Health Insurance
In life's unchartered waters, where an accident, injury or illness may befall us unexpectedly, health care insurance serves as a life jacket. It is both a necessity and an investment of paramount importance as it preserves our most precious resource- our health- and protects us from sudden, gargantuan medical bills. Since no two health insurance companies are alike, consumers should carefully review the various plans and options available in the marketplace before selecting a provider that best suits their
insurance needs. An optimal health insurance policy will provide the utmost flexibility and most extensive coverage and benefits at the lowest cost.
Consumers may obtain low cost health insurance and save as much as 50 percent by comparing, at third-party sites, online
insurance quotes from different insurers. There are numerous affordable individual and family health insurance plans online, which offer complete health insurance coverage and
long term care protection for the insured and his or her family.
Prospective purchasers may choose from among three categories of health insurance plans:
1. Reimbursement or Indemnity Health Insurance Plan
This type of plan grants policyholders absolute autonomy to choose their health care providers, hospitals, and doctors and to refer themselves to specialists without obtaining permission. Indemnity health insurance plans cover the insured's medical bills in part, fully or up to a designated amount for a fixed number of days. Before the health insurance provider pays the claim, the policyholder must usually pay a deductible ranging from $200 to $2,500. With a reimbursement plan, policyholders are typically charged higher health insurance premiums as well as out-of-pocket expenses and must complete more paperwork than they would under other plans. However, indemnity health insurance plans offer tremendous flexibility.
2. Managed Care Plans, Alternatively Known as PPOs, HMOs and POS
Consumers may generally obtain broader health insurance coverage by purchasing a managed care plan- a point of service (POS), preferred provider organization (PPO), or health maintenance organization (HMO) plan. Managed care plans are characterized by minimal paperwork, low health insurance rates, and low co-payments (sometimes this requirement is waived). A co-pay is the sum that a member pays at the time of treatment to defray part of the medical expenses. The majority of HMO plans offer complete health insurance coverage, small deductibles in the range of $0 to $1500, and low co-payments. While families usually pay the same or less for an HMO as for a PPO, the former charges a much lower deductible. HMO policyholders pay a monthly fee, which covers most health expenses for the month, irrespective of the extent of medical care being sought. Often, they must also make a co-payment, the size of which is determined by the type of medical treatment. Complex medical procedures and prescriptions command a different co-pay than routine doctor visits. Policyholders are assigned to a specific medical clinic or physician who will authorize the medical care. To be covered by an HMO, members must visit only doctors that belong to the HMO network, and to see a specialist, they must be referred by their primary care physician.
With a PPO health insurance plan, policyholders foot the bill for medical services and visits at the time of service and are then reimbursed for those expenses. This plan allows members to select their own physician from a wide network of doctors and offers them substantial flexibility. The majority of PPOs charge a reasonable health insurance rate and typically feature hospital deductibles in the range of $500 to $5000. PPOs are ideal for individuals suffering from chronic pain and for those with a condition necessitating care by a specialist since a PPO does not require a referral.
POS policyholders do not pay any deductible. However, they usually have to submit a low co-pay when visiting a doctor. Members are required to choose a primary care physician from the POS's network of providers. When needing a specialist, they must go through their primary care physician who will refer them to other physicians.
3. HSA Health Insurance Plan
This new and increasingly popular concept functions in a similar fashion to a PPO plan, in that members may select their own physicians from a long list of doctors. This health insurance plan charges a small monthly premium but a high deductible, typically exceeding $2400.
Prior to purchasing a health insurance policy, consumers should verify that it incorporates the following coverage options:
1. Hospital expenses: which include room, board and other costs incurred during a hospital stay
2. Surgical expenses: which include surgeons' fees and expenses associated with surgery
3. Physician's expenses: which include doctor visits at the physician's office or at the hospital
4. Major medical coverage: which include fees resulting from any significant injury or illness
When shopping for a health insurance plan, consumers should inquire about the availability of family health insurance and investigate the provider's reputation in the industry. A good source on health insurance companies is the state's insurance department. Prospective purchasers should find out if the health insurance plans they are comparing offer supplemental options that they may need down the line. These include (1) preventive care, (2) mental health benefits, (3) chiropractic care, (4) vision care, (5) maternity care, (6) prescription medication, and (7) dental plans. Consumers may choose to purchase and customize an individual health insurance plan. They may avail themselves of a group health insurance plan offered through a group affiliation or their employer. Furthermore, student health insurance plans are available to eligible college students in the 17-29 age range.
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