How to Avoid Predatory Health Insurance Plans

How to Avoid Predatory Health Insurance Plans

How to Avoid Predatory Health Insurance Plans

Even if you have never heard the term predatory health insurance, you may have been affected by it, nonetheless. What are predatory health insurance plans? They are plans that do not provide reasonable coverage for medical services and charge you the same or charge you too much (usually in premiums) for health insurance coverage.

All health insurance companies – ACA or privately owned – must adhere to certain standards and regulations in the health insurance industry. This includes offering minimum levels of health coverage for a fair price. Companies that overcharge or provide too little coverage are predatory health insurance companies. As a consumer and someone looking to save money on healthcare, you need to be aware of predatory plans and identify when an agent or provider is taking advantage of you. 

How to Identify a Predatory Health Insurance Plan

There are several ways that you can tell if a provider is offering a predatory health insurance plan.

High Insurance Premiums

In 2020, the average national cost for health insurance is $456 for an individual and $1,152 for a family per month. However, costs vary among the wide selection of health plans. Some plans are more expensive, while others are less. If you feel that you are paying too much for health insurance, then speak with an insurance broker who can help you compare your plan and premiums to similar plans from other providers. If your premiums are too high, it’s time to cancel your insurance.

Insufficient Coverage

With the rising cost of healthcare in the U.S., it makes no sense to get anything less than comprehensive coverage. This plan covers a broad spectrum of services such as doctor visits, emergency care, specialized procedures, mental health services, preventative care, and other forms of medical treatment. Before you take out a plan, look at the coverage it provides, and decide if it meets your needs. 

Too Many Rejected Claims

There are several reasons why health insurance companies reject claims. Lack of authorization, claim form errors, missed deadlines, insufficient medical necessity, out-of-network providers, or pre-existing conditions can all be valid reasons for a denied claim. However, if your provider keeps denying your claims on baseless grounds, you may be the victim of a predatory health insurance plan.

How to Avoid Predatory Health Insurance Plan 

The best way to save money on healthcare and avoid a predatory health insurance plan is to go through a health insurance broker or agent. A health insurance broker is a licensed benefits professional who can help individuals and businesses manage the health insurance selection process from start to finish. 

If you feel overwhelmed by the process of buying health insurance, you can benefit from professional assistance. Insurance agents and brokers help you sift through available options to find a healthcare plan that’s compatible with their company’s needs and budget. Working with a broker to get individual health insurance can be extremely valuable for some people. Here are some of the ways in which their services are helpful:

Quick Access to Support 

Plan holders have a designated person to contact if they need help solving problems with claims payments, coverage eligibility, access to care, and other issues—which you can’t get on a website.

Personalized Recommendations 

Brokers can explain the pros and cons of different benefits packages. They offer personalized advice to help people select the right plan.

Provide Specialized Health Insurance Knowledge 

Brokers can help you understand key healthcare coverage terms and help you make sense of your available options. Brokers can also help elderly consumers better understand their Medicare coverage and options for long-term care.

How to Determine the Right Health Plan

You may be wondering which health insurance company is the best? When choosing a plan, you first need to assess your personal healthcare needs, look at all your options, and choose a health insurance plan that fits your budget. How do you determine which health insurance is best? Ask yourself these questions:

  • How often do you visit your doctor?
  • What type of treatment do you need in the next 12 months?
  • What prescription drugs do you currently take?
  • Which healthcare providers/physicians do you prefer?

The Right Health Insurance Coverage from Insurance Enterprise

Insurance Enterprise offers comprehensive health insurance options for individuals, families, and small businesses. Our insurance agents can help you in the following ways:

  • We leverage what you pay for medical services. You end up paying much less than what insurance companies pay out.
  • We negotiate procedures and services from healthcare providers and treatment facilities within Multi-Plan on your behalf. So, if you are self-paying, you save up to 80 percent when you use a provider that is in the network.
  • PHCS Multi-Plan is the largest healthcare PPO network in the country.
  • You choose any doctor in the network.
  • Our plans pay out benefits based on all benefits schedules regardless if the benefit exceeds your discounted price. You simply pay the remaining balance.
  • Use Healthcare Bluebook, a simple online tool, to help you find the best care and price for your procedure in your local area.

We Offer Affordable Health Insurance in These States:

Contact Insurance Enterprise for Premier Health Insurance

 If you have questions about group or individual health insurance and need health insurance quotes, contact Insurance Enterprise at 888-350-6605. Speak to a licensed agent and find out more about how you can get an affordable health insurance plan.