Why a Health Insurance Page?
When you consider you medical care, health insurance usually plays a significant role in your treatment. Insurance companies can have limits on the types of treatments they will pay for, and sometimes you need an advocate to get your insurance provider to pay for your medical care. Therefore, it is important that you understand the types of policies availabe and how to find the right health insurance for you.
Types of Health Insurance
There are basically four types of health insurance available. There is the indeminity plan, or fee-for-service plan, and then there are three managed care plans – PPO, HMO, and POS plans.
- Indemnity Plans. Indemnity plans are also known as fee-for-service plans. You have the freedom to choose any doctor or hospital you want. However, you will then need to pay an annual deductible prior to the insurance company paying for any services. Then you pay a percentage of the bills. Usually the insurance company will pay 80 percent of the bill, however there are some indemnity plans that require you to also pay the co-payment. Often these plans will pay for medical tests and prescriptions, but they may not pay for preventive care. Due to the deductible and percentages, these plans can end up being more pricey than other options.
- HMO (Health Maintenance Organization). The benefit of an HMO is that you usually do not have to pay any deductible. You will, however, have to pay a co-payment at the time services are rendered. You will also have some restrictions on which hospitals and doctors you use. Usually HMOs require that you see the doctors in their network or that you get a referral for certain specialists. Many HMOs require that you pay for the service in full for out-of-network physicians. They may also offer special programs for disease management.
- PPO (Preferred Provider Organization). PPOs offer more freedom of choice than HMOs, but they may also be more expensive. PPOs will allow you to choose any doctor, but if you choose an in-network provider the costs will be significantly reduced. For instance the co-pay for an in-network provider could be $10, while the co-pay for an out-of-network doctor could be $20. Premiums tend to be a little higher for PPO plans, too.
- POS (Point-of-Service Plans). POS plans are more like a combination of an HMO and indemnity plan. You still need to choose a primary care physician as the gatekeeper to your care like an HMO, but you can go to physicians outside of the network for an indemnity-like fee.
How Do I Choose an Insurance Policy?
You have some options when it comes to choosing a policy. First, you can go through a broker or an insurance agent. An agent is a salesperson who works for one specific insurance company. A broker is someone who sells insurance for a variety of companies. You can use an in-person or online broker.
This site actually recommends a broker, because you can easily get a variety of quotes from one source. It is faster, because you often only have to give your information once. If you do not like to leave the house and you are knowledgable about health insurance, you can use an online broker.
It is also recommended that you get at least 3 quotes from insurance providers. You will want to compare those quotes to see who is offering you the best price and best policy. Take some time to compare co-payments, deductibles, coverage, and more. Make sure that the policy will meet your needs.
Also, make sure you check out the ratings for your insurance provider. Check out financial ratings at places like Standard and Poor’s.. You will want to choose a company that has at least an A rating so that you can be sure that they are a stable company financially. Also, talk with family and friends and check out consumer sites to be sure the company will provide good customer service. Look at your state’s Insurance Department to see if there have been a significant number of complaints against the company. Not only do you want to be sure your policy is affordable, but you will want to be sure your provider will be relatively easy to work with and get you the proper care.
When you get your policy, make sure you read it over carefully. Do not let anyone pressure you into signing right away. Look over the fine print and ask questions. You want to be sure you understand what is and is not covered. All of the things not covered should be outlined in your policy. Also, there may be special procedures you have to folllow for hospitalizations and more, so the fine print is very important to making sure you get proper care and coverage.
Note the Numbers
Once you have your policy in hand, make sure you note the major phone numbers and you keep them on hand. Many providers have patient advocates, and you never know when you will need one.
Helpful Links
- Insurance Information Institute. The Insurance Information Institute offers all kinds of information about health insurance and also provides news about the industry.
- Standard and Poor’s. Standard and Poor’s is an excellent place to find out the financial ratings on each company.
- Hoover’s. Hoover’s is a business site. They will tell you financial ratings and information about the company itself. There is an excellent amount of information on this site including links to a variety of companies and business approaches.
