In this chapter I will give my strategies for how I configure my client’s coverage. Over time you will develop your own model for what you believe to be the ideal configuration based on your client’s wants and needs. What I share here is only meant to be an example. By no means do I think “my way” is the only way! My strategy is centered on finding the best overall plan configuration for my client taking into consideration their budget, desires, needs and unique circumstances. I also consider my compensation for both my time and knowledge. From the VERY beginning I teach the client what to look for when evaluating health insurance.
In order of importance:
1. Annual out-of-pocket maximum (this is by far the most important item to look at in any health insurance plan).
2. Plan deductible.
3. What is the co-insurance for lab, x-ray and other tests?
4. Is there a deductible for brand drugs and is there an annual cap on RX drugs.
In my opinion everything else in a health plan is “fluff”. For example office visit co-pays, wellness visits, ambulance deductible etc. Basically those items are inconsequential when evaluating out of pocket risk. What you want the prospect to understand is that health insurance was designed to protect their assets from a catastrophic medical expense AND to allow their loved ones to seek the best medical attention should they get SICK! That’s it! You don’t get car washes, oil changes, tires or and routine maintenance with your auto insurance, so why would you expect to get those ancillary services with health insurance? Because the health insurance companies have conditioned people to want those things so they can charge more on a monthly basis. Most individuals are accustomed to $10 office visit co-pays with their employer sponsored group HMO, but those “extras” are exorbitantly expensive when included into individual health insurance and you need to educate the prospect of that. Continue reading ‘Strategies For Designing Your Clients Health Coverage to Maximize Coverage and Minimize Cost’ »