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Health InsuranceBasic Types of Health Insurance
Today's health insurance market is broken into many segments. Some
are highly specialized in their coverage and others are more
comprehensive. The more comprehensive and inclusive the health
insurance the higher the premiums.
As its name implies, short-term health insurance is temporary
coverage and lasts from one to six months. Some companies may allow
the insured to renew the policy one time but the total length of
coverage will not exceed twelve months. This is perfect for someone
who just dropped off their parents' policy because they graduated
from college or maybe they hit that age limit and need health
insurance before they find a full-time job. Or maybe for somebody
between jobs. Plans are typically offered with a number of deductibles ranging from $200 to $2,000. Most young adults choose the $500 deductible or the $250 deductible. Older adults generally choose higher deductibles to offset their higher premiums. The down side of short-term policies
In many short-term policies the deductible you pay is per injury or
illness. That means you must meet the deductible all over again each
time you are treated for a ear infection or other illness. After you
meet the deductible, the company pays 80 percent of the next $5,000
in expenses and then pays 100 percent.
And what happens if you bought a three-month policy only to find that
the job you hoped to land - with health benefits - has not't
materialized? Don't count on automatically being able to renew your
short-term policy, because it doesn't work that way. You have to go
through the application process all over again and take out a new
policy. If you had any illnesses or injuries during your previous
policy period, those now become pre-existing and won't be eligible
for coverage. Catastrophic health insurance policies are intended only to pay for major hospital and medical expenses, not routine visits to the doctor's office or trips to the ER to get stitched up. A catastrophic plan would cover things like treatment in an intensive-care unit for 10 days after an auto accident or complications from a pregnancy that land you in a hospital. Catastrophic health insurance policies typically come with a very high deductible from $500 to $15,000 and a high maximum benefit payment, such as $1, $2 or $3 million. Who buys catastrophic health insurance? There are two groups of individuals who commonly purchase catastrophic health insurance. The first is the young adults who are self employeed or do not have coverage through their employer. They are healthy on no medications and would rather pay their own office visit and save the premium. The second group is primarily made up of individuals between the ages of 50 - 65. They typically choose high deductibles $5,000 and up and are primarily concerned with catastrophic losses associated with heart attacks, cancer and other such illnesses. Is Catastrophic Coverage Right For You? As with all insurance you are gambling that you are going to need the coverage. With catastrophic coverage you are elimination coverage to reduce premiums. Be careful not to take a deductible larger than you can afford and plan for what you're comfortable with is the worst happens. Shop around on your own or talk to an independent insurance agent to make sure you get a plan that's right for you. For more information and rates on catastrophic health insurance visit our specialist site below.
Up until about 30 years ago, most people had
traditional indemnity coverage. These days, it's often known as
fee-for-service. Indemnity plans are a bit like auto insurance: you
pay a certain amount of your medical expenses up front in the form of
a deductible and afterward the insurance company pays the majority of
the bill. Fee-For-Service For years, indemnity or fee-for-service coverage was the norm. Under this type of health coverage, you have complete autonomy when it comes to choosing doctors, hospitals and other health care providers. You can refer yourself to any specialist without getting permission, and the insurance company doesn't get to decide whether the visit was necessary. You don't, however, have complete autonomy. Most fee-for-service medicine is managed to a certain extent. For instance, if you're not already incapacitated, you may need to get clearance for a visit to the emergency room. On the down side, fee-for-service plans usually involve more out-of-pocket expenses. Often there is a deductible, usually of about $200, before the insurance company starts paying. Once you've paid the deductible, the insurer will kick in about 80 percent of any doctor bills. You may have to pay up front and then submit the bill for reimbursement, or your provider may bill your insurer directly.
Under fee-for-service plans, insurers will usually
only pay for reasonable and customary medical expenses, taking into
account what other practitioners in the area charge for similar
services. If your doctor happens to charge more than what the
insurance company considers reasonable and customary, you'll probably
have to make up the difference yourself. Fee-for-service plans often include a ceiling for out-of-pocket expenses, after which the insurance company will pay 100 percent of any costs. Traditional fee-for-service coverage offers flexibility in exchange for higher out-of-pocket expenses and is not for everyone. Shop around on your own or talk to an independent insurance agent to make sure you get a plan that's right for you. For more information and rates on short-term health insurance visit our specialist site below.
Preferred Provider
Organizations (PPO'S)
A Preferred Provider Organizations is the least
restrictive type of managed care. PPOs have made arrangements for
lower fees with a network of health care providers. PPOs give their
policyholders a financial incentive to stay within that network. Is a PPO Right For You? Rates and coverage vary form state to state so shop around on your own or talk to an independent insurance agent to make sure you get a plan that's right for you. For more information and rates on PPO health insurance visit our specialist site below. Point-of-Service (POS) "Managed Care" A Point-of-Service plan is a little more least restrictive type of managed care. Point-of Service plans like PPO's have made arrangements for lower fees with a network of health care providers and give their policyholders a financial incentive to stay within that network.
However, Point-of-service plans introduce the
gatekeeper, or Primary Care Physician. You'll need to choose your
primary care physician (PCP) from among the plan's network of doctors. Is a POS Right For You? Rates and coverage vary form state to state so shop around on your own or talk to an independent insurance agent to make sure you get a plan that's right for you. For more information and rates on POS health insurance visit our specialist site below.
Health Maintenance
Organizations (HMO's) A Health Maintenance Organization plan is the most restrictive type of managed care. Like Point-of Service and PPO's, HMO's have made arrangements for lower fees with a network of health care providers and give their policyholders a financial incentive to stay within that network.
HMO plans also utilize a gatekeeper, or Primary Care
Physician. You'll need to choose your primary care physician (PCP)
from among the plan's network of doctors. HMO's require that you only
see their doctors, and that you get a referral from your primary care
physician before you see a specialist. In most cases you'll need to
get clearance before you can visit the emergence room, if your able.
In general, you must see HMO approved physicians and use HMO approved
facilities or pay the entire cost of the visit yourself. Is a HMO Right For You?
HMO coverage is a trade-off between premiums paid and plan
flexibility. HMO's offer some very attractive rates but are very
restrictive when it comes to coverage. Rates and coverage vary form
state to state so shop around on your own or talk to an independent
insurance agent to make sure you get a plan that's right for you.
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