Understanding
Health Insurance
The cost of health
insurance is rising at alarming rates. More and more
people are opting for less expensive plans. In order
to make the most of your insurance, it is imperative
that you understand your health insurance policy, what
it covers, and what charges you are responsible for.
Although all
health insurance companies offer similar plans, there
are several major types of insurance:
Major Medical Insurance
This insurance
usually has a deductible and once satisfied, the
insurance company will pay a percentage, often 80% of
medical costs. The insured is responsible for paying
the deductible as well as the remaining 20% of
charges. More…
HMO
Health Maintenance
Organizations focus on preventive and long term care
of an insured. Each insured must choose a Primary Care
Physician that coordinates their overall care and
provides referrals to specialists when needed. There
will be a co-payment required for doctor visits. This
type of health insurance is more restrictive than
Major Medical but is also less expensive. More…
PPO
A Preferred
Provider Network works similar to a HMO, however,
insureds are able to choose to go outside of the
network of doctors. Normally, a deductible and higher
co-payments are required for out of network doctor
visits. More…
POS
A Point of Service
Plan is a combination of a PPO and HMO. The insured
still chooses a Primary Care Physician. This doctor is
still responsible for referrals to specialists.
Specialists can be in or out of the network. Patients
can choose to see specialists without referrals,
however, the insurance company can choose not to pay
for services. More…
Based on your
family situation and your individual health needs, you
will need to determine which type of policy is best
for you.
By Eileen Bailey
See
also:
Major Medical
Health Insurance
Health Maintenance
Organization (HMO)
PPO Preferred
Provider Organizations
Point
of Service Health Plans
Health Insurance
Terminology
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