What is the difference between a quote and an application? A quote is strictly a “base” premium based on the data (date of birth, sex, city, etc.) given. Final rates are based on full medical underwriting.
How do I apply? Applications can either be paper, online or by phone.
How long will it take for my application to be approved? Depending on your past medical history and if medical records are required. Underwriting may take place immediately or up to four weeks.
What are the limitations regarding pre-existing conditions? Some carriers will consider covering pre-existing conditions with an increase in your premium. Others will riders (not cover) those conditions. The length of the rider may be as short as one year or may extend through out the contract depending on the severity of the condition.
Do the plans you offer include a physician office copay or prescription drugs? Many plans do include these options but keep in mind that you are paying a higher premium for them.
What is an out-of-pocket limit? After you spend a predetermined deductible you and the insurance company share expenses until you have met your out-of-pocket maximum. At that point the insurance company pays the remainder of your medical expenses for the benefit period. Once a new benefit period begins you are responsible for the deductible and out-of-pocket limit again.
What is a lifetime maximum? The health insurance company will pay up to a certain amount during your lifetime. This amount varies by company.
What are exclusions and limitations? Exclusions are services that are not covered such as cosmetic surgery. Limitations are the number of visits (or dollar amounts) the insurance company will pay for certain services. Some of the more common services with limitations are physical therapy and home health care visits. These limitations may be by the benefit year while other may be for the entire policy period.
How often do rates change? You will see an increase in premiums on individual policies at least once per year. Some policy do have six month rate increases. Some companies offer plans that will lock in premiums for 24 or 36 months.
