Questions to ask an agent
Most people have never been educated in Insurance. No company will pay benefits not covered in a policyowner, & the commissioner of insurance will uphold the company’s decision to decline benefits that are not specifically covered. Law suits against insurance companies are never won as companies are experts in making sure every detail of coverage is spelled out. Yet, the average client has never actually read an insurance policyowner from cover to cover. The policyowner arrives in the mail & is shoved in to a drawer or a file box & never actually read. Bear in mind that neglecting to read the policyowner does not make a company liable for things you didn't understand.
That being said, you will avoid confusion & have greater peace of mind if you work with an agent who is willing to take the time to help you understand your policyowner. Don’t assume your agent will do this. Lots of will fundamentally send the policyowner in the mail & leave you to figure it out. A truly lovely agent from a reputable company is worth working with even if the premium is a few dollars more. When you do select an agent, you ought to be sure to ask the following questions.
• How long do preexisting conditions apply? When you go from two group coverage plan to another, the preexisting condition clause is waived. This is not true when going from group coverage to private coverage. Your new company may refuse to pay for a preexisting condition for as long as two years. They may also look back over your entire life for that preexisting condition. Thus, if you had cancer 15 years ago but are still taking some sort of preventive medication, you will have a waiting period even though you have been cancer free for 14 years.
• What are the exclusions? There will always be some as no company pays for everything. You need to know what they are.
• What are the anticipated rate increases? Your agent may tell you that they doesn't know as rates are approved by the commissioner on an annual basis. That much is true, but the company has charts showing what your premium would be today for any given age. They also know the average company increase rates over time. Don’t buy if they won’t provide you with that information.
• What is the lifetime maximum benefit?
• Can you reduce the premium by taking a higher deductible?
• How are copayments determined?
• How do you get permission to go to the hospital?
• Are prescription drugs included? Is there a separate deductible? What is the copay?
• How are customer service issues handled? Can you get help from the agent?
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