Archive for July, 2013


MRL Rebates, Why is My Insurer Sending Me Money?

Medical Loss Ratio is what it stands for, what it means is a little more complicated.  The MLR is a percentage of insurance premium dollars spent specifically on claims reimbursements or medical expenses and activities that improve the quality of care.  Insurance companies are required to meet an 80% ratio in the individual market.  If your insurance company fails to meet this percentage, they must give you a refund of any premiums you have paid that exceed the Medical Loss Ratio. 


Health Care Reform and Medicare Supplements

There is a lot of talk in the news about no person being denied coverage because of a pre-existing condition.  What the media is not telling you is, that only applies to plans that are considered the ‘minimum requirement’ of coverage for a Qualified Health Plan (QHP).  Medicare Part A alone meets this requirement, so any additional or supplement insurance coverage can still exclude based on your current health conditions.  If your rate has increased and you are considering reapplying for coverage to reduce your costs, it is usually better to move sooner than later. Changes in your health may stop you from being able to make changes down the road.


If you’ve Got it, Use it

Are you ‘non-grandfathered’?  Few people know what this term means and even fewer know what it means for their insurance benefits.  If you bought your insurance after March 23, 2010 you have a non-grandfathered plan and that means you have more benefits than you may realize.  Essential health benefits have been added to these plans and richer benefits will continue to be added which are considered Essential Health Benefits (EHB)  Contact your licensed agent, your insurer or Texas Medical Plans to review your coverage often.  If you’ve got them, use them! Everyone should get the most from their insurance and Texas Medical Plans can help you do that.

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