Health Insurance Basics
Health insurance is a necessity for all individuals. This is because even a minor illness can quickly become a life threatening condition that you can cost thousands of dollars to treat. Many illnesses have been financially devastating to many people and families and having adequate health care can assist you in covering those medical expenses as well as helps to ensure that you can afford preventative medicine as well.
It is important to understand how health insurance coverage works before you purchase a plan. The health insurance plan that you choose must meet your needs as an individual or family. There are several different types of health coverage available and having an understanding of health plans can help you choose the right one.
Health care plans will typically pay for most, and possibly all, of the cost of treatment for illnesses and injuries. These are usually classified as ?managed care? or ?fee for service.?
Most people are familiar with ?fee for service? plans and they are often referred to as ?indemnity plans.? These are plans that are sold by traditional insurance companies and you can go to any doctor you want and you don?t require a referral if you need a specialist. A fee-for-service plan will often pay for most of the costs of treatment for medical conditions that are covered in the policy. In most cases, your healthcare provider will bill the insurance company directly for the cost of your care, but in some instances you may have to pay the bill and then file a claim for reimbursement with the insurance company. With a fee-for-service plan, you will be required to pay a premium, deductible and coinsurance.
Co-insurance is the portion you have to pay once you have met your deductible and the plan begins to pay benefits. Generally, your plan will pay 80% after the deductible has been met, but you are then required to pay the leftover 20%. The amount that the insurance company pays depends widely on the state you live in. As with a deductible, the higher you pay in co-insurance, the lower your premiums.
Managed care plans use ?networks.? This means that you have to choose from a specific list of doctors, clinics, hospitals and health care providers. These providers are contracted with your plan to provide services to members of the plan. Some managed care plans will require that use only providers in the plan for your routine care. Others will pay for care from any provider, but offer you more financial incentives for sticking with those in the network.
Managed care plans are usually a more affordable option. Managed care networks provide healthcare professionals with ?built-in? clientele, thus allowing them to lower their rates. These plans also emphasize preventative care to keep medical conditions at bay. In general, the trade-off for these programs is that you may not be able to use your doctor of choice, but you will receive increased affordability.
There are three types of managed care plans including:
? Preferred Provider Organization Plans ? These allow you to go to any provider you wish, but you will save if you use providers that are in the network. You do not have to select a primary care physician for a PPO plan.
? Health Maintenance Organizations ? These require you to only receive care from providers within the network. There are exceptions should a medical emergency occur. With a HMO, you will have to choose from a ?primary care physician? list. Your physician will oversee your medical care and provide you with referrals to specialists and other providers you may need.
? HMOs with a POS (Point-of-Service) ? If this will allow you to use a healthcare provider outside of the network, without first having to receive a referral. However, you will pay more for using those providers. A POS plan may also exclude the option for out-of-network care in certain medical situations.
Kevin Powell offers FREE Guide To Choosing The Right Health Insurance Coverage that has helped people just like you to get affordable health insurance. Check it out at http://www.health-insurance-net.com
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