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May 14, 2001
Health Insurance Considerations for the Free Agent
By Larry Reese

Health Insurance! Those two words bring fear and chills to the self-employed or small business owner. With so many of us becoming self-employed, free agents, independent contractors or employed by a small business we have to start taking a more active role in obtaining and managing our health insurance. The days of getting great health coverage through our employer are being offered to fewer and fewer of us. So how do you know what to get? What questions should you ask? Below are 4 questions you have to ask your health care provider and if you don't like or don't understand the answers get some help.

In general, with an individual policy you can be dropped with a 30-day notice, you can be singled out for a rate increase depending on the number of claims you file and maybe most important you may NOT be covered while you are working. See question 1 below..

Questions to ask your provider.

1) Are you covered while at work? Many individual policies do NOT cover you while you are working. They expect workman's comp to cover you. But if you are a small business or self-employed do you have workman's comp?

2) Are you covered while you travel? Many times when you travel you would be out of network, what does that do to the amount you are responsible for?

3) Do you pay usual and customary or usual, customary and reasonable charges? The American Medical Association sets the usual and customary charges. If your insurance uses the words reasonable, normal, or ??? you might find your portion of the bill to be a lot higher than you anticipated.

4) Who determines what is medically necessary? Does your doctor make it or is that most critical decision made behind the scenes by your insurance company?

For years we have relied on our employers to provide us with the proper coverage and information. As more and more Americans join the "free agent" market we have to take a much more active role in first selecting our coverage and then managing our overall health care expenses.

Larry Reese is a freelance writer from Southern California. In addition he is a licensed life (health) agent in the State of California #0D27460. Larry can be reached at (949) 637-5985 or

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