Purchasing Health Insurance: Basic Facts You Need To Know
With the costs of medicines and hospitalization increasing, health care has become extremely expensive for most people to tolerate. As important as it is to buy health insurance, it is also important to save money, especially in these times of economic difficulties. The only way to save money and to get a good deal is by researching. Before committing to a specific health care insurance, one must study the variety of health plans that are being offered by conducting some online research.
It can be overwhelming to research and not understand a word of what is being read. That is why prior to researching, one must learn there are two different types of health insurances. One type is called indemnity plans, also known as reimbursement plans, and the second type is the managed care plans, which include health maintenance organizations, preferred provider organizations, and point of service plans.
With indemnity plans, offered by most traditional insurers, a person is allowed to choose their own doctor and is entitled to either completely pay for the medical expenses, pay part of it, or up to a specified amount per day for a specific period of time. Then the medical expenses are reimbursed, however, in some cases the reimbursement may be limited.
The managed care plans provide wider coverage and make an arrangement between the insurer and a selected network of health care providers like doctors, hospitals etc. Policyholders are offered major financial motivation to use the providers in that network. However, a health maintenance organization may require that a primary care physician in the network will coordinate the entire health care of the patient and refer to specialists, also in the network.
One must be aware of what managed care plans consists of and their differences. Health maintenance organizations (HMOs) are prepaid policies; members pay a monthly fee despite of how much medical care is needed in a specific month. By being a member, this grants you and your family complete care including doctors’ visits, hospital stays, emergency care, surgery, lab tests, x-rays and therapy.
Preferred provider organizations (PPOs) are made up of doctors and/or hospitals and the insurer pays for services as they are rendered and then it is reimbursed. With point of service plans (POS) one pays no deductible and usually only a minimal co-payment when they use a healthcare provider within their network.
POS plans are a mix between an HMO and a PPO where you have a primary care doctor and you get most of your health care from but you also have the option to choose to see doctors outside of the network at your own cost.
One should also examine the type of coverage offered by each health insurance organization and understand that it may vary. If one were to be hospitalized, hospital expense insurance pays for the room, board and incidental service costs. Surgical expense insurance covers surgeon’s fees and related costs associated with surgery. Physicians’ expense insurance pays for visits to a doctor’s office or for a doctor’s hospital visits.
Major health insurances offer a very broad coverage with maximum benefits that are designed to protect the customer from catastrophic illness or injury. While buying health insurance like these, one must check carefully and read between the lines of the policy to see if the additional benefits include prescription drugs, preventive care, mental health benefits, maternity care, vision care and others.
There may also be some expenses besides the monthly premium expenses that are not covered by some health care insurance organizations which can be really heavy especially if there are small children or members who visit the doctor frequently. Another expense one should be aware about is a co-payment. A co-payment is an amount one has to pay every time a health insurance provider is visited. There are some deductibles which are amounts to be paid towards medical expenses before the insurance company begins to pay the claims. There can be coinsurance also where the percentage on the medical costs has to be borne.
Health insurance is usually offered through a group plan such as at work or through another group affiliation like a club or a school. However, one can also purchase an individual health insurance. Before buying any health insurance, one should get online and find information, compare rates, review plans and options offered by each company and select the one that appeals the most. The best health insurance plan is the one which has the greatest flexibility and the most benefits at the lowest costs. One needs to shop around and get the best quotes before committing to a specific insurance. One must also make sure the reputation of the health insurance broker is good and in case of doubt the state’s department of insurance gives the full information.
Watch the video related to health plan
Reforming American Health Care Conversations host Harry Kreisler welcomes George C. Halvorson, Chairman and Chief Executive Officer of Kaiser Health Plan and Kaiser Foundation Hospitals, for a discussion of health care reform. Topics covered include: thinking systemically and comparatively about health care; roots of the American crisis; prerequisites for positive change; lessons of managed care systems such as Kaiser, Mayo and Cleveland; the implications of information technology for reengineering American health care; grading Obama’s reforms; and lessons learned from a career in health care management. globetrotter.berkeley.edu globetrotter.berkeley.edu conversationswithhistory.typepad.com www.thenewpress.com
Help answer the question about health plan
What do you think of McLaren Health Plan?I am a State of Michigan employee and I am looking to switch my health insurance to McLaren. It is the least expensive plan offered, and I am really looking to save money. Any insight would be great! Thanks!
@pcsassy03 Well what do you expect? Shes just misdirected. Shes focused in the wrong direction, smart yeah.. But its in vain when misdirected.
Hello, I'm not sure how you define "rich," but high-end policies are either 80/20 plans (and the wealthy can afford the 20% they pay), low-deductible plans, or plans their corporations write themselves and are provided free to them. They have the freedom to go to any doctor they choose, anywhere in the country. However, that's still a lot running around. Personally, I've been with Kaiser for 20 years and if you're willing to be an advocate for your health care, Kaiser is the best HMO out there, and it's under one roof.
@teknoguy2002 Yes, I agree, the people who have completely legitimate reasons for health care should have it, but just until they are back on their feet. We shouldn’t give it to people who just don’t try. We are heading in a direction that all health care will be controlled by the government. I don’t mind us helping one another for short periods of time but health care is a private business and the government should interfere as little as possible.
Obama's is a little closer to a single payer system, where as clintons is not. All in all, under obama's plan people and small businesses are subsidized if they participate in the federal program, under clinton's plan you can be subsidized no matter the program. There are pros and cons to both, in obama's there are few less choices, but it also costs far less.
I own operate my own business. so i am in need of health plan.
@dland95 (Sorry only needed like 40 more letters)
But for the most part, the uninsured aren’t that way by choice. And even then, they’ve been paying taxes just like everyone else.
That's a major reason why I supported Obama over Hillary. Fining poor people for not having insurance is a sign of over reaching liberal heavy handedness that I don't care for. How can people pay the fine if they can't afford health insurance.
@dland95 Some people just can’t afford Health Insurance. Some people who CAN afford the insurance don’t get it, because even if they had it they can’t afford the copay. It’s not about who applies themselves, except in the case of extreme laziness, but I think that is actually rare.
Some people don’t get health insurance just because they don’t want to. Fine by me, but if something happens, there should be some guarantee to the healthcare system they go to for care that they will get paid.
Last I heard, there is no government health plan in the works. Lieberman managed to kill it.
Meanwhile, there are still 2 different plans b/n House and Senate and we won't know what the outcome is until they are reconciled.
All dentists have a unique provider number which represents them, and their place of work. Your health insurance is likely asking for that number.
If you give your dental office a call, they can provide you with the detail for your dentist.
She has valid concerns, as do all the people opposing the bill. But the long and short of it is, Rep. Grayson had a very good point. If you get hit by a bus, and you don’t have insurance, you have to pay all the medical expenses. If you have a job it’s not a problem, but you could lose it as a result of the accident. Then even with a payment plan, you can’t afford to pay. The hospital system then ends up footing the bill. People need to be responsible for themselves, not leave it to chance.
The thing is, people that are uninsured generally didn’t apply themselves. They never tried to make something of their lives and as a result didn’t make enough money to pay for insurance in case something happened to them. When something does happen, they come whining saying how they have never had a chance. They have always have had a chance and never took it. So now the productive, tax paying members of society have to pay for someone not feeling like applying themselves.
It should remain privatized. The Government can hardly run itself without being in the red. I don't need the government taking care of my health care.
“everyone NOW has access to healthcare”, the emergency room; is like saying, if everyone has a gun, we don’t need government intervention and force a dept of military on us.
@dland95 Charities are all well and good, but they jsut don’t end up helping everyone who needs it. Not by a long shot.
Let’s say I get laid off this week. I’ve been paying taxes all my life, paid into SS, and even have health insurance. After I lose my job, I no longer have my health insurance. If I get sick, I can’t afford to pay for it because I just lost not only my job, but my insurance as well.
I see where you’re coming from, and I do agree, some people just shouldn’t be helped.
Obama cares nothing about the very young and the very old. He only cares about those who can pay taxes.
No one knows.
There have been no bills present. It's all just heresay still.
@teknoguy2002 I do see your point about people who can’t afford it. I don’t see a reason why other people should pay for it when the uninsured can’t. That’s what charities are for.