health insurance
Whether you are looking to take care of your family, or you're simply looking to take care of yourself, health insurance has become one of life's necessary options. There is no law that states that you need to have some kind of health insurance coverage, however, if you don't have it, you might find that it will end up costing you far more in the long run, either financially or in terms of health.
All in all, there are four broad categories of health insurance available for purchase from most health insurance providers. (Features and costs vary from provider to provider) These include:
- HMO (Health Maintenance Organization)
- POS (Point-Of-Service)
- PPO (Preferred Provider Organization)
- Indemnity (Also known as Fee-For-Service)
Although Indemnity health insurance policies tend to be more expensive, they are also considered to be the most flexible, allowing for more freedom of choice within the policy. The least expensive, and therefore most common form of health insurance coverage is the HMO plan, which is quite inflexible, having its options limited by its provider. A more detailed description of each of the four categories of health insurance follows below.
HMO - Although HMOs offer the cheapest form of health insurance coverage, they also offer the most limited set of options. Costs associated with doctors within the HMO will be covered, however any health related costs outside the network will need to be dealt with independently. Within your HMO, you choose a Primary Care Physician (PCP) from a list of networked doctors, and he will be responsible for coordinating your care which will include:
- Routine/Preventive care
- Treatment of illness/injury
- Referrals to specialist when required
Although most HMOs do not require a fee for doctor visits, others might require a coinsurance fee of $5 - $10. This would be outlined before purchasing the HMO.
POS - POS plans are slightly more expensive than HMOs, however they also offer more freedom. As with an HMO plan, you will need to select a PCP. If your PCP makes referrals for you outside of the POS network, your POS plan will continue to pay for all or most of the bill.
PPO - A PPO plan is far more expensive that the common HMO plan, however it frees you up from being tied into a network, and allows you to see the physician of your choice. (Fees, however, will be lower if you stay within an established network) If you stay within an established PPO network, you will pay a reduced member copayment, or a fixed amount for services. If you go outside the network, the costs will still be covered, however you will have to pay a higher copayment based on the higher charges and you will need to meet the deductible. You may also have to pay the difference between the actual fee and the amount covered by your plan.
Indemnity - The most expensive type of health insurance, indemnity plans also afford the greatest amount of freedom and flexibility. There is no network of any kind, and you are fee to visit the doctor/hospital/medical facility of your choice. Said facility will submit a claim to your insurance company, and they will pay for any/all services that are covered under your plan. (Exact fee is based on the level of indemnity health insurance you choose)
Typically, you will be reimbursed for 80 percent of the doctor bill, and you will need to pay the other 20 percent.
Policies usually have an out-of-pocket maximum, which means that after your expenses reach a certain limit in a given year, your insurance company will then pay for all of your covered benefits.
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Check out a list of < HEALTHCARE PROVIDERS >
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