Affordable Health Insurance
In America health care is not automatically provided by the government, which means that people who do not have health insurance find themselves in a tenuous situation. That is because the cost of a hospital stay could be financially devastating. In addition to the financial cost, it is an unspoken fact that even though hospitals are required to accept patients that come to their emergency rooms, uninsured patients do not receive the same quality of medical care as insured patients do.
Work Related Health Insurance
It is estimated that 84.7% of Americans have some form of health insurance, and around 60% of Americans that are covered by health insurance, receive it through their job or the job of their spouse or parent. If you are employed, and your employer has a health insurance plan, you generally cannot be denied coverage because of your health status or a disability. If you are denied health insurance because of a prior medical condition, there are nondiscrimination laws which prohibit that type of behavior. However, your employer can deny you coverage if you are part time or do not have enough time on the job. If you do not have a job, or if your employer does not offer health insurance, you may be eligible for coverage through the plan of your spouse or parent. Under the new health care laws, children can receive coverage under their parents plan if they are less than 26 years of age.
Individual Insurance Policy
If you are self-employed, or unable to get health insurance through your job, you can buy a private health insurance policy. Around 9% of Americans purchase private insurance. If you decide to buy a private health insurance policy, you will find that finding affordable health insurance is not always easy. The cost of a policy can be very expensive. Health insurance coverage for an individual with a family can cost thousands of dollars per year.
Affordable Health Insurance
Regardless of whether you get health insurance through your employer or buy a private insurance policy you will want to minimize your health care cost. In order to get affordable health insurance, that adequately meets your health insurance needs, you should understand about the different types of health insurance plans that you can choose from. There are two types of health insurances, Fee for Service (Indemnity) Plans, and Managed Care Plans.
Fee for Service Plans
Under a fee for service plan, you choose your medical provider and the insurance company pays for all or part of the plan according to the terms of the policy. Usually the insurer pays a percentage of the cost, and you the insured pay a smaller coinsurance cost. These plans are usually offered through employer plans, but can be purchased by individuals who purchase private insurance. Few people purchase fee for purchase plans because they are the most expensive type of health insurance around.
Managed Care Plans
There are three types of Managed Care Plans, HMO’s, PPO’s, and POS’s. These plans are popular because they are engineered to hold down health care cost.
Health Maintenance Plans
In a Health Maintenance Plan (HMO), you pay a pre set cost for your medical care. You are then assigned a physician that is selected by the HMO. The HMO will then take care of all your medical needs, and you will only have to pay a small deductible of ($15.00 to $20.00) per visit. HMO’s are cheaper because in order to receive benefits you must use their required physician, except in emergencies. Some HMO’s have been known to limit a patient’s medical options in order to lower cost. HMO’s use the economy of scale to keep cost low.
Preferred Provider Organization
Preferred Provider Organizations (PPO’s) are managed care plans that are able to get preferred contractual arrangements because they represent a large group of patients. Many government and union plans are PPO’s. In a PPO, you are not required to see a specific provider, but you will receive a discount if you use a provider in the PPO network. Generally you will be required to pay a small copayment of ($25.00 to $30.00) per visit.
Point of Service
A Point of Service Plan (POS) is a hybrid of the HMO and PPO plans. The POS resembles an HMO because the primary care physician is required to make a referral to other providers within the plan. If you decide to see a physician outside of the plan, the insurer will pay a predetermined amount of the bill, and your cost will be higher than if you stayed in the network. These plans are usually more expensive than an HMO, but they give you the freedom to choose your own physician whether they are in the plan or not.
Questions that you Need Answered
• How much is the premium?
• Does the policy cover hospitalization and major medical expenses?
• Is there a limit on hospital and major medical coverage?
• What are my choices concerning a physician and health care provider?
• Does the policy cover prescription drugs?
• Does the policy cover dental and prescription expenses?
• What are the deductible amounts?
• What are the co-payment amounts?
• What are the limitations on pre-existing expenses?
It is important to get answers to these questions before purchasing a health insurance policy.
Medical emergencies are the most common cause of personal bankruptcy in America. If you or a member of your family becomes seriously ill, the cost of having no medical insurance or insufficient medical insurance could be financially devastating. When purchasing health care insurance you need to keep in mind that no single plan will cover all of the cost of your medical care.
When choosing your medical insurance you must first make sure that you have adequate coverage. Secondly it is important to compare coverage’s so that you can make an informed decision about the best coverage for the most affordable price. Most medical insurers provide websites that explain their different coverage’s and lay out the amount of their premiums. Remember that when you make long term financial plans choosing the proper medical insurance could be one of the most important decisions that you will make.
Resources:
http://www.bcbstx.com/getting_started/how_to_shop/questions_to_ask.html
http://www.kiplinger.com/basics/archives/2003/11/fee.html