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January 2009 | Modern Hygienist
Fair deal on health insurance? Selecting your own healthcare insurance is often more difficult than receiving employer-provided insurance, yet it is well worth the added effort. When it comes to selecting their healthcare insurance, the majority of professional hygienists are on their own. According to the 2008 MH Hygienist Salary Survey, only 36% of respondents noted they received healthcare benefits from their employer. Many survey respondents listed healthcare insurance as a chief concern along with overall compensation. This article lists some suggestions and precautions on finding the proper health insurance on one’s own. Many hygienists work for themselves, as independent contractors, and must obtain individual health insurance policies. Generally, these typically are more difficult to obtain, and are more expensive than employer-provided group insurance policies. There are features to look for in an individual healthcare insurance policy.
Where to begin A good place to start is by looking for your own health insurance agent or broker…which often takes more effort than looking for a life insurance or a property insurance agent. This is because many people obtain health insurance from their employer, making individual agents scarcer. A good way is to check with your state’s insurance department for a list of independent insurance agents, check the Internet for brokers, or ask friends for references. Note that there is a difference between an agent and a broker. An agent works for an insurance company, and may be allied with single or multiple companies. An independent agent is an independent contractor with the company or companies, and has the authority to legally obligate the insurance company to provide coverage according to terms and conditions as bound. Conversely, a broker works for the client. A broker is not an insurance company employee, and has permission to seek insurance quotations for a client. As a representative for the insured, the broker approaches several insurance companies to provide adequate coverage. Unlike an agent, a broker does not have the authority to legally obligate an insurance company to provide coverage according to terms and conditions as bound. They present the client’s information to the insurance company, and if the company agrees, the insurance company will bind the coverage. Esther Carrera, a health insurance broker with Carrera & Associates in Elk Grove Village, IL, says the first step anyone should take when looking for health insurance on their own is to determine coverage need. “Determine whether you have a short-term need or a long-term insurance need,” she said. Although every case is different, according to Carrera, there are basic items to look for: “A deductible that is affordable, out-of pocket costs one can live with—including co-insurance expenses, and a provider network that is broad enough to suit even unknown future needs,” she said. It can take awhile to get the right policy, and the process may involve evaluating several policies. Carrera recommends one should stop their looking when a particular policy answers their required needs. Advantages of a broker For all this, Carrera recommended enlisting the help of a health insurance broker, because finding insurance on one’s own can be quite time consuming, particularly while holding down a fulltime job. In general, the broker interviews the client to determine client needs, any pre-existing conditions or medications the client is taking, hospitalizations, and deductible preference. The broker then seeks out the insurance plans best suited to the client (often while the client is busy at their own job). Solo difficulties Looking for the right healthcare policy on one’s own, without professional help, can average as long as six months, according to Carrera. Other disadvantages of looking independently, she added, can be a lack of knowledge—including failure to know what to look for, or understanding the terms used. Because of this, she said, the individual may end up very surprised at their results when they go it alone. For example, where one lives makes a difference in health coverage. Some states have passed laws to guarantee coverage to all their residents—guaranteed-issue laws. Other states offer a “community-rating” system, which requires insurers to charge everyone the same standard rate, regardless of their health. Sometimes these requirements limit the ability of health insurance companies to raise premiums. But often, these well-intentioned laws have backfired, forcing some healthy people to pay much more for their premiums. Be sure to check your state laws.
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