HEALTH INSURANCE - COMMON TYPES OF

Individual Health Plan - Health insurance designed for one individual person

Family Health Plan - Family is normally classified as a group of related individuals under the same household. There are a few exceptions to this, one being children away from home at school. Normally a student can remain on the policy until they are a certain age, this varies by Health Insurance Carrier.

Group Health Plan - Comprised of multiple Individuals or Families. Group Health is an organizational unit contained in a plan. These groups can be employment, associations, schools, government, etc. Generally to be defined as a group plan, an employer or organization must pay 50% of the premium or the amount of the individual for each participant in the plan.

HMO - Health Maintenance Organization: This type of health plan is geared toward pre-chosen care providers. Also known as in-network. You have a primary care physician who is your point of contact. Unlike the PPO, your primary physician must refer you to a specialist prior to you being able to see one.

POS - Point of Service: This plan is sort of a mix of an HMO and PPO. You can choose to go through your primary physician or access care through a PPO provider. If it is in-network you will have lower co-payment than if you were to chose an out-of-network provider.

PPO - Point of Provider Organization: A type of managed care where the PPO might have predetermined rates with care providers. These providers are also known as in-network. The cost to you for each visit could be lower than if you were to go out of network for health services. You are normally responsible for the difference between the amount your health insurance company pays and what the fee for services is from the health care provider. PPO is generally considered better than HMO because you can choose to refer yourself to another provider or specialist if you feel the need to do so.

MSA - Medical Savings Account: This is a pre-tax account where you can defer your earnings to fund medical expenses. These accounts are set up in coordination with a HDHP or High Deductible Health Plan. Generally the HDHP type plans are going to be much less expensive than the standard deductibles. You must be Self Employed, work for a qualified small business or a qualified small business owner to be able to utilize this type of plan.

HSA - Health Savings Account: Health Savings Accounts (HSAs) were created by the Medicare bill signed by President Bush on December 8, 2003 and are designed to help individuals save for future qualified medical and retiree health expenses on a tax-free basis.

HEALTH INSURANCE QUOTES AND BUYING A POLICY

If your employer offers Health Insurance, you will have your choice of plans such as HMO or PPO. If not you will have to purchase your own coverage. Health Insurance can be a major expense and just as important as the cost, you need to make sure the right plan is chosen for yourself and your family.

Getting Health Insurance Quotes

If you are self employed or work for a small business that doesnt offer a health plan and need to purchase an individual or family plan, you should talk to a Health Insurance Broker that is able to write insurance through several different insurance companies. It will save you time and effort in having to provide your personal information and making contact with multiple companies. Your Health Insurance Agent will find out for you, which plans will better suit your needs and give you a comparison sheet on what each plan offers as well as cost breakdowns by deductible.

How much will my Health Insurance Cost

Monthly premium costs are definitely a major factor. If you are obtaining insurance through a group plan with your employer, you will only be paying a portion of the total premium if they are not picking up the entire tab already. As health care costs rise, it is becoming more prevalent that employees participate in the cost of the plan along with their employer.

Make a list of questions such as:

How much will I be paying for my health insurance per month?
What deductible options do I have and how much will I have to pay myself before the insurance kicks in for coverage?
After I've met my deductible, what percentage of the medical bill will I still need to pay for and how much of the medical expense is reimbursed?
Do I need to cover all medical expenses or just the major ones?
What are the cost differences for using out of network care providers?

There are many deductible options ranging from less than $500 to in excess of $5000. Generally in the upper range of deductibles is considered a "Major Medical Plan" meaning its only going to start providing coverage if something very costly occurs. Choosing higher deductibles is really dependent on what you're ongoing medical needs are. If you rarely visit a doctor, then you should choose a higher deductible plan. The savings off the monthly premium rate could easily make it worthwhile. If you only see a doctor once or twice a year for a minor issue, it could only cost a couple $100 dollars, but the premium saved could be thousands!

What services do I normally need? Does the plan cover them?

Do you have a Family Doctor that you have been visiting and wish to continue to use that doctor? This could be a major factor in which company you choose and if it is going to be an HMO or PPO provider. The fastest way to find out who you should pick in this case is to call your doctors office and see what Insurance Companies they are considered in the network of and who they recommend.

Find out if the new plan allows you to see a specialist and what the procedure is before you can see one.

Do you have pre-existing medical conditions and are they covered?

Check and make sure that any pre-existing medical conditions are covered under the new policy. Many times, if you were already covered under a previous plan and it is still in effect without a break in coverage, it could carry over and be covered in the new plan. The worst case scenario would be to find out after switching plans that your condition is not covered and you must pay out of pocket for as long as you have that condition! Chronic conditions such as Diabetes, Asthma, Cancer or AIDS are definite factors. If you have a chronic condition, make certain to inquire how it will be treated with the new plan.

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HEALTH INSURANCE - COMMON TYPES OF

HEALTH INSURANCE QUOTES AND BUYING A POLICY

Getting Health Insurance Quotes

How much will my Health Insurance Cost

What services do I normally need? Does the plan cover them?

Do you have pre-existing medical conditions and are they covered?