Residents of San Diego County and other parts of Southern California often have questions that are not answered in the Health Insurance Basics page. We have posted a few of these frequently asked questions with our answers. If you have a question that is not answered here, we invite you to submit it to us. By answering these questions, we can provide helpful information for all visitors to our site.

I am young, fit, and in good health. Do I need to have health insurance?

To go without health insurance, you need to be more than young, fit, and in good health. You also need to be wealthy – so wealthy that you can afford to pay hundreds of thousands of dollars in medical expenses in the event that you are hospitalized for a catastrophic injury or illness. In fact, even a short stay in a hospital or serious disease requiring multiple tests and treatments can wipe out a young family’s savings and assets, such as equity in a home. The smart thing to do is to buy a health insurance policy with a high deductible. The premiums will be low, because the health insurance does not cover minor medical expenses, but you will be covered in case you face major medical expenses due to accident, injury, or an unforeseen illness.

We have young children. How can we avoid “death by a thousand co-pays”?

You can limit out-of-pocket costs for routine screenings, well child visits, and physicals by enrolling in a managed care health insurance plan, such as an HMO or PPO, that emphasizes disease prevention, rather than treatment only. Managed care plans give you access to physicians and laboratories within a network of healthcare providers who agree by contract to keep their costs low in exchange for a steady flow of patients.

I am not satisfied with my current health insurance. Does it make sense to change plans?

Too often consumers remain with a health insurance plan they are dissatisfied with simply because they do not have time to shop around for a better one. Others worry that changing plans will be too costly. At Blanket Health Insurance, we believe it is never too late to get the health insurance that suits you best. We are happy to shop for the best plan to meets your budget. In fact, we have found that changing plans often saves our clients money.

I heard something about a 63-Day rule. What is it?

When your health insurance coverage ends because you have lost your job, changed employers, relocated, or for any other reason, you have 63 days to sign up for a new health plan without losing your “continuous coverage.” If you fail to enroll in a new plan within 63 days, you are deemed to not have continuous coverage. As a result, coverage of preexisting conditions can be delayed or denied. The 63-day rule does not apply to health insurance waiting periods. If you are hired by a new company and enroll in its health plan, you still qualify for continuous coverage, even if the coverage does not start immediately.

What does HIPPA mean and does it apply to me?

HIPPA is an acronym that stands for the Health insurance Portability and Accountability Act (HIPAA), which was signed into law in 1996. The law states that a person is entitled to affordable health insurance even after insurance has been lost through unemployment, relocation, divorce, or any other life change. The guarantee is not permanent, however. HIPPA provides that a person who has lost his or her insurance has a specified period in which to find in a new plan.

If I am employed after age 65, am I required to use Medicare?

If you are employed by a company that has at least 20 employees, your employer must provide health insurance benefits for employees aged 65 and up until they reach age 69. If your employer’s health insurance plan offers better benefits than the Medicare plan does, you can designate your company’s health insurance plan as your primary plan. If you do, your company’s health insurance will pay medical expenses first. Medicare will be billed only for charges not covered by your company’s insurance. Nevertheless, be sure to enroll in Medicare Part A as soon as you 65. Medicare supplements your employer-provided insurance at no additional cost to you. You only pay premiums for what is known as Medicare Part B, but you can delay enrolling in it if you wish. The only problem with delaying Medicare Part B enrollment is that your greater age or changing health could affect the cost of the premiums you will pay when you choose to enroll. Blanket Health Insurance suggests that you contact us before you turn 65 to discuss your options and come up with a plan that works for you.