Frequently Asked Questions

+ Health Insurance

What is a deductible and how does it work?
A deductible is the amount of money you must pay each year before your health insurance plan starts to pay for covered medical expenses.

What is coinsurance?
Coinsurance is a cost-sharing requirement where you are responsible for paying a certain percentage and the insurance company will pay the remaining percentage of the covered medical expenses after your plan deductible is met. For example if your policy has 80/20 coinsurance, once the deductible is met your plan pays 80% and you pick up the other 20% until you reach your maximum out of pocket.

What's the difference between a Primary Care Physician (PCP) and a specialist?
A Primary Care Physician, or PCP, is the doctor you would go to on a regular basis, such as when you're simply not feeling well, have an ear ache, the flu, or for a routine check up. A specialist is a doctor that your PCP might refer you to if the problem you have requires a doctor who specializes in a certain area of medicine like a Cardiologist or Neurologist. Most plans will have a higher copay when visiting a specialist, and some plans will require a referral from your PCP.

What's the difference between a Primary Care Physician (PCP) and a specialist?
Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO) refer to the type of network associated with the policy. With HMO's you must receive medical care from doctors, and at facilities that participate in your plans network. You'll need a referral from your PCP to see a specialist, and if you choose to seek care outside your network you will not be covered. Insurance carriers can charge a lower premium for their HMO plans because it is a small and restrictive network, and the providers who participate in HMO's have agreed to a lower reimbursement for their services.

PPO's will also have a network of providers, and although you will pay less money out of pocket for your medical care by staying in-network, you will still have coverage if you choose to go outside of the network. There is no referral needed to see a specialist with a PPO, and because PPO's reimburse providers at a higher level, you have many more doctors and hospitals participating in the network.

A new trend in the individual market is the introduction of POS (Point of Service) and EPO (Exclusive Provider Organization) network plans. Both bring their own unique restrictions and limitations so it's important to know what type of network your getting before you decide on a plan.

The bottom line is with any network other than a PPO your trading freedom of choice for premium savings so make sure you research the network carefully before you enroll in any plan.

If you need any guidance or assistance, please give Mason Insurance a call. Remember, using an agent cost you nothing so let us help you make the right decision!

+ Medicare

What should I consider when purchasing a Medicare Supplement Insurance Policy?
Be sure that you understand how it works with your Original Medicare plan and that it minimizes your out of pocket expenses. For more information contact us and we'll explain your choices and help you find the right plan.

Will a Medicare Supplement cost less if I purchase it with an insurance company instead of Mason Insurance?
No. Medicare supplement rates are regulated by the government. Because of this your rates will be same whether you purchase it through us or the insurance carrier. At Mason Insurance we take pride in being knowledgeable in all aspects of Medicare so give us a call at (817) 770-8804 and we will help you sort through and understand all of your options.

Will a Medicare Supplement plan cover me if I have a preexisting condition?
Possibly. Insurance companies will usually ask for proof of prior coverage before offering coverage for conditions. However, there are some instances when it is not necessary to provide coverage for pre-existing conditions. Please contact us so we can help you find the right plan to cover your health conditions.

What can I do if I'm declined for a Medicare Supplement Plan?
No two insurance companies have the same underwriting standards. So, if you are declined for coverage we can simply review your application and submit it to a different insurance company. At Mason Insurance we pay attention to the details, we do our homework up front and try to do it right the first time to avoid this situation.

Can my Medicare supplement insurance be terminated for any reason?
Generally no. The Federal Government provides protection against this happening. However, an insurance company can terminate your coverage if you fail to pay your premiums, if there are any omissions or misrepresentations on your application, or the insurance company becomes insolvent.

+ Life Insurance

Why Should I Buy Life Insurance?
One of the biggest reasons to buy life insurance is to provide money in case of death. If you're single and don't want to leave money to anyone, you may not need life insurance. But as you take on more responsibilities and your family grows your need for life insurance increases. The proceeds from a life insurance policy can replace the income lost to your family upon your death. The life insurance death benefit can also pay off debts and expenses, provide money to a charity or organization, and cover final and estate expenses.

How much life insurance do I need?
If you are providing financial support for people who are depending on you, you probably need life insurance. To determine how much you need, deduct the total income that would be lost upon your death from the sum required for your family’s ongoing financial stability. Beyond that, it depends on your particular circumstances (e.g., whether you have considerable net worth or few backup resources) and whether you want insurance for other purposes, such as educational funds or your own retirement income. Although there is no substitute for a careful evaluation of the amount of coverage needed to meet your needs, one rule of thumb is to buy life insurance that is equal to five to seven times your annual gross income.

Do I have to take a medical exam?
Typically yes, but there are “non-medical” policies available. These policies will ask a series of medical and life style questions on the application, and may also request your medical records, but there is no exam involved. These plans will be more expensive and are generally offered at lower face amounts. If you are agreeable to a medical exam, the cost is covered by the insurance company and the examiner will come to your home or office.

I don't smoke cigarettes, but I smoke cigars occasionally. Will I have to pay smokers rates for life insurance?
Because of the increased mortality risk associated with smoking, smokers almost always pay more for life insurance than their nonsmoking counterparts. Some life insurance companies distinguish between casual/social smokers and regular smokers and offer somewhat lower rates for those who smoke less. Rising cigar popularity raised numerous questions about how to classify cigar smokers, and this includes the use of smokeless tobacco as well. Let us help you fine the right carrier, because every insurance company will view this differently.

I am single. Do I need life insurance?
Single people often think they don't need life insurance, and in many cases, they are right. However, there are many factors that determine your need for life insurance, and marital status is just one. What you need to consider is if you died tomorrow, would you leave enough to cover your funeral expenses? If not, who would be responsible for paying? For many families, even a relatively simple funeral can create a major financial burden. For this reason alone, you might consider purchasing a small life insurance policy, or even a simple burial policy. As an alternative, you could invest the premiums you would spend on such a policy, and make sure your family knows this investment is earmarked for your final expenses, should the need arise.