Health insurance coverage is a major necessity for today’s active consumer. Taking the chance of not setting enough money aside in order to pay your monthly health insurance premium is basically gambling with your financial and physical well-being. Typically, health insurance benefits and coverage vary widely among the many different health insurance providers. However, they all have one common trait or feature and that is they all pay for a pre-determined amount of incurred medical cost for the policy holder or insured individual.
Health insurance may not seem as important to you right now and in many cases most people don’t acknowledge the fact that they even need health insurance until it’s to late. This usually happens right around the time when a consumer requires significant medical attention or assistance. For some folks even routine doctor’s exams and medical appointments can be the catalyst or wake up sign that health insurance is very vital to living a health and stress free life.
The United States health care system is unique in its own right due in large part to the privatization that has occurred in the medical and health care community. This is spurned the demand and need for an adequate health insurance policy and coverage system. Many other countries actually use a government-sponsored form of health care that doesn’t require insurance coverage in any form.
The three primary forms of health care insurance include the self-insured and uninsured consumers, managed care plans and indemnity health care plans. The self-insured and uninsured group of consumers normally consist of the self-employed and unfortunately folks that are currently not working or out of work. The latest figures show that about 35% of the folks needing health care insurance fall into this category.
Chances are you’ve probably already familiar with what a managed health care plan is, thanks in large part to the stories discussed in the newspapers, TV and local radio stations. After all, health care is a hot topic for many consumers living in the United States. Basically all a managed care plan does is offer contracted health care providers at pre-negotiated prices. There are three different versions of the managed health care plans provided in today’s medical community. The most commonly known is the Health Maintenance Organization or HMO. This plan requires its insured members to contribute a set dollar amount or fee each month in exchange for medical care. The typical medical services that are readily provided by an HMO include routine appointments, surgery and some outside specialization treatments (although the HMO plan usually frowns upon seeking medical assistance outside of the HMO network of providers).
The next managed care plan is the Preferred Provider Organizations or PPO. This health service plan normally requires the insured to make payment up front and then provides a re-imbursement to the member of the health care plan. Much like HMOs the PPO has a set network of doctors and health care providers that ity has negotiated with in advance in order to obtain better rates for medical treatment that may be required by its members.
The final plan offered by the managed health care plan is the Point of Service or POS plan. This plan isn’t really talked about as much as the HMO and PPO health insurance plans based on the fact that it’s not as common. A member of this plan avoids having to pay a deductible and a small co-payment fee provided they use a doctor that is a member of the POS network. The major drawback with this plan is if the insured member seeks treatment outside of the referral network then a rather large deductible is incurred along with some rather stiff charges.
Aside from the self-insured/uninsured plan and the managed health care plan there is still one more form of health insurance coverage that can be obtained by consumers who have a little more money that they wish to spend on their health insurance coverage. This plan is the indemnity plan and although it offers the least amount of restrictions when compared to all other health care plans it is also the most expensive. The reason for the high cost associated with this form of health insurance coverage is due to the ability for the plan member or insured consumer to visit any doctor or health care specialist they want to receive health care from as often as needed or required.
With several choices between which health insurance plan or coverage to choose from it really boils down to each individual consumer’s own unique needs, wants and desires when it comes to the health care they want provided to them. Searching for the right health insurance coverage can be a mundane and laborious task but it doesn’t have to be difficult if you know what you’re choices are prior to beginning your quest to find the best health insurance plan at the most affordable price.
By Tim Gorman