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Common Questions

Have you ever heard of anyone getting hurt on the way to work?  How about kids getting hurt at the park while playing?  Or someone getting hurt at home while doing every day chores and slipping on their kitchen floor or falling off a ladder while installing a light bulb?  I’m sure you have heard stories like these and many others.  Now, let me ask you a question…do you think that these falls and slips were planned?  Do you think that folks get out of bed in the morning and say…”humm..let me see… I think that I am going to fall on my way out and break my leg today”?  Of course not.  It’s ludicrous to think that people do that.  We do not possess the ability to see into our future and know when we are going to get hurt.  If we did, we would just plan for it both emotionally and financially.  Even though we are unable to know when we are going to get hurt and in need of medical attention, we can still plan ahead. How?  Health Insurance.

 

Health insurance can help cover many of the costs associated with unseen circumstances in which one can get hurt and/or become ill.  Most insurance health plans include essential benefits like doctor visits, specialist care, emergency services, medical transportation, inpatient and outpatient hospital care, lab work, preventive care, pregnancy, labor and newborn care, pediatric services, prescription drugs and much more.  Anyone of these benefits can be costly without a proper insurance plan.  However, with proper insurance in place, you can feel protected against these costs.

Medical care costs can be extremely high in some cases.  So high that it can cause people to get so much in debt that the only way out is bankruptcy.  So, what is the typical cost of some of these services:

 

  • Broken leg can cost up to $7,500

  • Three-day hospital stay can be as little as $15,000 and it can go over $100,000 depending on other services received during your inpatient stay.

  • Emergency room visit typically costs $500 to $750 not including any additional service or lab work.

  • Knee replacement can be as low as $30,000 and as high as $60,000

 

As you can see, medical costs can skyrocket quickly. By being properly insured you are protected in a couple of ways:

 

  1. Your costs are reduced after you meet your deductible.  The deductible is the amount you pay for covered health care services before your insurance starts to pay.  Some insurance plans have a medical deductible which applies only to major medical health care services.  In this case, your deductible will not apply to services such as primary care visits, specialist visits, lab work, etc.

  2. Maximum-Out-Of-Pocket (MOOP) is a very neat feature of health plans.  This feature protects you in case of catastrophic events where your medical care costs can be astronomical.  Each plan comes with its own MOOP and it represents the total amount that you would be responsible for paying regardless of the amount and cost of covered care received.  For example: If your plan’s MOOP is $4,500 and you have medical costs of $68,000, the most you will pay is $4,500; even if the cost was $1,000,000 all you would be responsible for paying is $4,500.  Now, keep in mind that this resets every year.

Another benefit which is included in most health insurance plan is dental and vision coverage for children 18 and under. Most dental plans include routine exams, x-rays, and cleaning at no additional cost. There are other common dental services which require a co-payment. Some of these services include, but are not limited to:

 

  • Fillings

  • Crowns

  • Root canals

  • Extractions

  • Oral surgery

  • Braces and retainers

  • Dentures and bridges

 

Vision benefits included in some health care plans include:

 

  • Preventive care such as eye exams

  • Frames

  • Eye glass lenses including lens protection such as scratch-resistant coating

  • Contact lenses

 

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5150 E Pacific Coast Hwy. Suite 200
Long Beach, CA 90804
Phone: (562) 206-0242
Fax: (562) 346-3201
E-mail: info@rojasifs.com
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