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Health Maintenance Organization

Health Care Services Through Your Individual Health Insurance Plan

by admin on March 29, 2009

in Health Insurance Info

An individual health insurance cover, simply stated, is an agreement between you and the insurance firm, aimed at protecting you against any financial constraints on account of a medical emergency. The one pertinent question you need to ask yourself is -what are the factors to be analyzed before deciding on an individual health insurance policy?

It is indeed a fact that medical and preventive sciences have made rapid advancements in today’s world. Nonetheless, it would be prudent to arm yourself with the best individual health insurance cover to protect yourself against any unforeseen illness. Indeed, America’s best health insurance companies are vying with one another in putting together some of the most imaginative individual health insurance policies designed to overcome any medical contingency. If you are unemployed, or self-employed, an individual health insurance policy is the right choice.

Consult with your insurance company if you can have your individual health insurance policy incorporated in its group policy. You may be paying a higher rate but the terms would be more advantageous than if you had to buy your own individual health insurance policy. If you are married, find out if your spouse’s employer is willing to include you in its group policy. If you are left with no option, then it is wise to buy an individual health insurance policy. Even though the insurance cover may be limited and the rates high, you would still be ensuring protection for yourself or your family against financial problems if you are suddenly confronted with a serious illness or medical emergency. Search for a good health insurance professional to help you with the best individual health insurance policy that offers you good value for money.

You have plenty of choices while selecting individual health insurance plans - The PPO Plan or the Preferred Provider Organization, the HMO Plan or the Health Maintenance Organization, the HDHP or the High Deductible Health Insurance and HAS or the Health Savings Accounts Qualified High Deductible Plan.

When considering individual health insurance plans a worthwhile option may be a health savings account plan which has few unique benefits. With individual health insurance plans, you can trade lower deductible health insurance for a plan that has a higher deductible. This will help you save money each month by lowering your premium. Besides the lower cost, higher deductible health savings account plan also has the added benefit of a tax favored savings account. Yet another interesting aspect of these individual health insurance plans is that the money you save rolls over year after year.

Even if you are already covered by your employer’s insurance scheme, you may still need to get additional coverage through an individual health insurance plan. This becomes necessary because employer-sponsored programs often fall short of individual needs. Extensive coverage for self and family can be achieved through a separate individual health insurance plan.

Individual health insurance plans are of two types: - Indemnity plans - Managed care plans. Indemnity plans are costlier but best suited for those who have particular health issues and need to be treated by specific doctors. Managed care plans cost less because you will be visiting a doctor or a hospital that is provided under the plan. If the treatment requires you to visit a specialist, you will need special permission from the insurance service provider. This plan is best suited for individuals without specific health problems, and wanting to pay less.

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Options For Affordable Health Insurance

by admin on March 17, 2009

in Health Insurance Info

Kevin Kielty asked:

If you have lost your job and need to find affordable health insurance coverage for yourself and your family, there are many options available. The first step is to learn what the different plans have to offer and how they differ.

What COBRA has to Offer

If you have just lost your job, the first thing you will need to do is to check into COBRA. COBRA allows you to continue on your employer’s health insurance plan for up to 18 months after loosing your job. If you have a pre-existing condition, COBRA can be a good option, however it can be expensive because your employer will no longer be paying a portion of the cost. You will have to pay the entire amount yourself.

If COBRA does not look like a good option for your family, there are a number of other types of insurance plans available. You will need to do some research and become familiar with some of the terms and what they mean before you can make a wise decision about which plan to choose.

Types of Insurance

There are basically 2 types of health insurance. One is fee-for-service which, is the traditional type of health insurance in which you can choose any doctor or hospital you wish. The amount of choices you get with a fee-for-service plan is a plus, but the cost of this type of insurance can be quite high. Alternatives to a fee-for-service plans are managed-care plans and Health Savings Accounts.

Managed care plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs) and Point-of-Service Plans (POS).

Under a Health Maintenance Organization or HMO, you choose a primary doctor who participates in the plan’s network and then all of your care is directed by that physician. If any test or visits to a specialist are required, that primary care physician must issue a referral and the specialist must be a part of that HMO’s network. HMO’s have the buying power of a large organization so you can often get your medical services for less and they are also focused on keeping costs down. Therefore, an HMO can be a less expensive option for health insurance. However, if you see a physician out-of-network or have any procedures done without prior approval, it can be expensive.

With a Preferred Provider Organization or PPO plan, there is also a list of participating doctors and hospitals, however you have the freedom to see any doctor who is part of the plan’s network. You do not have to designate a primary care physician. If you wish to be able to see health care providers outside the plan’s network, you will have to pay a higher coinsurance rate.

A Point-of-Service Plan or a POS has some similarities to an HMO and a traditional health insurance plan. With a POS, if you choose your primary doctor from within the plan’s network of physicians, then your costs will stay low. However, if you choose to go outside of the network, your costs will be much higher. The advantage of a POS health insurance plan is that you get the cost savings of an HMO but you still have the freedom to see physicians outside the network as well.

A Health Savings Account

Another option for saving on your health insurance coverage is to open a Health Savings Account or an HSA. An HSA is a savings account for people who have a high deductible health insurance plan. Money is deposited into a special HSA account where it earns interest that is tax-free and the money is not taxed when it is used for qualified medical expenses. HSAs will also have a network of health care providers and your cost will be lower if you choose to stay within the network. As with the POS, you do have the option to go outside the network but at a higher cost to you.

If you have lost your job and find yourself in need of affordable health insurance, the first step is to look into COBRA to see if it is the best option. If it is not, then the next step is to research the managed care options as well as a health care savings account. After you learn about the different plans and how they work, you will be able to make the best choice for meeting your family’s health insurance needs.

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