Health Spas Guide » Health Maintenance Organization

CIGNA Health Insurance Company of Arizona Review

admin — Mon, 12 Apr 2010 20:44:27 +0000

CIGNA Health Insurance Company of Arizona is a solid choice for those looking for affordable AZ health insurance coverage. Perhaps not as well known as many other health care companies, CIGNA has been around since the year 1792 when the Insurance Company of North America (INA) was formed by a group of citizens in Philadelphia, Pennsylvania. The company started offering health insurance when they acquired the HMO network of Los Angeles in 1978. A year later the company acquired HMO’s in Phoenix, Arizona and in Dallas, Texas. In 1982 the company became known as CIGNA when INA and Connecticut General Insurance Corporation combined.

Nowadays CIGNA has continued to grow in every state they offer coverage in, and the state of Arizona is not an exception. CIGNA covers about 500,000 members in the state of Arizona alone through their Arizona Health Maintenance Organization (HMO) network, their Preferred Provider Organization (PPO) network and their AZ Health Savings Accounts plans, not to mention that numbers continue to grow. The largest coverage area within the state is Phoenix where an estimated 150,000 members are located and the company has over 20 offices in the metro area of this city.

Based within the state in the city of Phoenix because is the largest member area within the state as discussed before, the company offers their benefits to residents of the following counties: Apache, Coconino, Gila, La Paz, Maricopa, Mohave, Navajo, Pinal, Yavapai and Yuma. Apart from the network of plans listed above they offer Medicare Advantage plans, Medicaid and Point of Service (POS) plans. Although the company itself is not a major insurance company within the United States, it has continued to grow and experts predict that it will continue its progress through 2008. With only 5 states where it offers coverage (Tennessee and Florida being the ones where it has expanded the most), it’s only expected that the company continue to expand across America.

Within Arizona, CIGNA offers only one plan that is good for the general person that is looking for a well-developed, low-cost and comprehensive coverage Arizona health insurance plan. The plan itself is available to individuals that are 18 years of age or older, families with children up to 18 years of age or 23 if the son/daughter is a full time student and children without an adult subscriber who are at least 3 months of age. In order for you to receive coverage, the company asks that a person resides within one of the service areas for at least 9 months or more, unfortunately if you recently move to a service area you must wait the specified amount of time for you to be able to purchase a CIGNA plan.

The service areas within Arizona are divided into two. The Phoenix service area incorporates the counties of Maricopa and the city of Apache Junction. On the other hand the Tucson and Southern Arizona service area covers the counties of Cochise, Graham, Greenlee, Pima, Pinal and Santa Cruz counties.

The good thing about this one CIGNA AZ plan is that it covers everything one can think of when it comes to health care. For primary care physician (PCP) services a member must pay $25 with no limit on visits through the calendar year. For specialists they are required to pay a little bit higher ($50) but like PCP visits, there is not a limit on visits. Other services that are covered by the plan for which a member won’t have to pay a single cent are lab and x-rays and blood pressure checks.

The prescription coverage side of the policy is divided into three tiers like many other insurance companies do. For generic drugs a person should be expected to pay $15, for brand name medications they should expect to pay $40 and for specially drugs they are expected to pay up to $60 dollars. The emergency care fee is $150, however there are special places within the Arizona service areas that are sponsored by the company called CIGNA Medical Group Urgent Care , that a member can go to in order to avoid the emergency room fee. In this group urgent care facilities, a member will only have to pay $75.

The coverage for Inpatient Care holds a $1,000 year deductible for individual and a $3,000 year deductible pre family. After you have met the deductible you will only be required to pay a 20% co-insurance. For Outpatient Care the member has the same deductibles and the same 20% co-insurance after the deductible has been met. The only difference is that in outpatient every diagnostic test or x-ray such as a CT, MRI, MRA or PET would include $100 copayment.

Other important things that the plan offers include chiropractor services for $50 a visit (a limit of 12 visits per calendar year), maternity care in which you wont have to pay anything for prenatal and post-partum exams, but at the time of delivery a 20% co-insurance is applied. Vision coverage is also worth mentioning, you will pay $30 for one exam per calendar year at a CIGNA vision center. It is important to note that if you have an eye exam somewhere else, you will be charged full price for it.

Family planning services are also covered, although infertility treatment is left out of the equation and you would have to go somewhere else for that. The plan also offers short term rehabilitation, mental health services, substance abuse services and detox services. Out-of-pocket maximums for this plan are $3,000 for individual and $10,000 for family and the lifetime benefit is unlimited. This last part means that if you reach the out-of-pocket maximum within a calendar year you will not be cut off coverage.

By: James J. Robinson

5 Things To Look For When Buying Health Insurance

admin — Mon, 05 Apr 2010 17:14:22 +0000

The comfort and security of knowing you can see a doctor whenever the flu strikes or when you’ve broken your leg on the ski slopes is a privilege that many take for granted. Whether you have to select health insurance through your job or need to choose an independent company, there are plenty of factors that can affect your final decision. Weighing the pros and cons of various options is the best way to choose the health insurance that will accommodate your needs as an individual or family. Below are a few points to consider as you search for the best health insurance plan for you:

Know Your Choices

There are many different kinds of health insurance plans offered to the public. Knowing the various options you may qualify for will help satisfy your needs in the future. There are five type of health plans to consider: traditional indemnity, health maintenance organization (HMO), Preferred Provider Organization (PPO), Point of Service Plan (POS), and Health Savings Account (HSA). You should familiarize yourself with each option.

Know the Advantages and Disadvantages

Out of the five main types of health insurance plans, each one contains their own set of advantages and disadvantages. For example, with a traditional indemnity plan, individuals seeking complete freedom in the medical providers they can select should choose this option. But freedom comes with a price; the insurance plans produce higher rates and costs. This means individuals will face few restrictions, but also have to cope with no financial incentives that lessen patient financial responsibility.

Coverage and Benefits

An important factor to consider when choosing a health insurance plan includes the type of benefits offered and whether or not they will accommodate your needs. Some of the coverage capabilities to ask about include maternity, prescription, childcare, immunizations, emergency visits, and annual checkups.

Costs

Seeking information on the premium or employee contribution associated with a particular health insurance plan is important to make an effective decision. The cost you are responsible for will depend on the type of plan you choose; the deductible, coinsurance and co-payment; lifetime maximums, and the limitation of plan benefit coverage.

Are You Considered “Hard to Insure?”

If you are labeled as a “hard to insure” case, you may not find the most cost-efficient or accommodating health coverage. A few things to keep in mind include: avoiding lifetime maximums of less than $500,000, straying from plans that only offer hospital and surgical benefits, seeking out an HMO plan that tend to be the least expensive, and researching health insurance coverage provided by professional organizations, school alumni programs or unions.

By: Gabriel J. Adams

North Carolina Health Insurance

admin — Wed, 31 Mar 2010 05:32:20 +0000

Nowadays, you can find a variety of health insurance plans in the United States and North Carolina, the home of many brilliant physicians, hospitals, and reliable health insurance companies.

With the cost of health care getting higher and higher, you are likely to land in deep trouble if you have a serious accident or a major illness. Buying health insurance can save you from a financial disaster. Armed with health insurance, you can protect yourself and your family if you are in need of expensive medical treatment. In that case, a third party will pay your expenses, which can be an insurance company or even your employer.

Most people receive health insurance through their jobs. Called group insurance, it is less expensive and in many cases the employer takes responsibility of the total or partial cost. Although some employers offer only one health insurance plan, some others offer you a choice of plans: a fee-for-service plan, a health maintenance organization (HMO), or a preferred provider organization (PPO). Most of the plans have some kind of managed care program to help control costs. All HMOs, PPOs, and several fee-for-service plans, have managed care. In case you don’t get this benefit from your employer, you can go for an individual policy.

Health insurance companies in North Carolina offer several plans for individuals, couples and families. In NC, you find group health insurance programs for employees of all sizes of businesses. Health insurance plans in North Carolina are not beyond your reach because you can select a policy that matches your budget. In North Carolina many public and private employers offer a managed care option to employees. The state of North Carolina offers many types of managed care options to state employees and their dependents, and it also has a portion of the Medicaid population enrolled in managed care plans.

There are a number of health insurance companies licensed and approved to do business in North Carolina. The choice is yours.

By: Eric Morris

A Traditional Indemnity Health Insurance Plan Or A Managed Care Plan?

admin — Sat, 20 Mar 2010 23:33:50 +0000

For many years people felt that they were trapped between a traditional indemnity health insurance plan (a wide range of choice and high degree of security in the event of serious accident or illness which came at a high cost) and a managed care plan (a focus on preventative medicine at relatively low cost but with severely limited choice).

Today however it is possible to some extent to enjoy the benefits of both traditional indemnity insurance and managed health care through a variation on the original Health Maintenance Organization (HMO) model known as a Preferred Provider Organization (PPO).

A PPO is essentially an HMO which means that the insurance company will establish a network of healthcare providers and, in exchange for a relatively low cost, will encourage, or in some cases require, policyholders to seek treatment within the HMO’s network. Where treatment is taken outside of the HMO’s network much, if not all, of the cost of such treatment normally has to be borne by the policyholder. However, in the case of a PPO, the rules for policyholders who wish to seek care outside of the HMO’s network are relaxed.

Within an HMO a policyholder is assigned to a particular doctor or primary care physician (often referred to as a “gatekeeper”) and the policyholder must go through the primary care physician in order to receive treatment. If, for example, the policyholder wishes to see a specialist then he or she will have to be referred by the primary care physician and may or may not have a say in which particular specialist they are referred to.

In a PPO however no primary care physician is assigned and so no referral is required. Policyholders are free therefore should they choose to do so to seek treatment through a specialist who is not a member of the HMO’s network.

There are of course cost implications to this choice and policyholders will almost certainly have to pay more for treatment with a doctor or in a facility that is outside of the HMO’s network than they would if they sought treatment within the network. Nevertheless, unlike the HMO model, the PPO gives the policyholder the choice.

If you like, a PPO provides policyholders with the low cost managed health benefits of the HMO with the option to elect for the greater choice, albeit higher cost, of indemnity insurance when it suits their needs.

It will probably come as no surprise to find that today traditional indemnity policies are fast disappearing and that there are now twice as many people enrolled in PPOs as there are in HMOs.

By: Donald Saunders

Health Insurance When Living Abroad

admin — Tue, 23 Feb 2010 19:14:25 +0000

You may not know this already, but when planning on traveling abroad you cannot take your local insurance with you. You will need to purchase an international insurance plan offered by a multinational insurance company. While they may be hard to track down, it is the best way to assure that in the event of an accident or illness you will be able to acquire medical attention if needed.

Many of these plans will cover you up to six months in another country. When you speak with the insurance company, be prepared to give an extensive list of information to them. This will range from health problems you’ve had in the past ten years, your hereditary conditions to substance abuse, and almost everything else-if it has anything to do with your health be prepared to disclose the information. If you are planning on traveling with more than one family member, then be prepared to give information for each family member as well.

Many times your basic coverage will include emergency treatment regardless of which facility it is administered. This is not the case with minor medical treatment. It is important to know whether you are buying an insurance plan that is an HMO or PPO. If you are under an HMO or health maintenance organization, then you will be limited to receiving care from only the providers who are in their network. You can retrieve a list of all the companies within your insurer’s network upon request. If you are under a PPO, or preferred provider organization, you will have the opportunity to pick the best facility you see fit, but your insurer will only cover a portion of the incurred cost.

If you plan on staying abroad for more than six months then you will need to look into what is called expatriate health insurance. Only larger companies supply this type of insurance, as it is much more extensive with the type of options that can be applied to each policy. The type of treatment options that are covered with expatriate health insurance are those that are labeled as specialty treatments, like chiropractic therapy and acupuncture. There are many options that can be applied to expatriate health insurance depending on your family’s needs and how long you plan on spending abroad.

There are many options for health insurance when you are traveling abroad. While many individuals never consider purchasing insurance when traveling to another country, this should be at the top of your list when planning for a trip. Health insurance should not be taken lightly. Be sure you understand every aspect of your policy before deciding with any one particular company.

By: Roger Mitchell