Insurance World

The purpose of health insurance is to protect you from the alarming cost of medical care by providing you with insurance coverage for specified health and medical care services. Generally, you will pay a monthly premium, a deductible, and co-payments for services you receive. The cost for insurance is significantly less than if you had to pay for medical care out of your pocket. There are three basic types of health insurance, fee for service, consumer-directed, and managed care. These basic types of insurance plans cover hospital, medical, and surgical expenses, and depending on the particular plan you choose, possibly prescription drugs, mental/behavioral care, and dental.

A fee for service plan means the health care professional you choose will be paid a fee for each service provided to you. You can choose your own doctor and the insurance claim can be filed by either the doctor or the patient. A managed care plan will provide coverage to their members and offers incentives for patients who choose doctors participating in the plan’s network. The 3 types of managed care plans are HMOs, PPOs, and POS plans.

An HMO allows you to receive medical care through a network of participating physicians. You will generally select a primary care doctor, who will then refer you to a specialist when necessary. A PPO combines various features of an HMO and a fee for service plan. Members can choose from network doctors and pay lower upfront expenses, or choose any doctor they desire and pay more out of pocket expenses. A consumer-directed health plan gives members more choices and options in making health care decisions. Consumer-directed plans include a health account or fund designated for health care expenses. At the end of each year, unused funds will roll over to the next year.

A health insurance premium is the fee paid to the insurer to purchase health coverage. Premiums can be paid monthly, quarterly, or annually. Deductibles are the amount you will pay for covered services within a certain time frame, according to the terms of your plan, before you will be entitled to insurance benefits. Members with a high deductible may have to pay the first one thousand dollars of yearly medical expenses before the insurance would begin to pay, and those with a higher or lower deductibles would pay more or less, depending on the particular amounts specified in their plan. A co-payment is a stated amount or percentage that must be paid by the member along with each doctor visit, medical procedure, or prescription. For example, if your specified co-payments are $25, you will pay the first $25 of each doctor visit and your insurance would cover additional charges. Most insurance plans specify a different co-payment amount for prescriptions, doctor visits, and hospital or surgical care.

In choosing which type of health insurance plan is right for you, you must consider the affordability of doctor visits and hospital care, the amount of the monthly premium, the amount of the deductibles, and the amount of the co-payments. Make sure the plan you chose offers coverage for services you will actually use such as doctors, prescriptions, laboratory costs, treatment for preexisting conditions, and out-of-network care. Check the rating of the insurance company in question, the number of patient complaints in the past year, doctor drop out rates if the insurance plan includes a network, and the number of members who have dropped out of the plan in the past year. Health insurance that is subsidized by your employer is generally the least expensive, but if your employer does not offer health insurance, you should consider an individual health insurance policy. The cost of medical care is far too expensive to risk not having health insurance.

At last you can buy life insurance and get tax relief. The breakthrough results from changes in the Gordon Browns’ latest Budget speech but the tax relief is only available on a new special sort of life insurance policy. You can’t get tax relief on your existing life insurance policies.

These new policies exploit a loophole in the new Finance Bill and should result in savings of between 5% and 15% for standard taxpayers and around 30% for higher taxpayers.

But there are strings attached! You can’t add extras on to your life policy such as critical illness cover and the insured sum must be a fixed sum. Neither can you have a joint policy. Basically, it has to be a bog standard, level term, single beneficiary, life insurance policy.

Then there are more restrictions, but quite honestly, these are unlikely to pose a problem to anyone unless they’re very wealthy! You can’t have one of these special life policies if the annual contributions you pay into your pension plus the life insurance premiums, exceed Ј215,000 per year. Furthermore, if the value of your pension fund plus the payout on your life policy exceeds Ј1,500,000, the current limit set by the Chancellor, then the excess will be taxed at 55%. Conventional life insurance policies are excluded from this calculation.

Tax relief on the premiums is automatically collected by the life insurance company so you pay a premium which is already reduced by standard rate tax relief. If you’re a higher rate taxpayer, you’ll have to claim the extra tax through your self-assessment tax return. However, once you’ve told your taxman about your premiums, they should automatically continue to give you the tax relief through your tax code.

So why are the savings less than the value of the tax relief? Well, the reason is that the life companies have to administer the tax relief and there are certain operational restrictions imposed by the Inland Revenue on the insurance company. This means that the basic cost of these policies is a little more than conventional life insurance – but after the tax relief you should save.

As with all these loopholes, you must be aware that the Chancellor could remove the tax relief. Having said that, it is rare for a future tax change to be applied retrospectively so you are likely to be safe. Your income could also change and move you into a lower tax bracket. This would reduce your savings.

This new type of life policy is now available from most of the big UK insurers and specialist life insurance brokers. However, you won’t be able to get an online quotation – you’ll have to speak on the phone to a Life Insurance Adviser.

And just to confuse matters these policies are known under a range of names: Pension Term Insurance, Life Insurance with Tax Relief, Life Protection with Tax Relief – but they all mean the same thing.

Oh yes, let me confirm one miss-understanding. No, you don’t have to buy a pension at the same time!