The ABCs of Health Insurance

Choosing the right health insurance can be a difficult and confusing endeavor. The primer below is designed to give you a basic overview of what to look for in an insurance plan.

How to Get Health insurance

If you are fortunate enough to get health insurance through your job, your out-of-pocket costs are most likely deducted from your check. Many companies offer basic coverage including emergency room costs, doctor’s visits, prescriptions, x-rays, lab tests and chiropractic care. Additional health insurance is often available to cover dental, vision and long term conditions. This type of supplemental health insurance will most likely involve additional fees.

If you freelance or are a small business owner, you may need to purchase an individual health insurance policy. This can be accomplished by contacting a health insurance carrier or by contacting an insurance broker. The benefit of using an insurance broker is that a broker is not tied to any one carrier and can provide you with a variety of different rates.

However, a note of caution about choosing an individual health insurance plan-Be sure to check the rating of your company with A.M. Best, which evaluates the fiscal health of various insurance agencies. If the carrier’s rating is less than A, you need to keep searching for other options.

Types of Health insurance

There are two main types of health insurance; fee for service plans and managed care. Under fee for service plans, you will need to submit a claim for each medical cost. You are then reimbursed for each covered expense.

Under managed care, certain rules and regulations apply to keep healthcare costs as low as possible. PPOs and HMOs are two types of managed care plans. With PPOs, you have the option to see any doctor within the PPO network. You may also be referred by a PPO doctor to another doctor outside the network and still receive the lower cost. However, if you decide to see a PPO doctor outside of the network without a referral, your bill may be significantly higher.

HMOs stipulate that you must visit a doctor within the HMO network with the exception of emergencies. HMOs are excellent for covering routine medical costs such as checkups, flu shots and hearing tests. However, although HMOs are considerably easier on the pocketbook, they offer much less flexibility than PPOs.

Health insurance Checklist

Whether comparing programs offered through your job or shopping for health insurance on your own, you should take the following into consideration:

-Your overall health and the health of your family.

-How the health insurance plan handles fundamental care.

-Out of pocket costs to you.

When investigating a health insurance carrier, you may want to ask yourself the following questions:

-How often will you need to see a doctor? Do you or any family members require specialized care?

-Will the plan cover the basics beyond annual office visits? How does the health insurance plan handle maternity care, prescriptions, surgery, hospitalization, lab costs and other medical fees?

-Is there a deductible or amount of money that you need to pay before the health insurance plan begins to extend coverage? What is the co-pay, if any? (A co-pay is the difference between what the carrier covers and what you pay out.)

-How much will it cost to see a doctor outside of your plan?

All of these factors need to be carefully considered before choosing a health insurance plan.

Supplemental Health insurance

Beyond basic health insurance, you may wish to investigate supplemental coverage such as vision care, dental care, disability insurance and long-term care insurance. For instance, many plans cover dental cleanings and eye exams, but do not cover more extensive procedures. Disability insurance pays out an income if you are unable to work and long term care insurance can cover costs associated with an extended illness, such as at home care and physical therapy.

Take care to fully investigate the terms any supplemental health insurance that you choose to purchase.

By Andrea Pugno Di Ferro From: www.associatedcontent.com

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