Health insurance has proven itself of great help and financial aid in certain cases when events turn out unexpectedly when you are ill. When your health is in grave jeopardy, and finances seem incapable of sustaining your care, health insurance is here to the rescue. A good health insurance plan will make things better for you.
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There are two types of health insurance plans. Your first option is the indemnity plan, which includes the fee-for-service, and the second is the managed care plan. The differences between these two include the providers’ choice, the number of bills the policyholder has to pay, and the services covered by the policy. As you can always hear, no ultimate or best plan exists for anyone.
As you can see, some plans may be way better than others. Some may benefit your and your family’s health and medical care needs. However, amidst the sweet health insurance plan terms presented, there are always certain drawbacks that you may come to consider. The key is that you will have to weigh the benefits wisely. Especially since not all of these plans will pay for all the financial damages associated with your care. The following briefly describes the health insurance plans that might fit you and your family’s case.
Indemnity Plans
Flexible Spending Plans – These types of insurance plans are sponsored when working for a company or any employer. These are the care plans included in your employee benefits package. Some of the specific types of benefits included in this plan are the multiple options pre-tax conversion plan, medical plans plus flexible spending accounts, tax conversion plan, and employer credit cafeteria plans. You can always ask your employer about the benefits included in your health care/insurance plans.
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Indemnity Health Plans – This type of health insurance allows you to choose your providers. You can go to any doctor, medical institution, or other healthcare provider for a set monthly premium. The insurance plan will reimburse you and your health care provider according to the services rendered. Depending on the health insurance plan policy, some limit individual expenses. The health insurance will fully cover the remaining costs when that expense is reached. Sometimes, indemnity health insurance plans impose restrictions on services covered and require prior authorization for hospital care and other expensive services.
Basic and Essential Health Plans—These plans provide a limited health insurance benefit at a considerably low cost. Before opting for this kind of health insurance plan, one must read the policy description, which focuses on covered services. Some plans may not cover basic treatments, certain medical services such as chemotherapy, maternity care, or certain prescriptions. Also, rates vary considerably since, unlike other plans, premiums consider age, gender, health status, occupation, geographic location, and community rating.
Health Savings Accounts – You own and control the money in your HSA. This is the recent alternative to the old-fashioned health insurance plans. These savings products offer policyholders different ways to pay for their health care. This type of insurance plan allows the individual to pay for the current health expenses and save for untoward future qualified medical and retiree health costs on a tax-free basis. With this health care plan, you decide how your money is spent. You make all the decisions without relying on any third party or a health insurer. You decide on which investment will help your money grow. However, if you sign up for an HSA, high-deductible health plans are required in addition to this type of insurance plan. High Deductible Health Plans – Also called Catastrophic Health Insurance Coverage. It is an inexpensive health insurance plan enabled only after a high deductible of at least $1,000 for an individual expense and $2,000 for family-related medical expenses.
Managed Care Options:
Preferred Provider Organizations—This is charged on a fee-for-service basis. The insurer pays the involved health care providers on a negotiated fee and schedule. The cost of services is likely lower if the policyholder chooses an out-of-network provider, and the policyholder is generally required to pay the difference between what the provider charges and what the health insurance plan has to pay.
Point of Service—POS health insurance plans are indemnity-type options in which primary health care providers usually refer patients to other providers within the plan. If the doctors make referrals outside the plan, the plan pays all or most of the bill. However, if you refer yourself to an outside provider, the plan may also cover the service charges, but the individual may be required to pay the coinsurance.
Health Maintenance Organizations – It offers access to a network of physicians, healthcare institutions, providers, and various healthcare facilities. You have the freedom to choose your personal primary care doctor from a list that the HMO may provide, and this chosen doctor may coordinate with all the other aspects of your health care. You may speak with your chosen primary doctor for further referrals to a specialist. Generally, you are paying fewer out-of-pocket fees with this type of health insurance plan. However, there are certain instances in which you may be charged fees or co-payments for services such as doctor visits or prescriptions.
Government-Sponsored Health Insurance
Indian Health Services – This is part of the Department of Health and Human Services Program, offering all American Indians medical assistance at HIS facilities. Also, HIS helps pay for the health care services utilized at non-HIS facilities. Medicaid is a federal or state public assistance program created in 1965. These are available for people with insufficient resources to pay for health care services or private insurance policies. Medicaid is available in all states. Eligibility levels and coverage benefits may vary, though. Medicare – This is a health care program for people aged 65 and older with certain disabilities that pays part of the cost associated with hospitalization, surgery, home health care, doctor’s bills, and skilled nursing care.
Military Health Care includes TRICARE or the CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs). The Department of Veterans Affairs (VA) may also provide this service. State Children’s Health Insurance Program—This is available to children whose low-income parents could not qualify for Medicaid.
State-Specific Plans – This type of plan is available for low-income uninsured individuals.
You may have the prerogative to know about many different types of insurance plans. By learning which health care insurance fits your situation, you can avail of the many options that will likely be of great assistance to you when you need it most. Insurance costs have typically become one of the common drawbacks in choosing an insurance quote. However, weighing the benefits will matter. Ensure you always read the benefits, terms, and conditions before landing on whichever type of health insurance you choose.
