1. DOES YOUR PLAN COVER YOU ON AND OFF WORK?

Many health insurance policies have particular exceptions that exclude benefits for anything that might have been covered under Workers Compensation or similar laws. Now read that last sentence once more.

COULD HAVE BEEN COVERED!?

That is correct. A lot of 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 law to have Workers Compensation protection.

2. ARE YOU WRITING IT OFF?

Freelance contractors (1099's), home based business owners, professionals and other self employed people usually are not taking advanatge of the tax regulations accessible to them.

Many people paying 100% of their own costs are able to deduct their monthly insurance charges. Just that alone can lower your net out-of-pocket expenses on a proper policy by as much as 40%. Ask your accountant if you qualify and/or check out the IRS website for more details.

3. INTERNAL LIMITS

All true health insurance policies use some sort of internal controls to choose how much they will pay out for a specific procedure or service. There are two general methods.

-Scheduled Benefits

Many policies, some of which are expressly targeted for self employed and independent people, have a clear 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 offered one of these policies, be sure to see the schedule of benefits, in writing. It is crucial that you understand these types of limits in the beginning because once you reach them the policy will not pay anything above that amount.

-Usual and Customary

"Usual and Customary" pertains to the amount of payment for a doctor office visit, procedure or hospital stay that is based on what the majority of doctors and facilities charge for that particular service in that specific geographical or similar area. "Usual and Customary" charges represent the highest amount of cover on most health insurance policies.

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