Researching your health
insurance needs can be an intimidating task. Indeed, as the costs
associated with health insurance and medical care continue to climb, it's hard to know
where to begin.
Well, browsing this web site is a
good start.
At LearningAboutHealthInsurance.com, we put our knowledge to work for
you. We offer valuable information on many important aspects of the
health insurance industry. The topics discussed at this site are
grouped by categories that you can see listed on the right hand side of
every page.
Be sure to visit this site
often as additional articles and information are added on a regular basis.
If you have any questions about any of the
topics you see discussed here, please feel free tocontact us. In additional, please feel free tocontact us with your constructive feedback about this site.
A Brief Health Insurance
Primer
When researching any industry, it is
important to first have, at a minimum, a basic understanding of it.
This will help when dealing with various companies and their sales reps, as
well as helping you determine the right questions to ask. The
health insurance industry is no exception.
As with most types of
insurance, health insurance coverage varies greatly. Essentially
it is a type of insurance policy that pays a pre-determined percentage of a
policy holder's covered medical treatments.
When determining whether or not
you really need health insurance, you need to determine how risk averse you
are. Health insurance, of course, doesn't become an issue until you
need it. If you believe in Murphy's Law—that whatever can go
wrong, will—then you probably should consider getting health insurance.
Health insurance coverage varies by country. For example, in England,
France, Canada, Sweden and Norway, the doctors and hospitals are paid
by the government instead of an insurance company. In the United
States, health insurance is primarily offered by private companies.
In the United States, health
insurance policies can be broken into the following
categories:
-
Self-Insured:
This is where an individual has health insurance but
is responsible for paying 100% of the insurance premium. Self-insured
individuals (one individual or one family) will typically have an
individual policy, which is also commonly referred to as private, or
personal, health insurance. It is estimated
that this group comprises approximately 30% of the U.S. population.
-
Managed Care Plans: Managed
Care Plans can be further broken down into three categories. All are
basically networks that provide contracted services by specific providers
at pre-negotiated fees:
-
Health Maintenance
Organizations (HMO) are prepaid plans in which members pay a fixed
monthly fee, regardless of how much medical care is needed in a given
month. HMOs provide medical services ranging from office visits to
hospitalization and surgery, and usually require that you stay within
the network when you need services from physicians and hospitals.
-
Preferred Provider
Organizations (PPO) are groups of doctors and hospitals that provide
medical service only to specific groups. PPO members typically pay for
services as they are provided, and the PPO sponsor typically reimburses
the member for the cost of the treatment. In most cases, the price for
each type of service is negotiated in advance by the healthcare
providers and the PPO sponsor.
-
Point of Service (POS)
plans are not as common as HMOs and PPOs. With this type of managed
healthcare system you pay no deductible and usually only a minimal
co-payment when you use a healthcare provider within your network. You
also must choose a primary care physician who is responsible for all
referrals within the POS network. If you choose to go outside of the
network for healthcare, you will be subject to excess charges or
deductibles.
-
Indemnity Plans:
Also called fee-for-service, indemnity plans allow
participants to seek medical care whenever or wherever they need.
Participants can visit any doctor or specialist, as often as they
feel necessary. No referrals are necessary and there are no restrictions
when it comes to seeking medical help. Of course, such coverage is
by far the most expensive type of health coverage, which has resulted in
these plans being the least used type of health insurance today.
Determining which type of
health insurance is right for you will depend on your personal situation.
Researching and eventually choosing affordable health insurance coverage is a
time-consuming task and it can certainly be frustrating. Nevertheless,
it's something that everybody needs to consider sooner rather than later.
When you are
ready to go forward with the process of securing health insurance,
we feel quite confident in
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- Largest selection of quality
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Receive free instant health insurance quotes, as well as apply for health
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