Georgia Health Insurance 411

Georgia health insurance resource in plain language

Georgia Health Insurance 411 header image 4

How to Apply for Health Insurance in Georgia

March 10th, 2010 by Bob Vineyard
Respond

Believe it or not, there is an art (and a bit of science as well) to applying for health insurance in Georgia if you want to get the best offer. Some Georgia health insurance companies are routinely rejecting half of applications submitted. Overall, roughly 80% of applications that are not rejected will result in a modified counter-offer from the health insurance company.

So how do you improve your odds?

Work with an experienced agent. Seriously. We do this every day and know what underwriters are looking for and what they need to underwrite an application. Someone who only completes a health insurance application once in a blue moon will invariably provide too much information or not enough.

Health insurance applications are purposely tricky and redundant. If you are not careful you will give conflicting responses which will delay your application and reduce your chances of a better offer.

Medical history is important, including any medications you have been prescribed in the last 5 years. Some medical conditions and symptoms discussed but never diagnosed or treated can get your application rejected. Starting a new medication can result in a rejection as can stopping a medication without doctors approval. Any change in medication or dosage in the most recent 6 months can trigger a decline or disappointing offer.

Exact dates are not needed but general timelines are. Knowing the medical condition, medication(s), dosage and how often the medication is administered helps the health insurance underwriter to get a good idea of what kind of risk you present.

The application process consists of an electronic or paper application followed by (in most cases) a telephone interview. Too often clients will kill their chances of getting a fair offer during the phone interview unless they know what to expect. We counsel all clients on the entire process, and all applications are pre-screened before ever submitting to the health insurance company for review.

Health insurance companies also rely on information from MIB (Medical Information Bureau) as well as a prescription drug database such as IntelliScript or Ingenix (MedPoint).

You can request a copy of your IntelliScript report by calling (877) 211-4816; copies of your MedPoint information are available by calling (888) 206-0335. You can also go online for IntelliScript or MedPoint.

Each health insurance company is different in the way they underwrite an application. A rejection or increased rate with one company may produce a better offer from a different health insurance company. One thing is certain. Applying to several companies at once or in succession greatly reduces your chance of getting a good offer.

Like most things in life, you can do it yourself or work with someone who knows how the game is played. If you want to know what to expect and be assured of getting the best possible offer, work with a professional agent when applying for health insurance in Georgia.

  • Share/Bookmark

Tags:   · · No Comments.

Asthmatics – Finding Health Insurance in Georgia

March 6th, 2010 by Bob Vineyard
Respond

For most people with asthma, finding health insurance in Georgia will not be a problem. Each Georgia health insurance company will review your medical history and medication and make a determination.

Some major medical insurance companies will charge an additional rate, over and above the standard rate, to cover the risk while others will rider or exclude coverage for treating asthma.

Each health insurance company views asthma differently and your health insurance agent can be your guide by reviewing and pre-screening your application with multiple insurance companies.

All health insurance companies ask if you have visited the ER in connection with asthma or have been admitted in the last 5 years. If the answer is yes to either, you can almost certainly be assured your application will be declined.

When looking for Georgia health insurance, make sure your insurance broker asks for full details on your medical conditions and pre-screens your history before submitting an application.

  • Share/Bookmark

Tags: No Comments.

Ask The Doctor

March 4th, 2010 by Bob Vineyard
Respond

Q: Doctor, I’ve heard that cardiovascular exercise can prolong life. Is this true?

A: Your heart is only good for so many beats, and that’s it… don’t waste them on exercise. Everything wears out eventually. Speeding up your heart will not make you live longer; that’s like saying you can extend the life of your car by driving it faster. Want to live longer? Take a nap.

Q: Should I cut down on meat and eat more fruits and vegetables?

A: You must grasp logistical efficiencies. What does a cow eat? Hay and corn. And what are these? Vegetables. So a steak is nothing more than an efficient mechanism of delivering vegetables to your system. Need grain? Eat chicken. Beef is also a good source of field grass (green leafy vegetable). And a pork chop can give you 100% of your recommended daily allowance of vegetable products.

Q: Should I reduce my alcohol intake?

A: No, not at all. Wine is made from fruit. Brandy is distilled wine, that means they take the water out of the fruity bit so you get even more of the goodness that way. Beer is also made out of grain. So have a cup now and then!

Q: How can I calculate my body/fat ratio?

A: Well, if you have a body and you have fat, your ratio is one to one. If you have two bodies, your ratio is two to one, etc.

Q: What are some of the advantages of participating in a regular exercise program?

A: Can’t think of a single one, sorry. My philosophy is: No Pain…Good!

Q: Aren’t fried foods bad for you?

A: YOU’RE NOT LISTENING!!! ….. Foods are fried these days in vegetable oil. In fact, they’re permeated in it. How could getting more vegetables be bad for you?

Q: Will sit-ups help prevent me from getting a little soft around the middle?

A: Definitely not! When you exercise a muscle, it gets bigger. You should only be doing sit-ups if you want a bigger stomach.

Q: Is chocolate bad for me?

A: Are you crazy? HELLO Cocoa beans! Another vegetable!!! It’s the best feel-good food around!

Q: Is swimming good for your figure?

A: If swimming is good for your figure, explain whales to me.

Q: Is getting in-shape important for my lifestyle?

A: Hey! ‘Round’ is a shape!

Well, I hope this has cleared up any misconceptions you may have had about food and diets.

And remember:

‘Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body, but rather to skid in sideways – Chardonnay in one hand – chocolate in the other – body thoroughly used up, totally worn out and screaming ‘WOO HOO, What a Ride’

AND…..

For those of you who watch what you eat, here’s the final word on nutrition and health. It’s a relief to know the truth after all those conflicting nutritional studies.

1. The Japanese eat very little fat

and suffer fewer heart attacks than Americans.

2. The Mexicans eat a lot of fat

and suffer fewer heart attacks than Americans.

3. The Chinese drink very little red wine

and suffer fewer heart attacks than Americans.

4. The Italians drink a lot of red wine

and suffer fewer heart attacks than Americans.

5. The Germans drink a lot of beers and eat lots of sausages and fats and suffer fewer heart attacks than Americans.

CONCLUSION………

Eat and drink what you like.

Speaking English is apparently what kills you.

  • Share/Bookmark

Tags: No Comments.

The Health Care Summit

March 4th, 2010 by Bob Vineyard
Respond

No beer at this one. Too bad. If you are not ready to get out the torches & pitchforks after watching this something must be wrong.

  • Share/Bookmark

Tags: No Comments.

Locate Lost Life Insurance Policies

February 26th, 2010 by Bob Vineyard
Respond

Have you lost track of a life insurance policy? Has a loved one passed away and you are not sure you have found any or all life insurance policies?

The folks at MIB may be able to help.

170 Million Records. The decedent’s name is searched against our Policy Locator database. It contains over 170 million records representing inquiries submitted on individually underwritten life insurance applications processed during the last fourteen years.

Largest Fraud Detection Service. The data is collected by MIB from virtually every North American carrier involved in life insurance.

Match Against Applications. It is important to note that a Policy Locator search provides notice of an application which may have resulted in policy issuance.

For $75 per search, this is a valuable tool

  • Share/Bookmark

Tags: No Comments.

New Hope for Ovarian Cancer

February 26th, 2010 by Bob Vineyard
Respond

Those with ovarian cancer may have a new way to combat the disease. The WSJ reports that Avastin is showing promise in testing as a treatment for ovarian cancer. Avastin is already approved for colorectal, breast, lung and kidney cancers.

More good news.

Four years ago a 30 day dosage ran $8,000 per month. Now it is $600.

  • Share/Bookmark

Tags: No Comments.

About Those BCBSGA Rate Increases . . .

February 24th, 2010 by Bob Vineyard
Respond

If it seems like Blue Cross is the favorite punching bag of Washington and the media, it is not just your imagination.  Anthem/Wellpoint, parent of several Blue Cross plans (including Blue Cross of Georgia), is catching most of the heat.

Frankly, most of the criticism is a cheap, political ploy that is more theatrics than substance. But now it seems the AJC has jumped on the bandwagon in attacking the Georgia Blue Cross plans.

Alex Sabbeth’s anger went through the roof when he recently received nearly a 72 percent increase in his health insurance premium.

He sees it as proof of the health insurance industry’s desire for profits.

“Out of a habit of greed, they are raising people’s rates,”

This is a fairly common reaction, but without basis in fact.

Sabbeth’s policy — with a $10,000 deductible — was with Blue Cross/Blue Shield of Georgia. He had been paying $241.99 a month. The company’s letter told him that the new rate would be $415.40 a month, a one-shot increase of 71.6 percent.

He had just turned 60 years old, and while he is in good health he does have noncancerous lesions removed from his face about once a year.

Depending on how long he has been with Blue Cross, the increase could be part of their “normal” routine. Having worked with BCBSGA for several years I know their policies tend to get fairly pricey from the third year on. They are generally not a company I recommend if one is going to need coverage for more than a couple of years.

Blue is one of the few carriers that still use 5 year age brackets which means a big jump in renewal rates for ages that end in 0 or 5.

And the skin lesions have nothing to do with his renewal.

Sabbeth is concerned that the insurance company is trying to drive him off with the increase. He’s already searching around for a new policy.

Searching for a new policy is the right thing to do as long as he is aware his pre-existing condition will affect any final offer from a new carrier. Depending on the details, and the carrier he picks, it may not be a major issue. But most folks don’t know how to navigate the process of searching for and finding a plan that covers what is needed and delivers real value.

At Georgia Insurance Shop we pre-screen all applications before they are ever submitted to the carrier for review.

  • Share/Bookmark

Tags:   · Comments Off

About Those Blue Cross – WellPoint Profits . . .

February 22nd, 2010 by Bob Vineyard
Respond

The Obamahouse and media have seized on the WellPoint Blue Cross profits and are using the bully pulpit to drum up support for health insurance reform. ABC News provides some insight into the profit structure of WellPoint and for those who are paying attention, takes the hot air out of the Obama-Sebelius tag team attack.

Let’s take a look at the ABC News interview with WellPoint CEO Angela Braly.

Q: How does WellPoint make its money?

A: The Indianapolis insurer made about $4.7 billion in 2009, a total stoked by the $2.2 billion it received from the sale of a pharmacy benefits management subsidiary.

Outside that, WellPoint made most of its money through employer-sponsored group health insurance. It reported $2.4 billion in operating profit from that segment last year, which amounts to about 58 percent of its total earnings.

The insurer has said it gets only about 10 percent of its operating income from individual health insurance like the kind it sells in California.

For sure, $4.7 billion sounds like a lot of money to the average Joe.

But so does a $1.4 trillion dollar deficit. I don’t recall anyone complaining about that.

But I digress . . .

WellPoint made almost half their profit through the sale of a PBM subsidiary. MOST of their profit comes from employer group health insurance plans.

No one is complaining about that either. So what about those individual health insurance plans that have a target on their back?

Only 10% of their revenue, not profit, revenue, comes from the sale of individual health insurance.

The interview goes on to address why individual health insurance premiums in California will be increasing by double digits, and why businesses don’t set prices based on profits.

Interesting read.

At least for those with an open mind.

Or those who don’t have a personal agenda . . .

  • Share/Bookmark

Tags:   Comments Off

Blue Cross Pays for Sex

February 16th, 2010 by Bob Vineyard
Respond

Dr. Daniel R. Lerom is listed in documents as having a long-standing sexual relationship with his Lakeland patient, listed only as “HK” in a lawsuit filed with Hillsborough County Circuit Court.

Each time they two had sex, documents say, the doctor would bill her Blue Cross Blue Shield Insurance for their “sessions.”

  • Share/Bookmark

Tags: Comments Off

Health Insurance Premiums Rising – Underwriting Getting Tougher

February 15th, 2010 by Bob Vineyard
Respond

No, it is not your imagination. If you are trying to buy health insurance in Georgia you are going to find it pricier and harder to qualify. Premiums for new health insurance plans are jumping 6% on a quarterly basis in some cases. Renewals on existing major medical coverage for individuals and families are trending at 20% in many cases. Group insurance plans for business owners are looking at 30% increases on renewals and new business rates are also higher.

In addition to higher rates, underwriting of health insurance for individuals and families is getting tougher and taking longer. Health insurance companies are almost routinely requesting doctors records before making a decision on your application and in some cases are refusing to approve coverage if you have not had a physical exam in the last 12 months.

Medical conditions that in the past were either considered a “standard” risk or elicited a nominal upcharge in premiums are now become major stumbling blocks.

We have entered a “hard” market for health insurance.

Many of the economic factors that affect businesses in the mainstream are filtering down to health insurance companies. All health insurance companies are seeing a noticeable drop in enrollment and those who are applying for health insurance are generally in poor health. Those who have individual or family health insurance are dropping coverage altogether if they consider themselves healthy.

What is left on the books are generally those who are sicker which raises claim costs relative to premium income.

Toss in the folks who opted for COBRA that normally would not have if not for the ARRA subsidy and the health insurance companies have a mess on their hands.

Insurance companies that cater to the group health insurance market are seeing participation in COBRA plans double or more. While that block was never profitable, it is even less so now and is gradually becoming a larger portion of their overall block.

In spite of what you may hear from the media and politicians, profits are being squeezed and the only way to maintain financial solvency is to increase premiums and when allowed, tighten underwriting criteria.

Here in Georgia we are seeing rates on the rise and it is becoming more difficult to get an individual or family health insurance policy issued. I would estimate at least 90% of health insurance applications are either denied or issued at something other than standard rates. Some carriers have told us they are rejecting 40 – 50% of applications for coverage.

A lot of those people come to me for assistance. Not too long ago I would review a risk profile for a prospective client, pre-screen that profile with a handful of health insurance companies, and then we could make our choice.

I still do that but I am also finding that I have to submit an application to two or three insurance companies before we get an acceptable offer.

Until the economy turns around, and it is not showing any signs of doing so, anyone looking to buy affordable health insurance in Georgia will be disappointed in how difficult it has become. No amount of rhetoric or tax dollars from Washington will cure our problems until consumers and business owners have confidence in the future of the economy.

When consumers have confidence and the ability to make purchases other than the basic necessities, businesses will start to hire and expand. We don’t have a credit crisis, we have a confidence crisis. All of this is spilling over to drive up the cost of health insurance which only serves to fuel political flames.

We still have the ability to help clients find affordable health insurance in Atlanta, but it is just getting more difficult every day.

  • Share/Bookmark

Tags:   · Comments Off