your employer has chosen.
I am a strong advocate for HSA qualified plans. Here is a video that I created comparing the main differences between a traditional copay plan and an HSA plan. Maybe a North Carolina health savings account plan is right for your family and maybe not. Take a quick look at this short video adn let me know what you think.
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