1. DOES YOUR PLAN COVER YOU ON AND OFF THE JOB?
Many health insurance plans have specific exclusions that eliminate your benefits for anything that could have been covered under Workers Compensation or similar laws. Now read that last sentence again.
Many health insurance plans have specific exclusions that eliminate your benefits for anything that could have been covered under Workers Compensation or similar laws. Now read that last sentence again.
COULD HAVE BEEN COVERED!?
That is correct. Most self employed people and even some small business owners do not carry Workers Comp on themselves.
There are designed insurance plans that will cover you on and off the job — 24-hours a day, if you are not required by law to have Workers Compensation coverage.
2. ARE YOU WRITING IT OFF?
Independent contractors (1099's), home based business owners, professionals and other self employed people generally are not taking advantages of the tax laws available to them.
Many people who are paying 100% of their own costs are eligible to deduct their monthly insurance payments. Just that alone can reduce your net out-of-pocket costs of a proper plan by as much as 40%. Ask your accounting professional if you are eligible and/or check out the IRS website for more information.
3. INTERNAL LIMITS
All true insurance plans use some form of internal controls to determine how much they will pay out for a particular procedure or service. There are two basic methods.
-Scheduled Benefits
Many plans, some of which are specifically marketed to self employed and independent people, have a clear schedule of what they will pay per doctor office visit, hospital stay, or even limits on what they will pay for testing per 24-hr. period. This structure is usually associated with "Indemnity Plans". If you are presented with one of these plans, be sure to see the schedule of benefits, in writing. It is important that you understand these type of limits up front because once you reach them the company will not pay anything over that amount.
-Usual and Customary
"Usual and Customary" refers to the rate of pay out for a doctor office visit, procedure or hospital stay that is based on what the majority of physicians and facilities charge for that particular service in that particular geographical or comparable area. "Usual and Customary" charges represent the highest level of coverage on most major medical plans.
-Scheduled Benefits
Many plans, some of which are specifically marketed to self employed and independent people, have a clear schedule of what they will pay per doctor office visit, hospital stay, or even limits on what they will pay for testing per 24-hr. period. This structure is usually associated with "Indemnity Plans". If you are presented with one of these plans, be sure to see the schedule of benefits, in writing. It is important that you understand these type of limits up front because once you reach them the company will not pay anything over that amount.
-Usual and Customary
"Usual and Customary" refers to the rate of pay out for a doctor office visit, procedure or hospital stay that is based on what the majority of physicians and facilities charge for that particular service in that particular geographical or comparable area. "Usual and Customary" charges represent the highest level of coverage on most major medical plans.
