{"id":1,"date":"2012-02-01T17:32:05","date_gmt":"2012-02-01T17:32:05","guid":{"rendered":"http:\/\/online-health-insurance.int.apollobackstage.com\/articles\/?p=1"},"modified":"2013-05-13T16:15:39","modified_gmt":"2013-05-13T16:15:39","slug":"hello-world","status":"publish","type":"post","link":"https:\/\/www.online-health-insurance.com\/articles\/analysis\/health-insurance-introduction.php","title":{"rendered":"Treating health insurance like a consumer product: An introduction"},"content":{"rendered":"

Hi. My name is James Walsh. The producers of this site have asked me to write a twice-monthly column on health insurance topics for consumers. This is the first of what I hope will be many useful takes on the current state of health coverage in the United States.<\/p>\n

A few quick notes about my qualifications. For the last decade, I have been the editorial director and publisher of the Merritt Manuals<\/a><\/em>, a multi-volume technical reference encyclopedia used by insurance companies, risk managers, agent\/brokers and claims adjusters. The Insurance Training Collection, an educational tool based on the Merritt Manuals<\/em>, helps agents throughout the United States get and keep their licenses. I\u2019ve also written or edited consumer books on risk and insurance, including the bestsellers True Odds: How Risk Affects Your Everyday Life<\/a><\/em> and Get Your Claim Paid<\/a><\/em>.<\/p>\n

But enough about me. The purpose of this column is to give you, the reader, two things:<\/p>\n

1)\u00a0\u00a0\u00a0 a working understanding of how health insurance policies work and the health insurance marketplace operates; and<\/p>\n

2)\u00a0\u00a0\u00a0 practical tips for buying the best coverage for the best price.<\/p>\n

This column won\u2019t promote certain companies or products; I\u2019ll focus instead on information that will help you make the best health insurance buying decisions for yourself and your circumstances.<\/p>\n

You know your health insurance needs better than anyone, better even than experts and professionals. The first step in buying the right coverage is to focus attention on your situation and needs. To that end, here are seven basic tips that you should keep in mind when shopping for health insurance:<\/p>\n

1)\u00a0\u00a0\u00a0 Know yourself and your family. This simple point is important because who you are<\/em>\u2014including your age, gender and health history\u2014is the most important factor when it comes to setting up and pricing health insurance coverage. And \u201cyou\u201d is not always a single pronoun; a couple has different needs than a single person\u2026who has different needs than a family with young children.<\/p>\n

2)\u00a0\u00a0\u00a0 If you have a family, getting health insurance coverage for some members may be easier than for others. While it\u2019s easiest to insure everyone under a single policy, it might be more effective to insure kids under one policy, adults under another or individuals with specific health issues separately. This requires organization on your part\u2014but can yield better results, in terms of cost, coverage and claims paid.<\/p>\n

3)\u00a0\u00a0\u00a0 Know your own health history and the histories of everyone in your family. Surprisingly, some people prefer \u201cnot to know\u201d about their overall health\u2014especially if they have family histories of conditions like high blood pressure, cancer or genetic diseases. But this kind of \u201cignorance is bliss\u201d outlook doesn\u2019t work well for anyone in today\u2019s world.<\/p>\n

4)\u00a0\u00a0\u00a0 Understand that insurance policies are contracts between you (sometimes called \u201cthe insured\u201d) and an insurance company (sometimes called \u201cthe carrier). Most terms and conditions can be negotiated, if you are informed and determined. Finding a good independent insurance agent can help this process. A lot.<\/p>\n

5)\u00a0\u00a0\u00a0 Some people in the health insurance field hide behind legal jargon and tell consumers this or that request is \u201cillegal\u201d or \u201cagainst the law.\u201d Most insurance-related laws and regulations (leaving aside the Affordable Care Act of 2010) put requirements on insurance companies, not insurance consumers. There\u2019s not much\u2014short of outright fraud\u2014that an insurance consumer can do that\u2019s against the law. In most cases, the main risk that an aggressive consumer faces is that his or her policy gets cancelled or rescinded at some later date.<\/p>\n

6)\u00a0\u00a0\u00a0 Insurance, by industry tradition and design, is difficult to shop for on a comparison basis. Health policies and contracts are structured in such a way that \u201capples to apples\u201d comparisons are difficult; but you can make effective comparisons by learning some essential jargon and knowing standard policy components.<\/p>\n

7)\u00a0\u00a0\u00a0 The health insurance marketplace is going through more radical change than at any time in the last 50 years. In many cases, even experienced professionals aren\u2019t sure what current laws or regulations require\u2026or what current market conditions mean for specific types of coverage. This can make some professionals (whether they work for insurance companies, broker\/agents or government regulators) nervous and defensive. But the good ones will admit that industry standards are changing fast\u2014and will work with you to answer questions or find solutions.<\/p>\n

Clearly, the Affordable Care Act of 2010 (known in many circles as \u201cObamacare\u201d) has affected\u2014and will continue to affect, even if it\u2019s modified or repealed\u2014the market for health insurance coverage in the U.S. So, this column will look at that law often and from various angles. But I\u2019m not interested in partisan politics or repeating talking points from political party or another\u2026or one trade association or another. My only interest is in analyzing the law and related regulations for how they will affect how you buy health coverage.<\/p>\n

There\u2019s an old saying in the insurance industry: The best kind of insurance is the one that pays when you need it. My main goal in this column will be to help you get that<\/em> kind of health coverage.<\/p>\n

More specifically, in the coming weeks and months, this column will consider the following topics:<\/p>\n