Archive for the ‘Medicare Insurance’ Category
The insurance industries best kept secret: Public Insurance Adjusters
As the policyholder, you have a right to know about the insurance industries best-kept secret . . . Public Insurance Adjusters. We are the experts who represent you exclusively when a loss occurs to your business, commercial or residential property. The insurance companies have their representatives; you need someone whose loyalty is entirely to you.
For many homeowners, the preparation of a property damage claim without the assistance of their own insurance loss adjuster is unfamiliar territory. The documents are filled with complicated jargon and calculations that only a claims adjuster will thoroughly understand: depreciation, replacement costs, and actual cash value. At times, the list seems endless, especially when you have enough on your hands just getting your life back together. But it´s your responsibility to document and prove your claim to the insurance company, either by yourself or with the aid of a public adjuster.
Many policyholders just like you have asked the same questions: How do I estimate my loss? Will I recover enough to rebuild? Can I do this myself, without a public insurance adjuster? This uncertainty is easily removed through the professional assistance of our proven team of professional public adjusters.
What is a Public Adjuster?
Public adjusters are the only category of insurance adjuster who work exclusively for you, the policyholder.
• A company adjuster (often referred to as simply the “insurance adjuster”) works for the insurance company.
• An independent adjuster also works for insurance companies, not for policyholders. They are simply an independent agent rather than an employee, so an independent adjuster could be working for multiple insurance companies.
• A public adjuster represents the only category of adjuster that works exclusively for policyholders and never for insurance companies. This means there´s no inherent conflict of interest when it comes to advocating on your behalf to the insurance company.
Public adjusters will typically contact you after a disaster. It´s important for you to know what to ask so you can distinguish established and trustworthy firms from all the others.
Many people don’t realize that the insurance company doesn’t automatically pay their insurance claim. Instead, it’s your responsibility to prove your claim in order to get compensated for a loss. When a disaster occurs, the insurance company has adjusters, building engineers, claims managers and supervisors, all representing their interests. Who do you have representing yours?
As you are trying to rebuild your home and stabilize your life, there is little time for learning the ins and outs of insurance to make sure you’re not settling for less than you’re entitled to. Public Adjusters can help by:
• evaluating your policy to help present the strongest possible claim to your insurance company;
• measuring & documenting damages to detail and prove your losses: your house, your belongings, your additional living expenses;
• negotiating on your behalf with your insurance company;
• advising you of your options and keep you informed every step of the way;
• settling your claim for the maximum amount; and
• freeing up your time to focus on the emotional recovery of your family and your job.
Every property insurance claim is unique. Public adjusters can provide some or all of the following services:
• conduct a comprehensive review of your policy;
• assist you in complying with your policy’s requirements, such as mitigating further damage and being aware of time limitations;
• work with you to develop a proactive claim management strategy that maximizes your financial recovery;
• conduct a thorough evaluation of your loss, carefully researching, detailing and substantiating every aspect of your claim, including building damage, contents, and extra living expense claims;
• present and support an itemized claim package to your insurer;
• work as your advocate at all inspections and meetings with your insurance company;
• secure the best possible settlement in the shortest possible time frame; and
• communicate with you every step of the way.
For more information on how a Public Insurance Adjuster can help you; please contact: United States Adjusters, Inc at 877-357-2USA or email Info@unitedstatesadjusters.com
http://www.unitedstatesadjusters.com
The AARP (Association for Advancement of Retired Persons) is the predominant lobbying group for senior citizens in the United States. Healthcare reform is an issue that impacts many seniors today; many are worried that their Medicare or Medicare Advantage benefits will be cut. One of the methods proposed for finding the funding to insure more Americans is to cute Medicare’s reimbursements to doctors; this could lead to a decreasing number of practictioners who are willing to accept Medicare. That’s why it’s surprising that the organization has announced its support for the Democratic healthcare reform bill. Their power (40 million Americans over age 65 are card-carrying members) has the potential to push the House of Representatives’ and Senate’s bills over the amount of votes needed to pass. As a result, some Republicans have questioned AARP’s status as a nonpartisan organization. It must be said, though, that AARP has made enemies of politicians in both parties in the past; and their seeming neutrality gives their views more credibility.
Believe it or not, AARP is actually willing to endanger the business of its own corporate partners. It makes money off of Medicare Advantage plans and other products sold by UnitedHealthcare and other health insurance companies. The reform bill AARP is backing will, above all, see significant cuts to Medicare Advantage. AARP officials insist that the fact that they collect over $220 million per year from AARP-branded insurance doesn’t cause them to have a conflict of interest. Since they appear willing to sacrifice their own profits for what they believe is the greater good, respondents of a recent poll have greater trust in them to recommend the right solutions to our healthcare crisis. A majority of independents and Democrats have more confidence in the AARP than in health insurance companies. Even Republicans are equally confident in the seniors’ organization.
Still, the question remains: why would the AARP risk alienating a significant portion of its base? After all, senior citizens have consistently been the demographic least supportive of healthcare reform–largely since they have the most to lose. Maybe the fact that most of the budget cuts will be borne by Medicare Advantage as opposed to standard Medicare itself is expected to soften the blow. The majority of seniors would like to keep Medicare Avantage programs alive, but by no means have those programs been ideal. Many have had issues with government reimbursing the private insurers for this supplemental coverage for years. A case in point is the infamous “donut hole”: each year, Medicare Advantage covers a certain level of medical costs until patients have to pay the entire amount out of pocket. Although the Medicare Advantage plan kicks in again after a certain amount (often $5,000 per year), most policyholders’ spending tends to fall slightly under that amount. (Meanwhile, they continue to pay the premiums for their health insurance plan.)
Congress is scrambling to have a bill passed as soon as possible; the House may even vote on it over the weekend. AARP’s eleventh-hour support will boost the chances of reform. A lot of seniors may be vocal when opposing reform, but it isn’t fair to assume that the older generation who “already got theirs” and has public health insurance plans available to them doesn’t care about the masses of uninsured young people. Some criticism is based in their desire to avoid saddling future generations with massive national debt, while other senior citizens believe that insuring our population is the best way to give back. Either way, seniors have played a major role in the healthcare reform debate.
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FOR A BETTER INSURANCE EXPERIENCE…
Do yourself a favor and KNOW your insurance coverage. Not being fully informed can cost you hundreds if not thousands of dollars.
TO REDUCE INSURANCE PROBLEMS and MISUNDERSTANDINGS:
1. Have a copy of your insurance’s formulary.
What is a Formulary?
A formulary is a list of all the medication your insurance will help you pay for. This list does change over time, so make sure to have the most up to date edition. On a formulary, the amount you’re expected to pay is your co-pay.
Most insurance formularies are in levels or tiers.
EX: Tier 1 Generic Medication
Tier 2 Preffered Medication (Brand)
Tier 3 Non Preffered Brand Medication
Price generally escalates with increasing Tier position.
Also note that Tier 2 and 3 are both brand name medication. That is, there may be more than one brand name medication for the same condition. Your insurance may have a prefference.
So…
Ask your insurance to mail you a copy of your current formulary. You can also ask your insurance carrier where you can find a copy of your formulary online. If you have more than one insurance carrier, make sure you have access to each individual one.
ALWAYS go with a copy of your formulary to your Dr.’s office, or leave it with them. It will save you a potential headache and surprise at the pharmacy.
WHAT IF A MEDICATION IS NOT ON THE FORMULARY?
Don’t give up yet!! You can ask your Dr. directly, or your Pharmacy to conduct a Prior Authorization for you.
What is a Prior Authorization?
Usually in reference to non-formulary medication, but can also refer to non-formulary directions – For example your insurance carrier may only cover 30 pills of a medication within a 30 day period, but your Dr. prescribes it for twice a day (60 pills within 30 days).
If your doctor prescribes a drug that requires prior authorization for coverage, ask your doctor to call the number on your Prescription Insurance card to begin the authorization process. Your doctor’s office must complete a prior authorization form or call your Insurance at the number on your card to provide the necessary information.
And lastly, some insurance plans have preffered pharmacies. So make sure that your regular pharmacy is a participating pharmacy. This is usually not a big deal especially in regards to most retail pharmacies, but to be safe, call your insurance company to make sure. Getting medication filled at a non-participating pharmacy will cost you more!
For more Pharmacy Related Questions, please visit cvscustomers.com