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MEGA Life Offers Tips on Finding the Right Health Insurance Plan

Posted on: Wednesday, 5 December 2007, 12:00 CST

The rising cost of health care has made comprehensive health insurance unaffordable to many. For those who cannot afford a fully comprehensive plan, The MEGA Life and Health Insurance Company (http://www.megainsurance.com) offers the following consumer tips on health insurance.

As a subsidiary of HealthMarkets, MEGA is a leading provider of affordable health and life insurance to the self-employed, individuals and small businesses.

Consult the experts

A great place to start a search for insurance is by finding an agent you trust. Additionally, state departments of insurance are a great source for objective information about insurance providers -- much of it available on the Internet.

"When selecting an individual health insurance plan there are a multitude of very important decisions that must be made," said Jack Heller, Executive Vice President of UGA, the principal marketing division of The MEGA Life and Health Insurance Company. "A licensed and trained agent is your best resource to fully explain the policy you are considering, answer questions and assist you throughout the process and after the sale."

Know Your Options

A few basic categories of health insurance include:

Defined Benefit Plans

Defined benefit plans may make sense for consumers who have a limited budget but want some level of coverage. These plans typically cover most inpatient, outpatient and physician services, but in limited amounts.

Consumer-Guided Plans

Some consumer-guided plans offer access to information-packed Web sites with innovative tools that allow consumers to shop around for the best value among quality health care providers. These plans encourage consumer involvement in health care spending decisions while helping to maximize plan benefits.

Preferred Provider Organization Plans

A PPO plan offers a network of providers who provide health care services at a discount. They typically offer more coverage than Defined Benefit Plans and Consumer-Guided Plans, but generally also have higher monthly premiums.

High-Deductible Plans

Some high-deductible health insurance plans are designed to be compatible with a Health Savings Account (HSA). An HSA enables consumers to save and pay for qualified medical expenses on a tax-free basis.

A high deductible plan with an HSA may work well for consumers looking for an insurance company to pay catastrophic coverage who are willing to pay smaller claims out of pocket using the HSA. The plans allow consumers to save money on their premiums and put that into a tax-advantaged account should it be needed.

When buying insurance, it pays to ask questions. Find an agent you trust to sit down and walk through your policy. That way, when something comes up involving your policy, you will have an agent who is ready to help.

A few questions might include:

Policy limits

-- Are there per illness limitations?

-- What is the lifetime limitation on a policy?

-- Do you have any daily limitations?

Policy procedures

-- Are you restricted to certain hospitals or doctors?

-- Do you need to go to a primary care physician for authorization before you can go to a specialist?

-- How much are your co-payments and deductibles?

-- Are inpatient and outpatient services covered equally?

-- If you have an existing health condition, will it be covered?

If you have a pre-existing health condition, it is important to disclose that fully at the point of application. Health insurance companies routinely check medical records and failure to disclose health conditions can lead to termination of coverage.

State-run programs may offer ways to cover pre-existing conditions -- check with your state department of insurance. And if you have insurance with a health condition, avoid gaps in your health insurance coverage.

Once Covered, Make Your Plan Go the Distance

If you have a policy and require non-emergency health care, it pays to stay informed and engaged in your health care decisions.

Ask Questions

For non-emergency care, find out how much your treatment will likely cost, and how much will be covered. Ask whether there are less costly treatment options, including generic drugs.

Shop Around

You can get a good idea about how much health care typically costs by looking at unbiased Internet resources. Some plans -- such as MEGA CareOne Select consumer guided plans available in selected markets -- allow you to look up how much Medicare pays for physician-provided services.

Negotiate

If you talk to your doctor or health care provider and explain that you are on a budget or that you have a limited benefit plan, you may be able to receive a lower rate for services.

Take Advantage of Case Management

Your doctor and your insurance company want the same thing as you: for you to be healthy. When a major illness occurs, some insurance companies offer third-party case management to stretch your health care dollars. Case management is intended to maximize your policy's benefits by devising a treatment plan that will deliver quality care in the most cost-effective manner.

About The MEGA Life and Health Insurance Company

The MEGA Life and Health Insurance Company (https://www.megainsurance.com) is an insurance company domiciled in Oklahoma and is licensed to issue health, life and annuity insurance policies in all states except New York. MEGA is an indirect-wholly owned subsidiary of HealthMarkets, Inc.

About HealthMarkets®

HealthMarkets, headquartered in North Richland Hills, Texas, is a provider of health and life insurance products to individuals, families, the self-employed and small businesses. HealthMarkets offers products and services through its licensed insurance subsidiaries. The Company's offerings include individual and self-employed health insurance, small employer group health insurance, life insurance and reinsurance. Through its Consumer Guided Health Insurance plans, HealthMarkets seeks to provide affordable and accessible health coverage to individuals and small businesses. For more information, visit http://www.healthmarkets.com.

SAFE HARBOR STATEMENT UNDER THE PRIVATE SECURITIES LITIGATION REFORM ACT OF 1995: Some of the matters discussed in this news release may contain forward-looking statements that are subject to certain risks, uncertainties and assumptions. Such forward-looking statements are intended to be identified in this document by the words "anticipate,""believe,""estimate,""expect,""intend,""objective,""plan,""possible,""potential" and similar expressions. Actual results may vary materially from those included in the forward-looking statements. Factors that could cause actual results to differ materially from those included in the forward-looking statements include, but are not limited to, general economic conditions; the continued ability of the Company to compete for customers and insureds in an industry where many of its competitors may have greater market share and/or greater financial resources; the Company's ability to accurately estimate medical claims and control costs; changes in government regulation that could increase the costs of compliance or cause the Company to discontinue marketing its products in certain states; the Company's failure to comply with new or existing government regulations that could subject it to significant fines and penalties and/or result in restrictions on its operations; changes in the relationship between the Company and the membership associations that make available to their members the health insurance and other insurance products issued by the Company's insurance subsidiaries; changes in the laws and regulations governing so-called "association group" insurance (particularly changes that would subject the issuance of policies to prior premium rate approval and/or require the issuance of policies on a "guaranteed issue" basis); significant liabilities and costs associated with litigation; failure of the Company's information systems to provide timely and accurate information; negative publicity regarding the Company's business practices and/or regarding the health insurance industry in general; the Company's inability to enter into or maintain satisfactory relationships with networks of hospitals, physicians, dentists, pharmacies and other health care providers; failure of the Company's regulated insurance company subsidiaries to maintain their current ratings by A.M. Best Company, Fitch and/or Standard & Poor's; and the other risk factors set forth in the reports filed by the Company from time to time with the Securities and Exchange Commission.

Source: Business Wire

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