Affordable Health Insurance Information
More and more people are doing their shopping for health insurance on the Internet, finding affordable policies and the exact coverage they are looking for. With dozens of insurers advertising on every possible media outlet, comparing facts can become a daunting task, and being able to compare health insurance rates and coverage side by side on Insurancespecialists.com is a huge help.
Health Insurance Demystified
At Insurancespecialists.com, we have laid out the explanations of the different coverage packages, with their explanations, advantages and disadvantages. It is easy to be led astray and purchase a health insurance policy that is either too much or too little coverage for your needs. As an example, consider the choice of how much deductible you want to set: a young healthy person, with no pre-existing medical conditions may not visit the doctor very often; therefore, setting a higher deductible amount may be a way to save money. There are also different health insurance plans to consider, such as Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Indemnity Health Plans.
HMO – Health Maintenance Organization – Insurance Plans
An individual belonging to an HMO typically pays a smaller co-payment for each doctor’s visit and prescriptions. Additionally, many HMO insurance plans offer little to no deductible for doctor visits. These are in addition to your premium costs.
Doctors who are members of an HMO medical group (network) agree to offer office visits and other services for a set capitation based on the number of patients enrolled as his or her patients. Member doctors receive the capitation whether a subscriber receives services or not. The benefit of this type of plan is that, employers can more easily afford to offer medical coverage for their employees. A potential is that not all services may be covered under HMO plans: you may have to pay out of pocket for some services.
HMO insurance plans give you access to certain doctors and hospitals within its network. Some patients might not prefer this type of plan. Here’s what else you should know:
- Many plans will require you to select and list a primary care physician.
- If you need to visit a specialists, some HMO plans will require your primary care physician to make a referral first.
- Visiting a doctor or hospital outside of your HMO network means that you will not be eligible for coverage and pay out of pocket.
PPO – Preferred Provider Organizations – Insurance Plans
Members of a PPO can receive health care services from a participating medical network at a discount. PPO insurance plans typically provide more options than HMO plans. Similar to an HMO, patients have a network of doctors and hospitals to choose from for the lowest co-payment or out of pocket expense. Patients also have the freedom to visit a doctor or hospital outside of their network and will still receive coverage, but not at the same low rate of in network visits.
The advantage of PPO membership is reduced cost and freedom to the patient. A disadvantage of this type of coverage is that some procedures and treatment options need to be assessed by a utilization review board before they are approved. Doctors who participate in PPO health plans are sometimes forced to alter their treatment plan in order to assure that it will be covered. Here are a few additional things you should know about PPO insurance plans:
- You have more freedom in a PPO. Visit doctors or hospitals in or outside network.
- Receive a test or visit a specialist without receiving a referral from your primary care physician first.
Indemnity Health Plans
Before the rise of managed health care plans, indemnity health plans dominated the health care landscape. Doctors who participate in this type of health plan agree to charge discounted prices to insurers for services they render to patients. In turn, patients after reaching their deductible limit, are responsible for paying, in general about 20% of the price of the service. While more expensive than the other two coverage plans, indemnity health plans allow their clients to choose the doctor and the hospital they want, as long as they are in members of the plan.
As the cost of health care escalates, more insurers are approving treatments outside the scope of traditional medicine, as they are sometimes less expensive and just as effective. Acupuncture, chiropractic, and holistic programs are now being used as effective alternatives to more expensive therapies Within this same area, the concept of preventive medicine has developed into an important feature in health care. To save a trip the Urgent Care to receive treatment for a cold, many insurers are educating their constituents to be aware of the benefits of zinc, and other emerging treatments. As the saying goes, “An ounce of prevention is worth a pound of cure.”