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Netting the right health insurance policy

YOUR MONEY

The options are dizzying, with premiums, deductibles and co-payments that vary widely among plans and costs that are not always obvious. Here's how to avoid expensive mistakes.

June 21, 2009|Kathy M. Kristof

The one website that offered true online shopping was www.eHealthInsurance.com, where at least two dozen policies popped up in answer to our sample request. In addition to a button offering "plan details," the eHealth site also offered a "find doctor" button for each policy, which would be convenient for anyone who was attached to their current medical providers.

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Advice on applying for health coverage

Once you find a policy that meets your needs, either by electronic shopping or by talking to an agent, you need to formally apply for coverage. You'll need the medical records that you just dragged out to evaluate your needs to fill out the application, which asks for details of your medical history.

Make sure you fill it out completely and accurately, said Kansas Insurance Commissioner Sandy Praeger, who heads the National Assn. of Insurance Commissioners' managed care committee. Omissions on the application can be used to deny coverage later if you have a recurring ailment that wasn't previously disclosed.

"It's really important to answer the questions honestly," she said. "If you have questions about the terminology on the form, call your physician and ask what it means and whether it's something you need to report."

If you get accepted for coverage, you need to do one last thing before writing a check: Make sure your insurance carrier is licensed.

There are no figures on the number of potentially bogus health policies being peddled, but experts believe today's environment is ripe for a huge upswing in fraud.

The only way to determine that your insurer is legitimate is to call your state department of insurance and ask. Also ask if the company has a history of complaints and regulatory actions, suggested James Quiggle, a spokesman for the Coalition Against Insurance Fraud.

Don't be fooled just because your agent is licensed, he added. The company must be licensed too.

"The agent is simply an intermediary who sells the product," Quiggle said. "The fact that the agent is licensed doesn't mean that the product is real or valid. Agents can be duped into selling fake coverage because they didn't do their own due diligence or they could have signed on with a wink and a nod because they want the commission."

Ensuring that your insurer is real can be a life-or-death decision, Quiggle added.

"If you can't get timely medical care, your life could be on the line," he said. "And you don't want to end up having to be bankrupted by paying major medical bills on your own, when you thought they were covered by insurance."

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kathykristof24@gmail.com

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