Nothing in life is certain. That's why individual, family and employer-sponsored healthcare insurance
is important to have in place. If you exercise regularly, eat and drink in moderation and take nutritional
supplements, you are still at risk due to accidental injuries, viral or chronic diseases and other major
hereditary or genetic illnesses.
Preventive healthcare services, long-term care, hospitalization coverage and major medical
insurances along with a travel-related health insurance policy are the way to go. Believe me, I'm not
trying to make more sales for healthcare insurance providers either. Emergencies happen and you really don't
want to be caught short without some medical care insurance or limited coverage policies.
We want you to have the latest, best information on how to effectively buy the health
care policies and plans or block the denials or payment refusal strategies of medical insurance providers
and healthcare insurance policy issuers. If you are a user, partner or provider of healthcare services, we
hope the resources, articles and programs you find on our site increases your knowledge and
abilities.1
Be Healthcare Wise with our Preventive
Healthcare Resources
Easy Steps on How To Get Health
Insurance
By Daryl Dela Cruz
People tend to get confused when getting a Health Insurance. That's why they can be easily fooled by scams that
are pretending to be Health Insurance Companies. If you are one of those who does not know the procedures in
getting a health insurance plan or choosing the right insurance company, I've listed the steps below.
1.
Signing - Your employer will most probably let you sign an insurance. Sign it after ready
it carefully. It is almost the cheapest option you can see.
2.
Investigate - Examine description under COBRA (Consolidated Omnibus Reconciliation Act of
1985) if you've currently left your employer. You can continue your provision for 18 months beyond your
separation date, though you have to pay the premium yourself.
3. Look for an
Agent- Look for a health insurance agent to analyze plans and charges for you. The National
Association of Health Underwriters can help you in looking for one.
4. Fee-for-service
Plan- Acquire a fee-for-service plan. The biggest addition is that you have complete domination upon
choosing the doctor to see whenever you need a specialist. However, there is a relevant out-of-pocket charge
for this type of care, the premiums are generally higher, and if your doctor charges more than what is
considered usual, you may have to pay additionally for that care too.
5. Care
Plan - Sign up for a managed care plan where your insurance provider specifies which doctors you
can see.
6. Preferred Provider
Organizations - Preferred provider organizations (PPO's) have a list of doctors when choosing a
physician who will be your first contact for health care. If you see doctors in your insurer's organization, it
will cost you low co-payment. However, your co=pay is higher if you see a physician not in the network.
7.
Point-of-Service - Point-of-service (POS) networks are similar to PPO's, but your primary
care physician will be the one making the decisions about which specialists you can and cannot see. You can
still see a physician outside the POS network, but of course, it will cost you a higher amount.
8. Health Maintenance
Organizations - Health maintenance organizations (HMO's) are the most prohibitive, yet cheapest
managed care programs. Majority require that you see a doctor in their network, but allow low or no co-pays in
exchange. Most HMO's also oblige you to see your primary care physician before getting accredited to a
specialist.
9. Preexisting
Conditions - You have to know if the benefits are limited for preexisting conditions, or if you
have to wait before you're fully covered. Other plans may exclude entirely the coverage of preexisting
conditions.
10.
Compare - Analyze the prescription drug coverage given by different plans. Many plans
have combined benefit systems, and commonly offer a suggested list of prescriptions that have a less expensive
co-pay. Look for any medication you are taking on this list; drugs that are not on the list can have a co-pay
that is twice as high. Also, check if any plans bound the amounts of new prescriptions or refills on a given
medicine.
11. Check Your
Doctor - You have to make sure that your regular doctors are on your plan's preferred provider
list. Because of the modern technology, all plans provide a database of their provider on their website.
12. Examine the
Delays - Examine the different delays you could experience. Some plans are infamous about keeping
members waiting to see a doctor.
Must Know Health Insurance
Terms
By Jennifer Studer
Health insurance might sound like a foreign language. Three terms that one must understand before making a
buying decision are: deductible, coinsurance, and out-of-pocket maximum. If you understand these terms, you will
understand how much money you might need to pay in the event of a claim.
Deductible
Every insurance policy has a
deductible. A deductible is a portion of a claim that is not covered by the insurance. So, if you had a $16,000
claim on a policy with a $1000 deductible. You would be responsible for the first $1000 and your insurance would
help with the rest. The amount that the insurance company helps depends on the coinsurance. Be sure you understand
the deductible of your plan because some plans have multiple deductibles for families, and or for different types
of claims.
Coinsurance
Most health insurance plans have
a coinsurance. Coinsurance is a way to split the responsibility of claims between the insurance company and the
policy owner. Coinsurance kicks in after the deductible has been satisfied. A common coinsurance is 80/20. This
means that the insurance company will pay 80% and you are responsible for the other 20%.
So using the same example from before, on a $16,000 claim, after you satisfy your $1000 deductible your coinsurance
begins. Of the $15,000 left you would be responsible for 20% or $3000, while the insurance company pays 80% or
$12,000.
Say you needed to file another
claim, depending on the type of plan you have you may need to start this whole process over again. If however, you
have only one deductible to satisfy, check your plan to see what is your out-of-pocket maximum.
Out-of-pocket
Maximum
An out-of-pocket maximum is the
most that you are responsible for after the deductible is met. After your out-of-pocket maximum is met the
insurance company picks up the rest. For our example, lets say that your plan has a $3000 out-of-pocket maximum.
From the $16,000 claim, your deductible was $1000 and then with the 80/20 coinsurance you paid $3000. Seeing as
your out-of-pocket maximum was $3000, you have now met your out-of-pocket maximum. Now the insurance company will
pay 100% of your claims.
The example above is a $1000
deductible, 80/20 coinsurance, $3000 out-of-pocket plan. A large claim with this plan means that the owner can
expect to pay $4000. Be sure to take a look at your plan so that you know how much you might need to pay in such an
event.
Article
Source:http://EzineArticles.com/?expert=Jennifer_Studer
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