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Getting Prepared for Flu Season
10/8/2009

Health Insurance

The World Health Organization (WHO) is advising countries in the northern hemisphere to prepare for a second wave of pandemic spread. In many cities and towns, schools and hospitals are already dealing with wide-spread outbreak. A vaccine for the H1N1 strain of flu is expected later this fall, and the U.S. Centers for Disease Control suggest that the following groups consider the vaccine: pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems.
It’s always important to understand your health insurance policy, but with the potential for an increased demand for health care services, you need to be even more aware of your specific plan details. Take a few minutes to read your policy carefully in order to answer the following questions:
1. Is the vaccination covered by my insurance?
  • The seasonal flu vaccine and the H1N1 flu vaccine will be administered separately. Because H1N1 vaccinations have not yet been authorized by the Food and Drug Administration, they may not be covered by health insurance. Check with your insurance company to verify that your coverage will extend to the H1N1 vaccine.
2. Do I have a cost-sharing responsibility for the vaccinations?
  • Many health insurance policies have co-payments for yearly flu vaccinations. Ask your insurance company if you will have a co-pay for the H1N1 vaccine and what the cost will be.
3. If an office visit is required to obtain the vaccinations, does it require a separate co-payment?
4. Does your policy require a pre-authorization for hospital admission or other services?
5. What is your co-payment for the most common H1N1 treatments?
  • The two drugs doctors can prescribe to treat H1N1 flu are Tamiflu and Relenza. In addition, you should know of any limitations on the number of doses covered by your policy – per prescription or per year.
6. Does your policy cover over-the-counter medications?
7. Is your coverage accepted at walk-in care facilities?
  • If your area is heavily affected by the spread of the H1N1 flu outbreak, your regular physician might not be able to see you in a timely manner.
8. What is your out-of-network co-payment? 
  • If you must go to an out-of-network provider, be aware you will likely pay a higher co-payment for your office visit and any tests run during the visit.

Be prepared for any eventuality with the following checklist:

  • Have your health insurance ID card readily available.
  • Review your health insurance policy provisions. Know which doctors and hospitals are in your network.
  • Make note of your co-payments. Know how much a doctor’s office visit will cost. Check to see if your co-payments go up if you go out-of-network.
  • Keep handy a list of pharmacies and medications covered by your health insurance policy.
  • If you have plans to travel, make sure you check to see if there are any doctors or medical facilities in-network where you will be visiting.
  • Make sure you have contact details for your health insurance company available in case you have questions.
  • Ask your employer or insurance company for any and all applicable health insurance information that might be available to you in a simple-to-reference format. Post this information where it can easily be accessed by everyone.

Business Interruption Insurance

Business owners might be concerned about having to shut down their operations due to an outbreak or absenteeism. Check your business interruption policy to see what eventualities will trigger coverage under your plan. Coverage generally requires the interruption to be caused by physical damage or loss (e.g., fire or weather). Business interruption policies generally will not be triggered by epidemic or pandemic warnings or alerts from public officials. Business owners will need to rely on existing risk management and business continuity plans to mitigate losses due to emerging public health crises.

More Information

The federal government has created a Web site with information: www.pandemicflu.gov.

The U.S. Centers for Disease Control also has extensive information about H1N1 Influenza on its Web site: www.cdc.gov/swineflu/.

If you are unable to resolve any concerns you have about your health insurance with your insurance company, contact the Alabama Department of Insurance at 800-433-3966. You may ask a question or file a complaint through its website at www.aldoi.gov.

Beware of insurance fraud during this time of heightened awareness. To avoid insurance fraud, make sure the company you're dealing with is reputable and licensed to do business in your state. Before signing any paperwork or writing a check, STOP; CALL the Alabama Department of Insurance; and CONFIRM that the insurance company or agent is legitimate and licensed in Alabama.

DOI To Participate in Alabama I-Day 2009
9/23/2009
“I am happy the Department of Insurance again has the opportunity to be a part of this great program,” said Commissioner Ridling. “I encourage everyone with an interest in the insurance industry in our state to attend."
The program has been approved for 6 hours continuing education credit for insurance producers and 3.4 CLE hours for Alabama attorneys.
For additional information, click here to view the complete I-Day flyer.

Baby On Board Changes Insurance Needs
9/8/2009

Health Insurance 

  • Understand your coverage before the baby arrives. Review coverage options and find out exactly how your health care plan handles the costs of a new baby. Remember to consider prenatal vitamins, prenatal and neo-natal screenings and tests, emergency procedures, delivery (C-section and traditional) and pediatric care.
  • Notify your insurer of your new baby. Make sure you are aware of the deadline and requirements to register your newborn with your health insurance company. Similarly, if you are adopting a child, consult your employer and health insurance provider for the requirements to obtain health insurance coverage in advance.
  • Evaluate your options. If both parents have employee benefit options, compare the health insurance policies to see which one best fits the needs of your family. Review the co-pay amounts and different options carefully to see exactly what is covered – and what isn’t – for both parents and children. Most companies will allow you to make enrollment changes when a baby is added to the family. Check with the benefits administrator at your office about your options.
  • Make use of tax advantages. Ask if your employer offers a flexible spending account or health savings account (HSA). These plans allow you to set aside pre-tax dollars for medical expenses and child care.

Life Insurance

  • Plan the contributions of both spouses. Consider covering both spouses with life insurance, even if one is not employed outside the home. In the event of the stay-at-home parent’s death, the insurance policy can help the surviving spouse with the financial necessities of the household.
  • Account for child care costs. In determining the amount of life insurance to purchase, take into account your full child care costs (housing, education, child care, medical needs, etc.), especially for children under five years old or for kids with special needs.
  • Understand the types of life insurance. Understanding your life insurance choices will help you weigh the costs and benefits of whole life versus term life insurance as part of your overall financial plan.
    • Whole life insurance. Whole life insurance policies build cash value and pay a death benefit, but are more expensive. If you can’t afford whole life insurance right now but think you may want it in the future, consider term life insurance with a conversion option that will let you change to a whole life policy for a fee when you are ready.
    • Term life insurance. Term life insurance offers death benefit protection for a specified time period. For example, term life insurance may be appropriate during your child-rearing years or while paying off a mortgage. Term life premiums increase as you age. Term life is typically less expensive in your younger years than permanent life insurance, which covers you for your entire life and typically has level premiums.
  • Keep your policy current. Remember to update your policy to include your children as beneficiaries. If your children are under the age of 18, name a trustee who would administer the benefit of the policy until they are adults.

Auto Insurance

  • Check rates before upgrading vehicles. Auto insurance premiums are linked to vehicle age and type, so if you decide to get a larger vehicle, like a mini-van or SUV, to transport your family, it could affect your premiums.
  • Plan for carpools. Consider increasing your liability insurance in case of an accident when transporting other kids.

Homeowners Insurance

  • Notify your insurer of major additions. Alert your insurance company when making any major home improvements (usually anything over $5,000) to prevent being underinsured.
  • Protect the backyard. Inform your insurance company if you install backyard items for kids, such as a swing set, trampoline or swimming pool. You might consider increasing your liability coverage – that protects you in the event that someone is injured while on your property – with an umbrella policy.

More Information

If you have questions or are confused about your insurance coverage, contact the Alabama Department of Insurance at 334-269-3550, or online at www.aldoi.gov.

November 20, 2009
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