An important concept to grasp when selecting and utilizing a health insurance plan is whether or not your health care providers are participants in your insurance company’s network. Understanding this concept could very well save you a significant amount of money on your medical expenses.

To begin, I’d like to quickly define what a network is. A network is a group of health care providers (primary care physicians, specialists, hospitals, etc.) who are contracted with a particular insurance company. As a result of these providers being in network, the insured will receive “negotiated” rates for the services that are provided.

I believe it is fair to say that most people are aware the House of Representatives has passed a bill for our nation’s health care reform; however, the questions remain: how will the Senate respond to the idea of mandating individuals to purchase health insurance, and what is the consequence if they opt out of such a measure?

I was reading an article recently about a young man in Tennessee who was denied health insurance by several companies due to a pre-existing condition. He has residual back problems stemming from a car accident occurring about a year ago. Two companies offered him covered, one at a monthly premium of $1200, the other would cover any services not related to his existing back injury.

For those of you who are seeking health insurance coverage, be aware that certain pre-existing conditions may make it difficult for you to find affordable coverage. Such conditions include diabetes, cancer, certain mental illnesses, and some kidney, heart and liver diseases. When researching for coverage, you will want to review the pre-existing condition clause of the policies you are considering.

The NY Daily News published a brief overview of the Affordable Health Care for America Act, or H.R. 3962. It gives a gist of the who, what, why and how of this bill.

Should the bill pass in its present form, it will affect 96% of the American population. It is estimated to cost up to $1.2 trillion over 10 years. Income taxes will be raised for those earning $500,000 per year for individuals and $1 million per year for couples.

In conjunction with President Obama’s declaration that there is a H1N1 national emergency, health insurance companies, including Humana, are taking a proactive approach to covering the vaccine for their members.

Humana recently posted on their website that they are willing to cover the H1N1 vaccine for all of its current members who are fully insured. This benefit is even being extended to those clients who currently have immunization benefits excluded from their coverage.

This last week Democrats of the House of Representatives revealed their bill, a combination of three separate plans, for our nation’s health care reform. The proposed bill not only incorporates a government-run insurance option, but also introduces new taxes on the rich. Specifically, a 5.4% tax would be imposed on individuals making more than $500,000, and couples making more than $1 million annually.

The new bill requires individuals to purchase their own health insurance, as well as the majority of businesses to offer coverage for their employees. In addition, the bill prohibits insurance companies to refuse coverage based upon pre-existing conditions. Although the current health insurance market is in dire need of this very amendment, there have been no concrete numbers proposed as to the actual cost of such a plan.

Ironically enough, as Congress pushes to pass legislation that could put health insurance companies out of business, Unicare has decided to pull out of both the Texas and Illinois marketplace. In doing so, Unicare will be leaving almost 200,000 Illinoisans, and 400,000 Texans in need of new insurance. However, according to the insurance department, individuals will be able to transfer over to Blue Cross and Blue Shield of each state which is operated by Health Care Service Corp.

One of the biggest items being set into motion in the health insurance reform is creating a consumer- driven health care environment. Consumer-driven health insurance plans provide individuals the ability to take control of both their health and insurance. The idea is to educate individuals about their options, and create a health insurance market that allows individuals to compare plans, as well as force carriers to offer competitive prices.

With a HIA plan, a very prevalent policy with Anthem, individuals actually receive an annual allowance put into a Health Incentive Account. This money is to be spent in any manner you wish on covered health insurance expenses, and the money rolls over to the next year.

Protecting yourself and your family from major medical expenses is not to be taken likely. Unfortunately, there are people who believe that they have quality health insurance coverage, but later find out that their insurance plan doesn’t provide the coverage they truly need. Below is a list of features that should be avoided to when searching and applying for a health insurance plan.

1. Membership Fees:
   • You should never purchase a “health insurance plan” that requires you to pay a membership fee with the application. This is a clear indicator that the plan is a discount plan.

Shopping and comparing health insurance options can be a rather tedious task when trying to understand what the various terms mean, as well as how they function. The term coinsurance is a very important element when trying to comprehend how exactly your health insurance policy is going to protect you in the event that you needed medical attention.