1. DOES YOUR POLICY COVER YOU ON AND OFF WORK?
Many health insurance policies have particular exceptions that do not cover you for anything that might have been covered under Workers Compensation or similar legislation. Now read that last sentence again.
COULD HAVE BEEN COVERED!?
That is true. Many self employed people and even some small business owners don't carry Workers Comp on themselves.
There are tailored insurance policies that will cover you on and off work - 24-hours a day, if you are not mandated by legislation to have Workers Compensation coverage.
2. ARE YOU TAX DEDUCTING IT?
Freelance contractors (1099's), home based business owners, professionals and other self employed people typically are not taking advanatge of the tax ordinances accessible to them.
Many people paying 100% of their own premiums are eligible to deduct their monthly insurance premiums. Just that can lower your net out-of-pocket expenditures on a proper policy by as much as 40%. Ask your accountant if you meet the requirements and/or look up the IRS website for more details.
3. INTERNAL RESTRICTIONS
All true health insurance policies use some type of internal controls to choose how much they will pay out for a certain procedure or service. There are two normal methods.
-Scheduled Benefits
Many policies, some of which are chiefly marketed to self employed and independent people, have a specific schedule of how much they will pay per doctor office visit, hospital stay, or even boundaries on how much they will pay for tests in a 24-hr. period. This system is usually associated with "Indemnity Plans". If you are shown one of these plans, be sure to check the schedule of benefits, in writing. It is essential that you understand these kinds of limits in the beginning because once you reach them the plan will not pay anything above that amount.
-Usual and Customary
"Usual and Customary" relates to the rate of pay out for a doctor office visit, procedure or hospital stay that is determined by what the majority of doctors and facilities charge for that specific service in that exact geographical or similar area. "Usual and Customary" charges represent the highest amount of cover on most health insurance policies.
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