Health insurance has proven itself of great help and financial aid in certain cases when events turn out unexpectedly when you are ill, and when your health is in grave jeopardy and when finances seem to be incapable of sustaining for your care, health insurance is here to the rescue. A good health insurance plan will definitely make things better for you.
Basically, there are two types of health insurance plans. Your first option is the indemnity plan, which includes the fee-for-services, and the second is the managed care plans. 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, there is no ultimate or best plan for anyone.
As you can see, there are some plans which may be way better than the others. Some may be good for you 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, you will have to weigh the benefits wisely. Especially that not among these plans will pay for all the financial damages associated with your care.
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The following is a brief description of the health insurance plans that might be fitting for you and your family’s case.
Flexible Spending Plans – These are the types of insurance plans that are sponsored when working for a company or any employer. These are the care plans inclusive 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.
Indemnity Health Plans – This type of health insurance plan allows you to choose your own health care providers. You are given the freedom to go to any doctor, medical institution, or other health care providers 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 offer a limit on individual expenses, and when that expense is reached, the health insurance will cover the remaining expenses in full. 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 – It provides a limited health insurance benefit at a considerably low insurance cost. In opting for this kind of health insurance plan, one must read the policy description giving special focus on covered services. There are plans which may not cover some 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 are savings products designed to offer policyholders a different way to pay for their health care. This type of insurance plan allows the individual to pay for the current health expenses and also save for untoward future qualified medical and retiree health costs on a tax-free basis. With this health care plan, you decide on 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 adjunct to this type of insurance plan.
High Deductible Health Plans – Also called Catastrophic Health Insurance Coverage. It is an inexpensive health insurance plan which is enabled only after a high deductible is met of at least $1,000 for an individual expense and $2,000 for the family-related medical expense.
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 ad generally required to pay the difference between what the provider charges and what the health insurance plan has to pay.
The point of Service – POS health insurance plans are one of the indemnity type options. The primary health care providers usually make referrals to other providers within the plan. If the doctors make referrals that are out of the plan, that plan pays all or most of the bill. However, if you refer yourself to an outside provider, the service charges may also be covered by the plan, but the individual may be required to pay the coinsurance.
Health Maintenance Organizations – It offers access to a network of physicians, health care institutions, health care providers, and a variety of health care facilities. You have the freedom to choose your personal primary care doctor from a list provided by the HMO, 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 that you may be often charged with fees or co-payment 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 in paying the cost of the health care services utilized at non-HIS facilities.
Medicaid – This is a federal or s state public assistance program created in the year 1965. These are available for the people who may have insufficient resources to pay for the 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 aging 65 and older with certain disabilities that pay part of the cost associated with hospitalization, surgery, home health care, doctor’s bills, and skilled nursing care.
Military Health Care – This type includes the 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.