Not only can the various health care plans be confusing but knowing and understanding the coverage is important as well.
When someone states that it is “comprehensive” health insurance it means that the insurance company pays a percentage of the charges after your deductible or co pay is met. This includes both physician charges and hospital charges. Comprehensive care is tends to expensive however it can save you thousands of dollars if you have to be hospitalized.
When someone refers to “scheduled” health insurance they are referring to a basic policy. This policy allows for patients to have their basic health care met. Patients are able to go to the doctor on regular basis but have limit coverage for hospital care. Generally schedule health insurance has a cap on the amount it will cover each year.
It is a good idea to have both schedule coverage for your everyday needs and comprehensive for hospital coverage.
Both schedule health care and comprehensive health care are essential to have, especially if you own business. Your premium will vary depending on your age and overall health. However it is very important to budget health care coverage into your expenses. Your health depends on it.
The third health care plan in the U.S. is the Point of Service Plan, or POS. The POS plan is a combination of HMO and PPO plans. POS requires that patients pick a primary care physician that is in their network. If a patient chooses to go to a doctor outside of the network the patient will have to cover the majority of the cost. The plan will cover a minimal amount of the outside cost, but the patient is responsible for a large portion of it. The POS plan also requires that patients get a referral to see a specialist. If a patient is referred to a doctor outside of their network, the plan will cover the cost.
Some larger companies offer their employees a choice in what plan they would like. Many times small company’s can not afford to offer their employees the choice of plan.
Whether you choose a HMO, PPO or POS depends greatly on if your doctor of choice is part of their network. If the HMO that is being offered does include your doctor, please remember that the network can change. While your doctor may be on the list this year, next year he or she may not.
Preferred Provider Organization or PPO, is another prevalent health care plan in the United States. The PPO plan is a lot like the HMO plan but there are a few distinct differences.
With the PPO plan you are not required to pick a primary care physician. You are able to see any doctor that you choose. There is a list of doctors that are in the network and you are strongly encouraged to see someone from that list however it is not required. If you decide to see a physician in the network it will most likely be less expensive. For example your plan my only cover 65% of the cost if you see a physician outside the network compared with covering 95% of the cost if you see a physician in the network. You also do not have to go through the referral process to see a specialist. The largest draw back to the PPO plan is the deductible and many times the higher co pay. HMO’s tend to keep their co pays fairly low however you don’t have the option of seeing the physician of your choice. PPO offer much more options, but those options might come at a higher cost to you.
Health insurance for people that are self employed or small businesses can be both confusing and difficult. Not only are you responsible for insuring yourself when you are self employed but your family as well. If you own a small business you may have to cover a few employees. So what are your options for health care if you own your own business?
The first and probably most important thing to keep in mind is health care for the self employed and small businesses tends to be more expensive. This is due to the small number of people you are going to cover. Large businesses get a lower rate because they are going to be insuring so many people.
The benefit of supplying your own insurance is you get to shop around a bit more. This gives you the opportunity to find health care that offer more choices with both physicians and prescription drugs. You can also shop around for a lower deductible. These are all options that you can’t get if your company supplies health insurance.
Also keep in mind, if you are self employed you are able to deduct a percentage of the health care cost on you taxes. It probably won’t make up for the cost but, because health insurance is essential, it does help.
Health Insurance can be both overwhelming and extremely confusing. Even if you have had health insurance for years, you may not know exactly how it works and what different health plans are available.
The most prevalent is the Health Maintenance Organization more commonly referred to as HMO. HMO’s usually provide a list of physicians that a member can see and have rules and regulations that a patient must follow. The biggest complaint with HMO’s is the limited services that are offered.
HMO’s tend oversee the patients health very closely. Typically a patient must first see a primary care physician before they are able to see a specialist. The Primary Care Physician must refer the patient to specialist before the HMO will cover the cost of the specialist. Most plans allow for woman to pick an OB/GYN as well as a primary care. Some patients feel that the referral method is a hassle however it is how HMO’s try to keep their premiums and deductibles relatively low. Emergency situations do not require a referral.
There also HMO plans available with “open access” that do not require a Primary Care Physicians referral however they tend to have a higher co-pay and deductible.
If you are new to America or you are new to the workforce you may be wondering why exactly you need health insurance. Many countries offer a national health-care system, so some of you may be questioning why health insurance is important.
In a nutshell health insurance is exactly what the name suggests, it is insurance for your health. Depending on your employer and your insurance plan you will pay a monthly premium for insurance that will cover your doctor, hospital and prescription drug costs.
These premiums can range greatly by plan, your age, your overall health and how many people in your family you want to cover. Usually there is also a mandatory co-pay that you are responsible for each time your visit the doctor or purchase a prescription drug. The co-pay can be anywhere from $5 to $25 and even $50 in some cases.
However, while these prices may seem a little steep, the alternative is to go without health coverage. This decision can result in thousands of dollars in medical bill if you were to get sick or injured.
Health insurance is essential for anyone living in the US that is not cover by another plan. Not only can it save you thousands of dollars but will also offer your family peace of mind.
Twenty years ago the average American employ wouldn’t have dreamed of turning down company insurance in order to buy a private policy.
Group health insurance was the answer.
The company bore the brunt of the cost while employees paid minimal premiums and coughed up necessary, but equally as low co-pays. Add to that package a prescription drug card and it looks, on the surface, like insurance Utopia. Not anymore.
According to a report in 2007 by the Kaiser Family Foundation, the cost of employer-sponsored health care rose by 6.1%. This followed a 7.7% increase the year before and a 9.3% jump in 2005. Those costs are being passed onto employees. Employees with families get hit the hardest.
The bright side of buying a private health insurance policy is that if your family is relatively healthy, prices on the open market are relatively competitive. The other perk is that you only have to buy what you need. That is rarely, if ever, an option when choosing employer provided insurance.
If you have a pre-existing condition then your best bet may be to stick with your employer’s insurance. Though premiums may be higher, higher is better than no coverage at all. It’s a catch twenty-two and a decision that only you can make. Weigh your options. Can you really afford not to be covered?
If you are self-employed and in need of insurance for your family, there are options available to you. Keep in mind that there is no such thing as “cheap” insurance.
Don’t be fooled by gimmicky sales techniques or flashy websites. If your family is in relatively good health then it is just a matter of choosing an insurance company you trust with premiums and deductibles you can live with.
No longer is it just big businesses who are allowed to use health insurance premiums as business expenses One perk to being self employed is that you can now deduct the cost of health insurance premiums from your federal taxable income. While you can’t use your health insurance premiums as a cause for loss on your taxes, you can claim the deductibles to offset your taxes greatly.
Another option for the self-employed can come through a spouse. If your spouse works outside the home then it may be more financially beneficial to use his or her company insurance. The benefits to this strategy are that you usually can’t be denied and your premiums can’t be “rated-up” due to health issues. Low deductibles and prescription insurance cards are other reasons to look into keeping your spouse’s insurance while maintaining your small business.
With just under 20% of Americans uninsured it is no wonder it is such a hot topic these days. Even many who are insured can’t afford $500 per family member deductibles each year, let alone co pays. So, what are we to do?
For starters, be a proponent for change. Get involved; let your voice be heard.
Universal health care has been the buzz this election year. What many are fighting in countries that embrace this form of health care are long waits, sometimes years. But there are other options available.
Guaranteed issue insurance is highly touted by some. The problem with this form of insurance is that low-risk, or healthy people are over charged in order, some claim, to undercharge those at higher risk. Lastly, there are state risk pools, created for middle income individuals with chronic health problems that lock them out of traditional insurance eligibility.
If none of the above health care options appeal to you, then contacting your state representative is one way to make your concerns heard. Grass roots groups of concerned citizens pushing for better health care can be found in virtually every state. By lobbying Congress to make change, these groups are at least getting a foot in the door to insure that the 45 million plus Americans without health insurance can be covered.
