If you're trying to select the right kind of health insurance for your needs, you may find it pretty confusing. There are many kinds of insurance these days, and you may need a little help to figure out which one is right for you. Learning what some of the types of insurance really are is a good first step in taking care of your health care needs, as well as that of your family.
Traditional Health Insurance
When you think of health insurance, this is probably the one that comes to mind. The insurance company charges you a premium each month, and then you are covered for almost every doctor's office visit or emergency treatment. Usually you still pay a co-pay or deductible amount, but the rest will be paid or repaid by the insurance company. Most of the other types of insurance are variations on this basic type of insurance.
PPOs: Preferred Provider Organizations
Preferred Provider Organizations are similar to traditional plans, as they also cover most of your medical expenses in the same way. However, they cost the insurance company less and therefore can have lower premiums. How? By limiting the network from health care facilities that you can go to and still be covered to those on a list provided by the health insurance company. If you need treatment from a type of physician not included in the network, you will have to pay the entire cost yourself.
POS Plans: Point-Of-Service Plans
A Point-Of-Service Plan is also similar to a PPO, but begin instead with a primary care provider. You must see your primary physician for any and all problems, and he will refer you to a specialist within the network that is covered by your plan. This adds an extra step to any doctor's visit. Again, you must pay to visit any doctor or hospital that is outside the network covered by your plan.
HMOs: Health Management Organizations
HMOs are sort of a combination of the Point-Of-Service and Preferred Provider plans; like the PPOs, you may only visit health service providers on a list given by your health insurance company, but you must also be referred by your primary physician first. While these can be very restrictive rules, many HMOs have very low monthly premiums, and some have no monthly premiums at all.
HSAs: Health Savings Accounts
Health Savings Accounts are a newer type of health insurance system put into place in 2003. They are not really a type of insurance plan, but a way of saving money to use for medical expenses in the future without having to pay taxes on the savings. They are best used in combination with another type of insurance, with the savings used to pay high deductibles.
If you're not sure what type of health insurance is right for you and your family, consider making an appointment to talk with a professional insurance advisor or broker, and do your research before committing to anything. Health insurance is a vital part of your life plan, and with a little exploration you can find a plan that suits your needs perfectly.
Type Of Health Insurance
There are several options available to you when it comes to selection of health insurance plans. Specifically there are the Indemnity plans which offer the most flexibility in choosing which physicians they prefer to use. Then there are managed health organizations such as PPO's or Preferred Providers Organizations and HMO's Health Maintenance Organizations these types of plans usually require for you to use physicians from their pool of select providers. The POS or Point of Service Plan is also a form of managed healthcare but it differs in that it requires all insured to first visit the chosen primary care physician to obtain a referral for any additional medical treatment. In recent years there has been an expanded interest in a new form of health Insurance called an HSA's or Health Saving Accounts that allows for consumers to self managed health care cost. The idea is to provide low premium health insurance by utilizing a tax advantaged saving account that earns interest and combining it with a higher deductible insurance health plan that offers much lower premiums but requires the insured to cover some of the initial cost.
As consumer health care cost continue to soar it is important to do your research and determine what types of coverage features are important to you and your family. As well some of the plans have commingled the different features to establish new plans that meet different consumer needs and premium tolerances. Here are a few simple guidelines to help you make an educated decision for a plan for yourself and or your family.
Indemnity Plans
Indemnity plans as mentioned before have expanded physician choices giving your more flexibility in selecting your services, this type of plan is also know as fee for service health insurance plans however the trade off is usually reflected in higher health insurance premiums since you are not choosing a physician from within the network. All plans are not exactly the same and what services covered or physicians you can use may still vary from plan to plan. Indemnity plans usually combine both a deductible and a co-insurance which is the factor that can affect your final out of pocket expense. The deductibles offered may vary from a few hundred dollars to a few thousand dollars. The coinsurance may also have options so if you chose a coinsurance of 20% you would be responsible for 20% of any procedure and the insurance would cover the other 80%. Most Indemnity plans have a cap or stop loss that once a certain percentage or dollar amount of the coinsurance is met the policy will cover 100% of all covered expenses up to whatever the Lifetime maximum is within your plan.
Managed Health Plans or Network Plans
Health Maintenance Organizations prearrange for reduced health care expense through a network of physicians who have agreed to work within the organization at discounted fees. The HMO usually requires you to select a primary care physician from within the network. The idea is to use the network to both reduce healthcare cost and better manage what treatments are sought out by the patient. The benefit carries on to the consumer with lower premium cost.
A preferred provider organization (PPO) is another form of managed care, yet more closely similar to the indemnity type plans in that you have the option to select your own physician either from the network or outside of the network with the difference being that the cost of service is usually lower inside the network. Like the HMO a PPO negotiates price discounts for service with the physicians and care facilities, who become members of the PPO which passes on the savings to consumers in the form of premiums. Many consumers like the idea of having the ability to choose a specialist from the PPO network without having to see the primary care physician first for the referral.
A Point of Service or POS is also a managed plan but differs in that you are required to allow your primary care physician to act as an initial starting point for all medical service. The primary care physician is chosen by the insured from within the network and referrals and usually that specialist from within the network.
Self Managed Healthcare a New Breed of Plans Emerge
The concept behind Health Savings Accounts (HSA's) is that you choose a plan with a high deductible because plans with higher deductibles have much lower monthly premiums as low as ½ of the indemnity plans. The savings in premium for the high deductible plan is then placed into a Health Savings Account HSA owned by you. The contributions to the HSA are 100% tax deductible from your income up to the legal limits and the money accumulates tax deferred sort of like an IRA for healthcare. As long as the money is used for any qualified healthcare cost then it is also tax free. The best part is the contributions are yours to keep and they continue to accumulate interest. If you change jobs or become self employed the HSA account goes with you, and unlike Flexible Spending Accounts that have the "use it or lose it provision" these accounts do not forfeit your contributions. Currently the contribution maximums are $2900 annually for an individual and $5,800 per family. Most plans allow for one deductible per family per year. The risk is your out of pocket expense could be higher in the beginning until you accumulate enough funds. There are riders for these plans for any major medical needs to cover the deductible in the beginning while you are accumulating funds. The risks are not without reward though the premiums are much lower than traditional heath insurance plans and as mentioned previously the contributions are deducted from taxable income. If you choose this option it is important to make sure you study the plan carefully and make the monthly contributions or the plan will not be affective alternative to the higher premium plans.
Both Quamrul Polash & Dean Beard are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
Quamrul Polash has sinced written about articles on various topics from Health Insurance. Quamrul Polash is an established author and publisher on topics related to affordable health insurance, healthy living. Get a very popular report for FREE at. Quamrul Polash's top article generates over 5400 views. to your Favourites.
Dean Beard has sinced written about articles on various topics from Health Insurance. Chris Beard is a virtual insurance agent providing automated online and tele-service insurance services to protect Florida families with health insurance, HSA's, life insurance, and short term medical plans. Visit his web site for more information on Indi. Dean Beard's top article generates over 880 views. to your Favourites.