The Path to Private Health Insurance Coverage

The path to getting a private health insurance plan can often feel a little bit like playing a board game. No matter where you are on the medical coverage “game board”, there are often new discoveries to make along the way. At KaiserQuotes.com, we understand the frustration that personal health insurance can present to anyone shopping for a new plan. We hope to clear up any confusion with the following illustration.

To download a printable version of this info-graphic, click Private Health Insurance Info-graphic.

On this individual health insurance game board, let’s say there are two game pieces in play: Yellow and Blue. Notice that the first 3 steps are the same for both players: Get Quotes, Choose a Plan, and Apply.

• Get Quotes. That seems easy enough. Just type in a zip code, date of birth, and presto! Yellow and Blue now have free private health insurance quotes.
• Choose a Plan. This step can be a little harder, because there are so many private health insurance plans to choose from, and like game pieces, there are no two plans exactly the same. Let’s say that Yellow selects a Low Deductible Plan because he is relatively healthy and mainly wants low copays for doctor visits and prescription medicines. Blue, on the other hand, likes more predictability with his health services, so he chooses a Copayment Plan. When comparing private health insurance benefits, think of the types of medical services you most want to be covered, as well as affordability.
• Apply. Yellow and Blue are now ready to apply for their desired personal health insurance plans. Both choose to apply online because it is the fastest way to get a response back regarding an application. They muscle through the 29 question health survey, click the Submit button, and hope for the best.

Waiting for a Decision

Then the rubber meets the game board road. Yellow and Blue must often wait one to two weeks to receive an answer regarding their individual health insurance applications. Finally, they both receive an email. Yellow finds out that he is Approved, and Blue discovers that he is Denied. What?! Blue was denied for going to the doctor for some minor sleep apnea? “Sorry Blue,” says Yellow. “You never know what Underwriters are gonna deny you for these days.”

A Fork in the Road

At this point in the game, their individual health insurance paths are divided. Yellow has been Approved by Underwriting, so his last steps are easy: Pay Premium & Use Coverage. Bada bing, bada boom. Not so for his poor friend Blue. Blue has unfortunately been declined by Underwriting, giving him now 2 choices: He can either advance to the next space (Appeal), or skip this space and look for coverage that will take him regardless of his pre-existing condition. The latter idea is usually more expensive, so he chooses to appeal the denial in the hopes of being reconsidered for the less expensive private health insurance plan.

The Appeal: Your Chance to Stop Living in Denial

Appealing a decision is not always easy. Many customers must contact their doctor’s office personally to request a letter or to get test results proving that their pre-existing condition has either been resolved or is now under control. Let’s say that Blue gets a hold of his doctor, Doctor Aquamarine, and is able to get a letter with test results showing that his sleep apnea is very minor and under control. He submits the test results in his Appeal and hopes for the best.

A few days go by and Blue finally receives an email. It says, “Approved!” Blue travels up the Rainbow Road from Appeal to Approved. Yellow and Blue decide to throw a party at their humble abode to celebrate. Then, Blue pays his premium, starts using his private health insurance coverage, and the rest is game board history!

When Denial Strikes Twice

Let’s say that Blue’s appeal had not been approved. He might have thought that this would mean “Game Over”, but he sees on the path to getting health insurance game board that there are still other options after he receives a ’Health Insurance Denied’ notice. He knows that there are restrictions that apply to these other alternatives, but he’s still hopeful. Blue owns his own business, so small group health insurance might be his best option. If he qualifies for Group Coverage, there are no denials based on pre-existing health conditions. Six prescriptions? No problem. Diabetic? No problem. Sleep apnea? No problem. “Individual health Insurance Coverage, here I come!” says Blue.

This game board visual we have created mirrors the medical coverage journey that every individual experiences when applying for a private health insurance plan. At KaiserQuotes.com, we try to make this journey as smooth as possible. Give us a call at 1-877-752-4737 so we can help guide you down the path of personal health insurance coverage!