Further Thoughts You'll Need Next Time You Go Shopping For a
HealthCare Insurance Policy
Prohibited Marketing Practices. It is unlawful for a company or
agent to use high pressure tactics to force or frighten you into
buying a Medigap policy, or to make fraudulent or misleading
comparisons to get you to switch from one company or policy to
another. Deceptive "cold lead" advertising also is prohibited.
This lactic involves mailings to identify individuals who might
be interested in buying insurance. If you fill in and return the
card enclosed in the mailing, the card may be sold to an
insurance agent who will try to sell you a policy.
Check Your Right to Renew. States now require that Medigap
policies be guaranteed renewable. This means that the company
can refuse to renew your policy only if you do not pay the
premiums or you made material misrepresentations on the
application. Beware of older policies that let the company
refuse to renew on an individual basis. These policies provide
the least permanent coverage. Even though your policy may be
guaranteed renewable the company may adjust the premiums from
time to time. Some policies have premiums which increase as you
grow older.
Know With Whom You're Dealing. A company must meet certain
qualifications to do business in your state. You should check
with your state insurance department to make sure that any
company you are considering is licensed in your state. This is
for your protection. Agents also must be licensed by your state
and may be required by the state to carry proof of licensure
showing their name and the company they represent. If the agent
cannot verify that he or she is licensed, do not buy from that
person. A business card is not a license.
Keep Agents' and/or Companies' Names, Addresses and Telephone
Numbers. Write down the agents' and/or companies' names,
addresses and telephone numbers or ask for a business card that
provides all that information.
If You Decide To Buy, Complete the Application Carefully. Do
not believe an insurance agent who tells you that your medical
history on an application is not important. Some companies ask
for detailed medical information. If you leave out any of the
medical information requested, coverage could be refused for a
period of time for any medical condition you neglected to
mention. The company also could deny a claim for treatment of an
undisclosed condition and/or cancel your policy.
Look For an Outline of Coverage. You must be given a clearly
worded summary of the policy... READ IT CAREFULLY.
Do Not Pay Cash. Pay by check, money order or bank draft made
payable to the insurance company, not to the agent or anyone
else. Get a receipt with the insurance company's name, address
and telephone number for your records.
Policy Delivery or Refunds Should be Prompt. The insurance
company should deliver a policy within 30 days. If it does not,
contact the company and obtain in writing the reason for the
delay. If 60 days go by without a response, contact your state
insurance department.
Use the "Free-Look" Provision. Insurance companies must give
you at least 30 days to review a Medigap policy. If you decide
you don't want the policy, send it back to the agent or company
within 30 days of receiving it and ask for a refund of all
premiums you paid. Contact your state insurance department if
you have a problem getting a refund.
And again, do not rush or be pressured into deciding on a
policy. Trusting salespeople will take their time with you. If
you are uncertain about a particular program, have the
salesperson tell it to someone else, this sometimes helps too.