We all understand the importance of health insurance; however, as the types of health insurance continue to increase it is becoming more and more difficult to select the type of coverage that is best for you and your family. To help you find out which type of policy might benefit you the most, let’s take a look at the most common types of policies.
There is usually a lot of hype regarding HMOs so let’s look at that one first. A HMO is a health maintenance organization plan that works with a specified group of doctors and hospitals within the network. A primary healthcare physician is selected and you must obtain referrals for care that cannot be provided by that physician. The benefits of this type of plan are lower office visit costs and prescription drug co-pays. In addition, there will typically be either no or limited deductible costs for hospital stays. Depending on your coverage, there may also be no pre-existing condition cause limitations. It is also important to understand that your choice of doctors and hospitals will be limited with a HMO and you won’t be able to have out of network services covered.
A PPO or Preferred Provider Organization works similar to a HMO; however, the major difference is that you are not required to select a primary care physician. In addition to the benefit of being free to choose your own physician without worrying about a referral you also gain the benefit of limited or no deductible costs for hospital stays as well as a possible larger selection of physicians that might be available with a HMO. Out of network services may also be covered; however, for a higher charge than in network services.
A POS, or Point of Service, is also similar to a HMO in that you select a primary care physician. The difference is that you are free to choose out of network treatment if you’re willing to pay a higher out of pocket cost.
Another option is what is known as a traditional coverage policy. This type of policy will have a higher monthly premium as well as deductibles. In addition, you will generally be required to pay for services out of your own pocket up front and then submit claim reimbursement forms.
You may also wish to consider various types of disability plans, which cover a percentage of your income in the event that you experience an illness or accident that prevents you from working for a period of time. A short term disability plan will provide benefits from the first day of an accident or the eighth day of an illness up to 26 weeks. Generally, this type of plan will cover 66% of your weekly income.
Long term disability will begin after short term coverage has expired and will provide coverage for a variable term, depending on the policy you select. Some policies are limited to providing coverage up to two years while others will cover you up to the age of 65.
By: Joseph Kenny
Posts Tagged ‘Physicians’
Health Insurance 101 Explained
February 2nd, 2010Straight Talk About Health Discount Plans
January 1st, 2010
Why have health discount plans suddenly become so popular?
One reason is because they are useful whether or not you already have health insurance. A discount plan can be used to reduce the cost of procedures your insurance policy refuses to cover. But whether or not you have health insurance, there are several reasons why you might want to consider signing up with a discount health plan.
But first, a definition.
A discount health plan is what some people call an ” alternative” to dental insurance.
Here’s how it works.
You apply for membership with a company that offers the plan and agree to pay a monthly fee in return for deep discounts on your health services. The company then issues you a discount card.When you visit your physician, you simply present your card for an instant on-the-spot discount. Discount plans are not the same as insurance, and you are responsible for paying for all services. In return, you’re able to get health care at a deeply discounted rate. Now, back to the reasons you might want to consider a discount plan for yourself and your family…
It’s affordable. For instance, you should not have to pay more than $40 a month for a health discount plan that includes physician,dental, vision, prescription and chiropractic services. No limit on visits or services. With the best plans you can use the service as often as necessary without penalty. No age limit. You can sign up your loved ones, regardless of age. Includes Vision, Prescription and Chiropractic. Discounts on these services should be included at no extra cost. There is no waiting period. You should be able to start using the program the day you sign up. No paperwork to fill out. You don’t have to answer any health questions or deal with other paperwork hassles. You can change dentists/physicians. If you’re not satisfied with your physician or dentist, you can get another one Specialists are included where available. No referrals are needed for specialists. No pre-authorization for treatment required. Cosmetic surgery is included. Some insurance policies don’t include this. Ongoing (pre-existing) dental/medical problems accepted. No health questions to answer. If you have an ongoing problem, it doesn’t matter Outpatient services included. Ancillary services are included in your health plan Hospital advocacy program available. You have someone to negotiate your hospital expense if your bill exceeds $2500. 24-hour nurse-line provided. This could save you thousands of dollars in expensive trips to the doctor or emergency room.
Drawbacks of Discount Health Plans
One drawback of health discount plans is the failure of the company to deliver on its promises. And there are a few of those. I call them scams.
Barring that, here are a couple more things that might be considered drawbacks.
You have to pay the piper.Always keep in mind that health discount plans are not insurance. That means you are responsible for paying for all procedures and services performed. In many cases, your health care provider (doctor or dentist) will work with you on a monthly payment plan. Mine does. But make sure you work the details out with your physician before services are performed.
Not Enough Health Providers in Your Area
Another thing you should beware of is a plan with a short provider list. Before you sign up for any discount plan, check the plan’s health provider list and make sure there’s a sufficient number of health providers (doctors, dentists) in your local area.
You’ll lose any savings you might have gained if you have to drive across the country to find the nearest doctor or dentist.
By: Mike Griffith
