All
You Need to Know About Health Insurance
Let's face it--in today's world, health
insurance is a necessity. With medical expenses
soaring higher than a hang glider, paying
for them could have you digging deep into
the pockets of your jeans.
What types of health insurance are available?
Health insurance plans generally fall into
one of two categories: indemnity plans (also
known as reimbursement plans) and managed
care plans such as health maintenance organizations
(HMOs), preferred provider organizations
(PPOs), and point of service (POS) plans.
• An indemnity plan allows you to
choose your own doctors and pays for your
medical expenses--totally, in part, or up
to a specified amount per day for a specified
number of days.
• Managed care plans generally provide
broader coverage, but they all involve an
arrangement between the insurer and a selected
network of health-care providers (doctors,
hospitals, etc.). For example, an HMO will
require that a primary care physician in
the network coordinate all of your care
and refer you to specialists in the network.
No matter which type of health insurance
you buy, you'll need to make sure it offers
the right kinds of coverage.
What should be covered?
A good health insurance policy contains
several types of coverage.
Hospital expense insurance pays your room,
board, and incidental services costs if
you're hospitalized.
Surgical expense insurance covers surgeons'
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 medical insurance offers extremely
broad coverage with a very high maximum
benefit that's designed to protect you against
losses from catastrophic illness or injury.
What might be covered?
When comparing health insurance plans, check
to see if they provide additional benefits
that you may need, including:
• Prescription drugs
• Preventive care
• Mental health benefits
• Maternity care
• Vision care
What will it cost?
In addition to the monthly premium expense,
you may have other out-of-pocket costs.
These costs can really add up, especially
if you have children or other family members
who visit the doctor frequently. Check to
see if the health insurance plan you're
considering requires you to pay any or all
of the following:
• Co-payment: The amount you'll have
to pay each time you visit a health insurance
provider (generally required by HMOs).
• Deductible: The amount you'll have
to pay toward your medical expenses (usually
annually) before the insurance company begins
to pay claims (generally required by indemnity
plans).
• Coinsurance: The percentage of your
medical costs you'll have to pay after you
reach any deductibles that apply.
Where can I get health insurance?
You may get health insurance through a group
plan at work or through another group affiliation
(a school, a club, etc.) or by purchasing
an individual plan on your own. By purchasing
an individual plan on your own, you may
even be able to customize the health plan.
Shop online to compare rates from several
companies to find the best plan and rate
to meet your needs.
How do I decide which plan is best?
The best health insurance plan for you is
the one that gives you the greatest flexibility
and the most benefits for the lowest cost.
Unfortunately, there's no such thing as
a standard health insurance plan. As you
would when making any major purchase, you'll
need to shop around and get several quotes
before choosing a plan. Here are a few points
to consider:
• What co-pays, deductibles, and coinsurance
requirements apply?
• How much freedom do you have to
choose your own health-care providers?
• Does the plan cover the health services
that you need?
• Does the plan cover the health-care
providers you're currently using?
• Does the plan offer family, as well
as individual, coverage?
• Does the plan cover pre-existing
conditions? If so, is there a waiting period?
(The average waiting period is three months
to one year.)
• Does the insurance company have
a good reputation in the industry and a
positive rating from a major ratings organization?
(Contact your state's department of insurance
for more information
By insurance.com
|
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