HMO increase
9.75% for all counties

PPO increase
6.75% in Pima County
10.35% in Maricopa County and all other areas

HealthNet’s dental and vision coverage will also have a rate increase, going up from $19.53 to $20.

To receive a detailed medical insurance quote, please fill out our online quote request form. Coverage is available in Phoenix, Tucson, Flagstaff, and all areas of the state.

At the end of the form, it asks, “Any comments or special requirements?” Please use this box to explain your situation and include any relevant details that will help us guide you to the right policy. For example, is there a specific doctor or hospital you want to be able to visit? Do you have pre-existing conditions? Do you only need insurance on a temporary basis? Do you want to be able to move out of Arizona and keep your coverage? Do you need maternity coverage?

For us to best serve you, please include your phone number. Including your number is optional, but allows us to call you and quickly get all the information we need from you over the phone. (We will never share your phone number with anyone.) Please be prepared to discuss your medical history. We will be asking questions such as: Are you currently taking any prescription medications? Have you had any surgeries in the last 10 years? What is your current height and weight?

Each insurance company has different underwriting guidelines, so it is important we understand your situation before submitting an application. For example, there are some medical conditions that will result in a denial with one company, but that will result in an approval with another.

Once you fill out our quote request form, one of our agents will contact you shortly. We have been a top health insurance broker in the state of Arizona since 1988, and we look forward to serving you.

Currently, the University of Arizona’s plan breaks down to roughly $130 per month, although you’re not allowed to make monthly payments. According to their price sheet you’re required to pay $340.34 per month for the first three months of the year for the spring term and likewise for the fall term – which has past – $214.34 per month for the first three months of the fall term (August, September, and October).

I’m not saying this is a bad plan. In fact it’s great. But it is a one-size-fits-all option. If you’re looking for a less expensive, monthly payment option with another top carrier, read on.

Rates on the individual market vary by gender and age. If you’re a 19 year old male, your rates are different than a 21 year old female. On top of that, there are many plans and deductibles to choose from. Luckily, there are only about five carriers to look at. And we’ve developed a fool-proof system for determining which plan will work best for you. Read Step Three. Then read it again. Once you’ve figured out Step Three, click here for some instant quotes from us! Or, click here for an Email Quote and we’ll really narrow down the options to what will make the most sense for you.

For a 22 year old female living in Tucson, there are rates as low as $40 per month for a $10,000 deductible and as high as $290 per month for a $250 deductible. And, if you saw all the plans in between you’d be more confused than when you started!

All of the plans we provide quotes for do require medical underwriting. That doesn’t mean you’ll be required to take a physical, but it does mean there will be questions on the application regarding health. If you have any of the conditions listed in Step Six of this blog post or some that aren’t listed, give us a call at 1-800-600-9663 or fill out the Email Quote form.

Slow down there.

I’m going to show you how to purchase health insurance. After all, Obama’s Affordable Care Act (PPACA) is encouraging (forcing) everyone to become more proactive with and responsible for their health and health insurance. So let’s start from the beginning.

Step One: Figure out who you’re purchasing health insurance for.

Is it just for you? You and a spouse? Kids? Figure this out first. Have their age and date of birth handy.

Step Two: Determine how much is too much to spend per month.

Be realistic here. You aren’t going to get a family of four on a good health insurance plan for much less than $300 – $500 per month. Can you? Yes. But your deductible might be as high $7,500 or $10,000. Which leads me to the next thing…

Step Three: Decide how much expense you’re willing to share in the event of a major medical emergency.

This is the biggest factor when determining monthly cost. As is the case with auto insurance, the higher the deductible, the lower the cost. But, this is the part about health insurance that confuses most people. So, let’s give you an in-depth understanding of the basics of health insurance without telling you more than you need to know or putting you to sleep. There are three major components to any health insurance plan that are the biggest indicators of monthly cost. These are Deductible, Coinsurance, and Coinsurance Maximum (sometimes referred to as Out-of-Pocket Maximum). Forget about copays for now. They have little bearing on monthly cost. Whether you have $15 doctor visits or $35 dollar doctor visits is window dressing. But, whether you owe $3,000 or $15,000 in the event of a major medical emergency is of greater significance.

Deductible comes first. It has no bearing on your copays, for all intents and purposes. And copays do not contribute towards the deductible. So, if you have $30 doctor visits and a $5,000 deductible, from day one you’ll get $30 doctor visits. And even if you went to the doctor 10 times in a given year, the $300 you would have spent on doctor visits would not contribute towards the deductible. Deductible only applies to major things such as hospitalization, MRIs, CT scans, and inpatient and outpatient surgeries. Of course, that’s not all inclusive, but for the most part, those are the kinds of things the deductible will kick in for. So, let’s say you choose a $2,000 deductible. And then you develop some weird stomach ache that lasts 3 days. And let’s say you go to the Emergency Room because it’s 2am, and you’re worried. They do an emergency appendectomy for appendicitis. The bill is $25,000. When you finally get the bill you owe the first $2,000. But, that’s not all you’ll owe…

Coinsurance comes second. It’s separate from the deductible. Most likely you’ve heard of coinsurance and never knew what it meant. Ever heard of 80/20 in reference to health insurance? What 80/20 means is that AFTER the deductible you are responsible for 20% of the remainder of the bill. The health insurance company is responsible for 80%. But, it’s not always 80/20. Sometimes it’s 70/30. Sometimes 90/10. And of course you can opt for 100/0, which is essentially no coinsurance. But – and this is a big BUT that confuses most people – you do not pay your coinsurance forever.

Coinsurance Maximum comes third. There’s a cap, or limit, on how high your share (we’ll use 80/20 as an example) can get. Say you’re cap is $3,000. You wouldn’t believe how many people have said to me, “I don’t want any of that 80/20 crap!” And they say that because they think if the bill was $100,000 they’d owe $20,000. That is not the case. Let’s assume you have a $2,000 deductible with 80/20 coinsurance and a $3,000 Coinsurance Maximum. Not counting copays and other family members, you would never owe more than $5,000 on this plan for a hospitalization. The 20% caps out at $3,000 AFTER the deductible. That’s it. Final answer.

Once you’ve determined how much expense you’re willing to share in the event of a major medical emergency or hospitalization, we can now move on to the next step.

Step Four: Get some quotes.

You can get quotes in a number of ways. Of course the first place I’ll direct you is to our website – http://lehrmangroup.com - but there are plenty of other places online to get quotes, too. Remember, no matter where you go, the cost will be the same. Whether you go direct to a health insurance company, through us, or through another broker, the price will be the same. There really is no need to shop around unless you’re shopping around based on a broker’s style, or level of service.

Step Five: Find a comfortable balance between how much you’d like to pay per month and how much expense or risk you’re willing to take on.

Okay, so you’ve decided you can’t spend more than $450 per month. But the plan you feel most comfortable getting is more than that. This is where you have to decide if you want to spend more for what you want, as well as ask yourself, “do I need that much coverage?” As a broker, this is where I come in most handy. But if you’re doing this without a broker, you’re pretty much going to have to find a happy medium between comfort zone and monthly cost. Can you borrow money from a family member if you needed to cover a higher deductible than you prefer? Do you have savings on hand? Maybe an HSA makes more sense for you so you can sock away some funds tax-free for future medical use. The more you run into uncertainty in this department, the more I encourage you to call a broker. There are certain things that no explanation other than a conversation can answer. Also, if there are pre-existing health conditions, that presents a whole other aspect.

Step Six: Regarding Pre-Existing Conditions and Medication.

If you’ve had no trouble with the previous five steps, congratulations! There is one last concern, however that may apply. There is no simple answer to this, either. If you have pre-existing medical conditions or are on medications and want to waste as little time as possible, call a broker. Get a recommendation from someone so that you know they’re not just going to try and sell you something. Will pre-existing conditions keep you from getting health insurance. No. But some will. Here’s the deal (partially)…

Uninsurable Conditions. There are things that will definitely prevent you from getting insurance. Due to health care reform insurance companies have been getting a little more relaxed with who they’ll accept. Most likely they’re preparing for 2014 when they have to accept everyone regardless of health status. But for now, and this is definitely not all inclusive, you’ll most likely be turned down for:

• Addison’s Disease
• Alcoholism
• Alzheimer’s
• Autoimmune disorders
• Being extremely overweight or underweight
• Bipolar
• Cerebral Palsy
• Chronic liver disease
• COPD
• Crohn’s Disease
• Cystic Fibrosis
• ESRD
• Ehler’s Danlos
• Emphysema
• Heart Bypass Surgery
• Hemophilia
• HIV/AIDS
• Implantable Defibrillators
• Kidney Dialysis
• Kidney Stones
• Most forms of cancer
• Multiple Sclerosis (MS)
• Muscular Dystrophy
• Myasthenia Gravis
• Parkinson’s
• Pregnancy
• Rheumatoid Arthritis
• Schizophrenia
• Sleep Apnea
• Spina Bifida
• Stroke
• Transplant recipient/candidate
• Tuberculosis

Rate-Ups, Riders, and Waivers. Some companies will accept you with conditions. This is unpredictable. I tell all clients that I’m unsure about, “we just have to submit an application to know for sure.” The reason it is hard to know for sure is that there are so many factors that determine the final cost that the underwriters come up with. Are you a smoker that’s close to the weight limit with high blood pressure, high cholesterol and mild depression? None of those conditions alone will get you turned down (for the most part) but combined, it’s highly likely. It’s still worth submitting an application, just to be sure, but I wouldn’t count on a policy being issued. And, this is why if you have health issues, it’s best to talk with a broker. There are options for people with pre-existing conditions. The option that’s best for you depends on your situation.

I should mention that children can no longer be turned down for pre-existing conditions. No matter what, as long as the parent is insurable, the child will be accepted. Although, they may be rated up, too.

I hope this has shed some light on how to purchase health insurance. And if you went through with it and purchased – great job! Leave a comment below and let us know how your experience was.

I’m not quite 65 yet (a couple of years to go) and my health insurance policy from Blue Cross Blue Shield of Arizona costs me over $400 each month. My current policy has a deductible of $3000 per year, and I am responsible for all of my medical expenses until I reach that $3000 number. Each time I go to a doctor, fill a prescription or get an x-ray, I have to pay for it until I hit that $3000 limit.

One of the nice things about turning 65 years old is that you’re probably eligible for a Medicare supplement insurance policy. A Medicare supplement will almost always cost you less than the health insurance policy you had before turning 65, and your out of pocket costs when you use the supplement will probably be close to zero.

When I turn 65, I’m going to purchase another Arizona Blue Cross policy – a medicare Plan F supplement. Today, that plan would cost me just $134 – about one/third of what I pay now. And the Blue Cross Plan F policy will pay for just about every medical expense I may incur. There are quite a few insurance companies selling Medicare plans here in Arizona, but we feel that Blue Cross Blue Shield of Arizona is a very strong contender. Lehrman Group has been marketing Arizona Blue Cross Medicare supplement plans for almost 25 years, and in all that time not even one Medicare client has contacted us to complain about anything. That’s a heck of a record.

If you’d like more information about the Medicare supplement plans available here in Arizona, click HERE to request we contact you, or call us. Our Phoenix number is 480-442-1259. Our Tucson number is (520) 760-0392. Our toll free state-wide phone is (800) 600-9663.

“Healthcare.gov, launched in the summer of 2010, takes much of the mystery and frustration out of shopping for a health plan. For the first time, consumers can find and compare prices and benefits for thousands of private insurance policies as well as community health services and public health programs like Medicaid or Medicare.

The one-stop shopping website — required by the new health care law — has details on more than 4,400 plans across the country from more than 225 insurers and will be updated monthly. For anyone who’s searched online for airplane tickets or books, the process will be very familiar. And a novice should be able to get the hang of it pretty easily.”

Oh, if only it were true.

Let’s break down a visit to this frustration reducer.

When you click the link, the first thing you’ll notice is the big disclaimer:

“We are experiencing unprecedented demand at this time. Our coverage finder is still available and you will be shown all your potential coverage options. However, because so many people are in the system right now, the listing you get may include additional options that do not apply to you. You can save time by ignoring coverage options that clearly do not apply (for instance, if you’re not a veteran, don’t select “Veterans Affairs”).”

I’ll translate:

“We’re learning this as we go along – bear with us! You can still try to find coverage using this site. In fact, we’ll show you options that don’t even pertain to your situation. And if you’re not a veteran, don’t click THAT one.”

Step 2: Let’s get started.

Simple enough. I’ll select my state – Arizona. And, as is typical of most calls we receive, I’ll select Individual with Medical Condition. But wait a minute – what if you don’t know if your condition is considered one of THOSE conditions? You don’t. you’ll need to call someone for that. Ideally someone that knows what conditions are a major issue, a minor issue, or a non-issue. At least until 2014. But for the sake of this article, let’s proceed.

Step 3: 13 options to look into

Simple is right! I don’t need to go into each of the 13 options but out of the majority of the people we speak with, the fourth option is going to be the only one that applies. Assuming you don’t waste time exploring the other 12 options that don’t apply to you and you click on the fourth option – Health Insurance Plans for Individuals & Families – let’s see what you’re confronted with.

Step 4: Go to Arizona’s Insurance Department Website

If you didn’t feel like you were getting the runaround before, how about now? Let’s click this new link that’s advising a clueless consumer to now leave the very system they were directed to to “take the mystery and frustration out of shopping for a health plan.”

At this point, I can’t imagine any consumer actually going this far. Once you end up at the Arizona Department of Insurance – which is generally a place for a broad amount of information relating to insurance agent licensing, filing complaints regarding an agent or carrier. However, if you’re the type that is determined to get some answers, and happened to click on the one link – the only link – that might provide those answers, it would be the first link: Educational Materials and Resources. Let’s try that and see what happens. A long list of links appears. None of which provides answers to our original request.

Clearly, AARP and Healthcare.gov add more mystery and frustration to shopping for a health plan than you could possible handle. We’ve obtained no information about any terminology or carriers, no information about what an individual with a medical condition should do, and of course, we have no rates. And, I imagine, in most circumstances, we’re frustrated.

If you want information about health insurance regardless if you are healthy, have medical conditions, are pregnant, are disabled, are single or have a family, are under 18, or if you are a business looking for benefits for your employees, don’t waste your time. Call a broker. Ideally, us.

As an independent health insurance brokerage, we’ve come to realize over the years how difficult it is to understand the terminology and functionality of health insurance, deductibles, coinsurance, and out-of-pocket maximums. To make purchasing a health insurance plan painless, call us at (800) 600-9663, or click here to get rates that will be very easy to understand. We’ll be with you every step of the way.

There are actually only two kinds of Medicare plans. The original plan was designed by the US Government, and it comes in 12 different versions. The versions are called Plan A, Plan B, Plan C — all the way up to Plan L. The real difference between the plans is how much you pay for your medical bills and how much your insurance company and/or the government pays. Here in Arizona, we find that Plan F is the most popular; under Plan F, if you go into a hospital and the bills are $100,000, the government pays about $80,000 and your insurance company pays about $20,000. Pretty simple. Usually Plan A costs less than Plan B, Plan B costs less than Plan C, and so on.

All of these plans are regulated and designed by the government, so Plan F from one insurance company will be exactly the same as a Plan F from a different insurance company. Whether you buy Plan F from Blue Cross Blue Shield of Arizona, AARP/United HealthCare, Humana or another carrier, the plan would be exactly the same. You can use any medical provider you want, and plans are available in Phoenix, Scottsdale, Tucson, Yuma, and all other Arizona communities. Your consideration in selecting an insurance company only needs to be based upon the insurance company’s financial strength and its customer service department.

The second kind of Medicare plan is called a Medicare Advantage plan. If you are on one of these plans, you’ll usually have co-pays to pay when you visit a doctor, and daily co-pays if you are hospitalized. The hospital co-pays can be several hundred dollars per day. You must use medical providers that accept your plan, too — you can’t simply use any doctor you want.

If you would like to learn more about which type of Medicare plan is the best option for you, call Lehrman Group at (800) 600-9663 or click here for Lehrman Group’s Medicare request page and we’ll contact you.

The first place to check is with your regular doctor. Your doctor’s office might already provide this service, and since you are already a patient, you shouldn’t have any trouble making an appointment. If your doctor’s office doesn’t carry the shot you need, ask if they can order it for you. This might take weeks, so be sure to plan ahead.

TIP: If you have to pay out of pocket for an immunization, save your receipt and contact your insurance company to see if they will reimburse you. Blue Cross Blue Shield of Arizona pays 100% of the cost for travel immunizations.

Here are other Tucson facilities you can visit for travel immunizations:

University Medical Center Traveler’s Clinic (6th Floor)
azumc.com
Call 520-694-8888 for more information or to set up an appointment. The only insurance accepted is Blue Cross Blue Shield of Arizona.

Traveler’s Clinic at New Pueblo Medicine
6365 E. Tanque Verde Rd., Suite #120
Call 520-901-1550 or visit travelclinictucson.com for more information. Most insurance plans are accepted. There is a $40 consultation fee in addition to the cost of the immunization. You do not need to already be a patient here, so you can schedule an appointment quickly.

Concentra Urgent Care Center
Travel immunizations are available only at the South side location:
4600 S. Park Avenue, Suite 5.
concentra.com/patients/travel-health
Call 520-889-9574 to make an appointment. Travel immunizations are available on Fridays and some Saturdays. Insurance is not accepted for travel immunizations.

Pima County Health Department
Only available at the South location:
175 W. Irvington Rd.
pimahealth.org/immunizations/index.asp
Call 520-889-9543 for more information or to make an appointment. Appointments are available on Friday mornings. In addition to the cost of the shot(s) you need, there is also a $40 consultation fee. Insurance is not accepted.

University of Arizona Campus Health Center
(ONLY available to UofA students and employees)
health.arizona.edu/health_services_immunizations_travel.htm
Call 520-621-2292 to make an appointment.
The UofA’s Travel Clinic is only available to students and employees of the university. Appointments are available primarily on Fridays. There is a $20 consultation fee, in addition to the cost of immunizations.

Associations and franchisors find it difficult, if not impossible, to find any major medical health insurance carrier willing to offer a health plan to their members and franchisees. The insurance carriers consider the franchisees and the franchisor as separate companies, and they don’t look upon the franchisees employees as employees of the franchisor. Because of this, franchisees are usually on their own when trying to provide health insurance to their employees or for themselves. A franchisee with only a handful of employees may find it prohibitively expensive to provide health insurance benefits to his or her employees.

Lehrman Group is a major medical health insurance broker doing business nationwide since 1988, and we have a solution for associations and franchisors/franchisees. Whether your franchise or association has a localized membership of only a few individuals or many thousands nationwide, Lehrman Group can provide you with the health insurance benefits you require. We can offer your members high quality, major medical health insurance plans from United HealthCare, Assurant and Humana, three of the largest health insurance companies in the United States. Several types of plans are available, including PPO and HSA plans, and we make it very simple for your membership to receive quotes and apply for a plan. We will create a custom website where your membership can instantly view personalized rates and apply. We also provide your organization with a toll free number, answered in your group’s name, where your members can get rates, talk one on one with an agent, and apply for a policy.

There are a few companies in the USA that claim they can offer guaranteed health insurance benefits to associations and franchise companies, but these plans are not major medical plans. These plans are called “defined benefit” plans, and they offer very limited benefits – they’ll pay a set dollar amount for each day an insured is in a hospital, and they’ll pay up to a certain amount for surgical procedures. Usually what they pay is nowhere near what the bills actually total, and if you are covered under one of these types of plans and end up in the hospital, you’ll probably be in for a very large surprise when you find out what you’ll actually end up having to pay. The plans are very expensive when you consider what you have to pay for the monthly premium versus what the carrier will pay when you are hospitalized.

If you are a franchisor or a director of an association looking for a health plan to offer your members, contact Lehrman Group at (800) 600-9663, ext 11 for more information, or click here and complete the small form requesting us to contact you.

As long as your medical visit is at a network provider for preventive reasons, and not due to a symptom you are experiencing, your insurance company must cover these services at no cost to you. There is no copay, deductible, or coinsurance to meet.

- Blood Pressure Screening
- Cholesterol Screening
- Colorectal Cancer Screening (Sigmoidoscopy, Colonoscopy)
- Depression Screening
- Diabetes Screening
- Mammography
- Obesity Screening
- Breastfeeding Support (coverage begins August 1, 2012)
- Contraception / Birth Control (coverage begins August 1, 2012)
- Cervical Cancer Screening
- Osteoporosis Screening
- Well-Woman visits
- Immunizations

Some of the covered services do have limitations. For more information, view the complete list at healthcare.gov.

Immunizations covered include Hepatitis A & B, MMR (Measles, Mumps & Rubella), Tetanus, Diphteria, Meningococcal, Pneumococcal, and Influenza. For more on immunizations, click here.

If you are a Blue Cross Blue Shield of Arizona customer, check out this PDF from Blue Cross, Preventive Health and Wellness Recommendations.

Not covered yet? If you are looking for health insurance, please fill out this online quote request form or give us a call at 1-800-600-9663.