With the new health care reform, states were to have set up high-risk health insurance pools for individuals with pre-existing conditions that could not get coverage in the private market.
This pool was to be in effect on 6/1/2010, but Illinois has yet to establish.
Individual's eligible for coverage must have gone without health insurance for the past 6 months in order to apply.
Currently, Illinois has always had The Illinois Comprehensive Health Insurance Plan (ICHIP) for high-risk insured's. There were 4 types of coverage available, and depending on coverage there is a 6 month waiting period for coverage on pre-existing conditions. There is no current requirement to how long you have been without health insurance for.
For more information please feel free to contact The Shoppe.
-The Shoppe
The Health Insurance Shoppe is Chicago's first storefront marketplace for individual, family and group health insurance coverage. You can walk in and shop for a comprehensive plan that fits your lifestyle, needs and budget.
Wednesday, June 23, 2010
Friday, June 18, 2010
Make sure you know what Hospitals are covered with your health insurance
Be careful when applying for new health insurance coverage in the private market.
The #1 mistake people can make is going to a hospital or doctor that is not in their health insurance plans network of providers.
Click to see a list of hospitals covered by major health insurance companies in Chicago...http://bit.ly/NetComp
Even though your plan may be a Preferred Provider Organization (PPO), many insurance carriers offer smaller networks of providers for a discounted cost in monthly premium.
Depending on the insurance carrier, plans have separate deductibles and out-of-pocket expense limits for non-participating providers.
When selecting a smaller network of providers, make sure that your hospital of choice is in the network as well as your current doctor if you have been seeking care with him/her for a while.
If you live in the City of Chicago you will not find Northwestern Memorial, Rush, and possibly Advocate.
For any questions, please contact The Shoppe. Hope this was useful information.
Thanks!
-The Shoppe
The #1 mistake people can make is going to a hospital or doctor that is not in their health insurance plans network of providers.
Click to see a list of hospitals covered by major health insurance companies in Chicago...http://bit.ly/NetComp
Even though your plan may be a Preferred Provider Organization (PPO), many insurance carriers offer smaller networks of providers for a discounted cost in monthly premium.
Depending on the insurance carrier, plans have separate deductibles and out-of-pocket expense limits for non-participating providers.
When selecting a smaller network of providers, make sure that your hospital of choice is in the network as well as your current doctor if you have been seeking care with him/her for a while.
If you live in the City of Chicago you will not find Northwestern Memorial, Rush, and possibly Advocate.
For any questions, please contact The Shoppe. Hope this was useful information.
Thanks!
-The Shoppe
Tuesday, June 15, 2010
How to cut your costs with HSAs
Are you looking to cut your health insurance premium cost's. Look no further than moving to an HSA compatible plan.
The below link will take you to a comparison of 3 plans of health insurance coverage from Blue Cross and Blue Shield of Illinois for a 35 year old male living in Chicago.
http://bit.ly/bWHWFo
The comparison will show 2 traditional plans of coverage that have office visit copays with 1 HSA compatible plan that does not provide office visit copays, but will cover annual physicals under a $20 copay.
The comparison will show the costs for someone who has been having issues with their stomach and acid indigestion. The insured first seeks care at their internist who then must refer to a Gastroentologist, a specialist.
In the comparison all 3 plans have the same cost exposure other than for office visits. The HSA compatible plan is the most beneficial in this scenario, since it has the lower deductible and provides 100% coverage after the deductible is met...and did I mention it is the lower cost in premium..??
As for the Rx illustration, none of the plans have a copay. With BCBSIL you must select a $500 or lower deductible in order to receive a $10 copay for generics and cost share for preferred and brand name drugs. The presented plans will all discount the cost when purchased in-network and the final paid will be applied to the plans deductible.
In this scenario, if the insured has an HSA compatible, they are allowed to take up to a $3,050 above-the-line tax deduction for 2010. The insured would have to open a Health Savings Account (HSA) at a local bank for free or for a $2-$3 monthly fee.
In this example, the insured could pay for these expenses out-of their own pocket or via credit card (get miles) and can definitely work out a payment plan with the provider. The insured would then have to make deposits into their HSA for any amount up to the total amount of expenses prior to 4/15 of the following year. A deduction can only be taken for the total amount on the HSA ledger.
Now...when the insured is to contribute monies into the account, he/she can then immediately withdraw the money as a reimbursement to what they had paid out-of-pocket or on credit card. This then allows them to use the HSA strictly as a tax-vehicle for medical expenses, rather than a savings account.
Hope this is all making sense. There is no need to pay the insurance company more in premium to have office visit copays or to have a lower deductible.
Please call the shoppe with any questions!
-The Shoppe
The below link will take you to a comparison of 3 plans of health insurance coverage from Blue Cross and Blue Shield of Illinois for a 35 year old male living in Chicago.
http://bit.ly/bWHWFo
The comparison will show 2 traditional plans of coverage that have office visit copays with 1 HSA compatible plan that does not provide office visit copays, but will cover annual physicals under a $20 copay.
The comparison will show the costs for someone who has been having issues with their stomach and acid indigestion. The insured first seeks care at their internist who then must refer to a Gastroentologist, a specialist.
In the comparison all 3 plans have the same cost exposure other than for office visits. The HSA compatible plan is the most beneficial in this scenario, since it has the lower deductible and provides 100% coverage after the deductible is met...and did I mention it is the lower cost in premium..??
As for the Rx illustration, none of the plans have a copay. With BCBSIL you must select a $500 or lower deductible in order to receive a $10 copay for generics and cost share for preferred and brand name drugs. The presented plans will all discount the cost when purchased in-network and the final paid will be applied to the plans deductible.
In this scenario, if the insured has an HSA compatible, they are allowed to take up to a $3,050 above-the-line tax deduction for 2010. The insured would have to open a Health Savings Account (HSA) at a local bank for free or for a $2-$3 monthly fee.
In this example, the insured could pay for these expenses out-of their own pocket or via credit card (get miles) and can definitely work out a payment plan with the provider. The insured would then have to make deposits into their HSA for any amount up to the total amount of expenses prior to 4/15 of the following year. A deduction can only be taken for the total amount on the HSA ledger.
Now...when the insured is to contribute monies into the account, he/she can then immediately withdraw the money as a reimbursement to what they had paid out-of-pocket or on credit card. This then allows them to use the HSA strictly as a tax-vehicle for medical expenses, rather than a savings account.
Hope this is all making sense. There is no need to pay the insurance company more in premium to have office visit copays or to have a lower deductible.
Please call the shoppe with any questions!
-The Shoppe
Friday, June 11, 2010
Let's talk about Health Savings Accounts (HSA)
What is an HSA?
- An HSA (Health Savings Account) is a government regulated savings account where you can contribute money, tax-free, to pay for your medical expenditures, such as your deductible, prescriptions drugs, dental, vision and so on... Any unused funds in the account for the year, roll over to the next year. Your money in the account will earn interest that is tax-deferred.
- In order to have an HSA you must apply for a qualifying High Deductible Health Plan (HDHP)
- An HDHP is a health insurance plan with a deductible greater than $1,200 that does not include any pre-paid benefits such as an office visit copayment or prescription drug card.
- In Illinois, there are only two carriers that offer deductibles below $1,000. All other carriers begin at $1,000 or $1,500 for non HSA plans.
- First, when you become a member of an insurance carrier, you are given access to their network of providers, known as a PPO (Preferred Provider Organization). By seeking services at providers within the network, you fully utilize the plans benefits. This allows you to receive a negotiated rate on the services provided.
- An example would be a doctor charging $100 to the public for an office visit in relation to an accident or illness. If the doctor is in your carriers network, you would not be subject to the $100, but a negotiated rate, which could be anywhere from 20-50% lower.
- The final negotiated rate is what the insured would be responsible to pay the provider, which would be applied towards the plans deductible, whereas an office visit copay would not apply to the plan. An insured may be responsible for around $65-$70.
- Second, 90% of insurance carriers cover your annual physcial for males and females along with a females annual OB/GYN visit at 100% or under a copay, even HSA plans.
- If a non-HSA plan has an office visit copay, the copay will only cover the cost of the initial visit, the negotiated rate. Once lab work, diagnostic tests or X-rays are ordered...than they all become a deductible expense and do not fall under the copay.
- Now, keep in mind that doctors all charge different rates, especially a specialist which could run around $300/visit before the negotiated rate.
- You can always call your doctors billing department and ask how much they charge for visits.
- If you currently are in treatment and take prescription medication, carriers may offer a genric presciption drugs card on non-HSA plans than require you to meet a separate $500 or $1,000 deductible for Brand or Preffered Brand name drugs, before a copay would then apply.
- HSA plans will apply the cost of your prescription to your plans deductible, whereas if there was a copay for a Brand or Preferred Brand name drug, it would not be applied to your deductible
- If you were on a Brand Name drug and had a copay of $35-$75/month, the copay would not go towards your deductible. This is an average of $500 in annual copays that would be an out-of-pocket expense. If you had an HSA plan, than you would have lowered your deductible exposure by $500, meaning you would owe less on a larger claim, if there was one.
What does a copay cover?
Office visit copays cover the cost of your visit to either a specialist or non-specialist physician. Usually, a plan will have a copay from $20-$50.
When paid, your copayment does not apply to your plans deductible or out-of-pocket expense limit.
Your copay will only covers the cost of what the physician charges for that particular office visit. If you receive any immunizations or vaccines at the time of visit, they will be covered under the copay. If the doctor requests any additional lab work or diagnostic tests, these will not be covered under the copay, and be an expense subject to your plans deductible and/or out-of-pocket expense.
-The Shoppe
When paid, your copayment does not apply to your plans deductible or out-of-pocket expense limit.
Your copay will only covers the cost of what the physician charges for that particular office visit. If you receive any immunizations or vaccines at the time of visit, they will be covered under the copay. If the doctor requests any additional lab work or diagnostic tests, these will not be covered under the copay, and be an expense subject to your plans deductible and/or out-of-pocket expense.
-The Shoppe
Tuesday, June 8, 2010
Faced with COBRA??
You may not know...but for someone who has been terminated from employment after 6/1/2010 they are not eligible for COBRA subsidy and will be responsible for the whole cost.
If you are now faced with the high cost of COBRA, here are some options:
1. If you have medical conditions that make you ineligible for health insurance in the private market you can pursue ICHIP. The Illinois Comprehensive Health Insurance Plan (ICHIP) is our states high-risk insurance pool. If you have medical conditions that make you ineligible for health insurance in the private market you can pursue ICHIP. The Illinois Comprehensive Health Insurance Plan (ICHIP) is our states high-risk insurance pool.
- Depending on your age and smoking status, COBRA may be lower in cost
- Would need a declination letter from a private carrier to be eligible for coverage if COBRA has not exhausted
2. Depending on medical condition coverage you can pursue coverage in the private market and possibly be offered coverage w/o any exclusions, but with an increase of premium to take on health risk
3. If you are not receiving treatment and have a clean health bill then seeking coverage in the private market is your best alternative to COBRA.
Please call or stop by the shoppe with any questions.
Thanks,
The Shoppe
Friday, June 4, 2010
Reviews from the shoppes clients..
The Health Insurance Shoppe allows current and past clients to write a review about their experience on YELP.
We currently have a total of 6 reviews but only 3 are being shown on YELP, while the other 3 are being filtered since the reviewers are not active on YELP.
Below are our 6 reviews from our clients...enjoy :-)
Jason B.
Chicago, IL
11/3/2009
Ashley W.
Chicago, IL
1/22/2010
We currently have a total of 6 reviews but only 3 are being shown on YELP, while the other 3 are being filtered since the reviewers are not active on YELP.
Below are our 6 reviews from our clients...enjoy :-)
Jason B.
Chicago, IL
11/3/2009
The Health Insurance Shoppe was a pleasure to work with. Mr. Wishner is extremely knowledgeable on the subject. I quickly understood the underlying aspects of the different policies and made a decision with their guidance and expertise. I plan on referring all of my friends to The Health Insurance Shoppe. It was refreshing to actually sit down and discuss my options with someone in person versus today's automated world.
Ashley W.
Chicago, IL
1/22/2010
For the many of us out there attempting to find the right health insurance plan, I strongly recommend that you consider the Health Insurance Shoppe. Working with the owner Jordan was quite pleasurable. It's refreshing to have an actual individual to talk to about the matter and find a plan that meets each applicants unique needs. Not only can you drop into his office on the fly (big plus!) but he is great about emailing and following up with phone calls.
Overall, if you are over your head trying to sort out health insurance, it is definitely worth your time to stop in. I am a 24 year old female and I did not feel pressured or taken advantage of during the process. Jordan is highly personable and it shows that he has the desire to help individuals become insured.
Like I said earlier, its worth the trip to Roscoe Village if you are contemplating heath insurance issues.
Overall, if you are over your head trying to sort out health insurance, it is definitely worth your time to stop in. I am a 24 year old female and I did not feel pressured or taken advantage of during the process. Jordan is highly personable and it shows that he has the desire to help individuals become insured.
Like I said earlier, its worth the trip to Roscoe Village if you are contemplating heath insurance issues.
Carine M.
Chicago, IL
2/18/2010
We were approved in no time at all (for real, today is 2/18 at 9:47am, we finished our application at 6:15pm on 2/15) . Fast service, too! Thanks Jordan!
We had a great experience shopping for health insurance at the health insurance shoppe. First of all, there is a super cute and friendly dog named Vail there that entertained our dog while we took care of business.
Jordan was great and answered all of our questions. We got on a great plan (once we're approved; cross your fingers everyone), and we are super excited to save $800/month!!
Jordan was great and answered all of our questions. We got on a great plan (once we're approved; cross your fingers everyone), and we are super excited to save $800/month!!
Wylee J.
Chicago, IL
3/1/2010
The Health Insurance Shoppe made it easy to select the right health insurance plan for me. As a freelancer, it's hard to find an affordable plan that still provides the coverage that I need. Jordan was able to help me select the best plan for me as well as go over it with me in person. He was extremely helpful throughout the entire process. I highly recommend stopping by or calling if you need health insurance!
Kay B
Chicago, IL
4/30/2010
If you are looking for Health Insurance, your search is over. Jordan at the Heath Insurance Shoppe is wonderful. He is very good at explaining all of your options so you can make an educated choice in Heath Care. I would highly recommend him. He is very professional and very knowledgeable.
Burt I.
Oak Park, IL
5/22/2010
I found myself with somewhat difficult problem of trying to get short term health coverage for my son who was bumped off my family plan when he turned 19. I was told by several other insurance agents that the best I could do was pay a very high Cobra premium due to several preexisting conditions. I had resigned myself to writing a big check (basically throwing money away) but as a last resort I called some more agents. I was lucky enough to find Jordan Wishner at the Health Insurance Shoppe.
He was the first insurance broker I talked to that had the breadth of knowledge about the ins and outs of getting coverage with preexisting conditions in this complicated market. Within a week we had approval for coverage for my son at about one third the price of Cobra.
Jordan literally saved me thousands of dollars of Cobra payments. I highly recommend you consult Jordan for your health insurance needs. He's extremely competent and patient and knows the market very well. He went out of his way to help solve what seemed like an unsolvable problem before I talked to him.
He was the first insurance broker I talked to that had the breadth of knowledge about the ins and outs of getting coverage with preexisting conditions in this complicated market. Within a week we had approval for coverage for my son at about one third the price of Cobra.
Jordan literally saved me thousands of dollars of Cobra payments. I highly recommend you consult Jordan for your health insurance needs. He's extremely competent and patient and knows the market very well. He went out of his way to help solve what seemed like an unsolvable problem before I talked to him.
Wednesday, June 2, 2010
Health Insurance 101
If you are in the search for a health insurance plan, Health Insurance 101 can be a great tool to help understand the following:
- Difference between insurance carriers
- HSAs
- Glossary of commonly used terms
The link below will direct you to Health Insurance 101
Thanks,
-The Shoppe
#1 benefit to why HSA compatible plans are the plan to choose
Whether you are looking for health insurance coverage or are currently insured, the below link will take you to an illustration that will show how much one is to pay for a $10,000 hospital bill from 5 plans provided by BCBSIL.
HSA Plan Exposure Comparison
All 6 plans presented cover an annual physical and annual OB/GYN visit (mammogram and pap smear) under a $20 or $30 copay, even the HSA plan.
The first 5 plans will provide the same copay for additional office visits as well. The HSA plan will not provide a copay and require you to pay the discounted amount of the visit towards the plan deductible.
Now onto the illustration....
The highlighted plan, being HSA compatible, is the lowest cost of the plans presented. Not only is it the lowest in premium, but it also provides the least risk to the insured for a hospital expense as illustrated.
Now, if I compare the cost of the HSA plan to the first plan presented with the lowest deductible, the annual savings in premium is $793. Since the HSA plan does not have copays, that amount in savings is more than enough to cover the cost of additional visits other than preventative. Make sense?
Why should I pay an insurance company more premium for a plan that will cost me more at time of a large claim?????
As for the actual Health Savings Account (HSA)...This is a no-brainer. HSAs can be opened at a local bank branch for free or for a $2-$3 monthly fee. With the account, the IRS allows for an individual to deposit up to $3,050 for 2010. The total amount deposited into the account, is taken as a above-the-line tax deduction, reducing your taxable income by up to $3,050.
Remember the account is optional. In the presented illustration, the insured can pay for these expenses on a credit card or another payment other than the HSA. Anytime before 4/15 of the following year, the insured can make deposits into the HSA for the amount spent, and then immediately withdraw as reimbursement. This way, funds hit the ledger in order to take a deduction.
So...to sum it up, the one with the HSA plan will be able to take a 100% tax deduction on the total amount spent for the hospital bill, where as anyone on the other 5 plans would only be able to deduct if the expenses were greater than 7.5% of their total adjusted gross income.
Make Sense?
Please call the shoppe to learn more on HSAs.
Thanks!
-The Shoppe
HSA Plan Exposure Comparison
All 6 plans presented cover an annual physical and annual OB/GYN visit (mammogram and pap smear) under a $20 or $30 copay, even the HSA plan.
The first 5 plans will provide the same copay for additional office visits as well. The HSA plan will not provide a copay and require you to pay the discounted amount of the visit towards the plan deductible.
Now onto the illustration....
The highlighted plan, being HSA compatible, is the lowest cost of the plans presented. Not only is it the lowest in premium, but it also provides the least risk to the insured for a hospital expense as illustrated.
Now, if I compare the cost of the HSA plan to the first plan presented with the lowest deductible, the annual savings in premium is $793. Since the HSA plan does not have copays, that amount in savings is more than enough to cover the cost of additional visits other than preventative. Make sense?
Why should I pay an insurance company more premium for a plan that will cost me more at time of a large claim?????
As for the actual Health Savings Account (HSA)...This is a no-brainer. HSAs can be opened at a local bank branch for free or for a $2-$3 monthly fee. With the account, the IRS allows for an individual to deposit up to $3,050 for 2010. The total amount deposited into the account, is taken as a above-the-line tax deduction, reducing your taxable income by up to $3,050.
Remember the account is optional. In the presented illustration, the insured can pay for these expenses on a credit card or another payment other than the HSA. Anytime before 4/15 of the following year, the insured can make deposits into the HSA for the amount spent, and then immediately withdraw as reimbursement. This way, funds hit the ledger in order to take a deduction.
So...to sum it up, the one with the HSA plan will be able to take a 100% tax deduction on the total amount spent for the hospital bill, where as anyone on the other 5 plans would only be able to deduct if the expenses were greater than 7.5% of their total adjusted gross income.
Make Sense?
Please call the shoppe to learn more on HSAs.
Thanks!
-The Shoppe
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