Health Insurance Guide - Individual Health Insurance Rates Section

Individual Health Insurance Rates Navigation



Best Health Insurance Companies
Nanny Health Insurance
Rising Health Insurance Premiums
Health Insurance Definitions
Health Insurance Premiums
Health Insurance Companies In North Carolina
Health Insurance Rate Quotes
Health Insurance Companies Usa
Health Insurance Brokers Australia
Health Insurance Ca
Wps Health Insurance
Canine Health Insurance
Veterans Health Insurance
Short Term Health Insurance
Health Insurance Companies Uk
Affordable Health Insurance Texas
Health Insurance Rates
Opm Health Insurance
Hbf Health Insurance
Health Insurance Complaints
Health Insurance For Nannies
Affordable Health Insurance In California
Alternative Medicine Health Insurance
Council For Affordable Health Insurance
Private Health Insurance Uk


Best Sellers

Annuities: The Shocking Secrets Revealed.
Discover the Shocking Secrets that Banks and Insurance Companies Don't Want You to Know.

Affirmations Software - Sculptor3.
Affirmation goal setting motivational software, for improved mental/physical health, personal growth.

The Power Of Positive Habits E-Book.
Learn how to Re-Program your Mind & Body and reach your goals Automatically!

Self Improvement: The Top 101 Experts.
This eBook is best described as an Encyclopedia of Self Improvement with information on 101 of the top Experts in the industry.

Find Spiritual Balance With Deepak Chopra & Authentic Ayurvedic Products At Chopra.com


Best Individual Health Insurance Rates products

Instant Health Insurance Quotes

Get a FREE Glucose Meter at FreeGlucoseMeter.com!


Simple. Affordable. Accurate. Shop the OMRON® Webstore!

Blood Pressure Monitors from Omron Webstore!



Main Individual Health Insurance Rates sponsors

Individual Health Insurance Rates

 

Latest Individual Health Insurance Rates Amazon Book Added




Partners

 

Welcome to Health Insurance Guide

Individual Health Insurance Rates Article

Tips for Choosing the Right Health Care Plan
Larry Denton

Health care in America is changing rapidly. Twenty years ago, most people in the United States had idemnity coverage, which meant the insured person could go to any doctor, hospital or health care provider (which would bill for each service given), and the insurance company and the patient would each pay a portion of the bill.

Today, however, more than half of all Americans who have health insurance are enrolled in some kind of managed care plan, an organized method of both providing services and paying for them. Different types of managed care plans work differently and include preferred provider organizations (PPOs), health maintenance organizations (HMOs), and point-of-service (POS) plans.

You may have heard of these terms before. But what do they mean, and what are the differences between them? More importantly, what do these differences mean to you? Even if you don't get to choose your health plan yourself (for example, your employer may select the plan for your company), you still need to understand the type of protection your health plan provides and what your must do to get the health care that you and your family really need.

Choosing between health plans is not as easy as it once was. And although there is not one "best" plan, there are some plans that will be better for you and your family's health needs. Plan differ in how much you have to pay and how easy it is to get the services you need. No plan will pay for all the costs associated with your medical care. However, some plans will cover more than others.

Health insurance plans are usually described as either indemnity (fee-for-service) or managed care With any health plan, however, there is a basic premium, which is how much your or your employer pay, usually monthly, to buy health insurance coverage. In addition, there are often other payments you must make, which will vary by plan. In considering any plan, you should try to figure out its total cost to you and your family, especially if someone in the family has a chronic or serious health condition.

With an indemnity plan you can use any medical provider (such as a doctor and hospital). You, or they, send the bill to the insurance company, which pays part of it. Usually you have a deductibel--such as $500--to pay each year before the insurer starts paying.

Once you meet the deductible, most indemnity plans pay a percentage of what they consider the "Usual and Customary" charge for covered services. The insurance company generally pays 80 percent of the Usual and Customary costs and you pay the other 20 percent, which is known as co-insurance. If the health care provider charges more than the Usual and Customary rates, you will have to pay both the co-insurance and the difference.

In addition to idemnity plans, there are basically three types of managed care plans: PPOs, HMOs, and POS plans. Preferred Provider Organizations (PPOs) are closest to an idemnity plan. A PPO has arrangements with doctors, hospitals and other care providers who have agreed to accept lower fees from the insurer for their services. As a result, your cost sharing should be lower than if you go outside the network. If you go to a doctor within the PPO network, you will pay a copayment (a set amount you pay for certain services--say $10 for a doctor of $5 for a prescription). Your coinsurance will be based on lower charges for PPO members.

If you choose to go to a doctor outside the network, you will have to meet the deductible and pay coinsurance based on higher charges. In addition, you may have to pay the difference between what the provider charges and what the plan will pay.

HMOs are the oldest form of managed care plan. HMOs offer members a range of health benefits, including preventive care, for a set monthly fee. There are many kinds of HMOs. If doctors are employees of the health plan and you visit them at central medical offices or clinics, it is a staff or group HMO. Other HMOs contract with physician groups or individual doctors who have private offices. These are called individual practice associations (IPAs) or networks.

HMOs will give you a list of doctors from which you must choose a primary care doctor. The doctor coordinates your care, which means that generally you must contact him or her to be referred to a specialist. With some HMOs, you will pay nothing when you visit doctors. With other HMOs there may be a copayment, like $5 or $10, for various services.

If you belong to an HMO, the plan only covers the cost of charges for doctors in that HMO. If you go outside the HMO, you will pay the entire bill.

Many HMOs offer an indemnity-type option known as a Point-of-Service Plan or POS. The primary care doctors in a POS plan usually make referrals to other providers in the plan. However, in a POS plan, members can refer themselves outside the plan and still get some coverage.

If the doctor makes a referral out of the network, the plan pays all or most of the bill. If you refer yourself to a provider outside the network and the service is covered by the plan, you will have to pay the coinsurance.

Whatever your choice of plans, medical insurance is rapidly becoming an absolute essential commodity. With the cost of a simple doctor's visit approaching $65 and with major procedures now costing thousands upon thousands of dollars, you can not afford to be without health insurance for you and your family.

About the Author

Larry Denton is a retired history teacher having taught 33 years at Hobson High in Hobson, Montana. He is currently V.P. of Elfin Enterprises, Inc., an Internet business providing valuable information on a variety of timely topics. For a waiting room full of tips, resources and advice about health insurance, visit http://www.HealthInsuranceGate.com




Individual Health Insurance Rates News

Obama scare: Health Insurance rates rise at their lowest pace in 15 years - St. Louis Post-Dispatch


Health Jackal

Obama scare: Health Insurance rates rise at their lowest pace in 15 years
St. Louis Post-Dispatch
That's the lowest rate of increase since the mid-1990s. Health insurance still is staggeringly expensive. The average cost of individual coverage now is ...
Survey: Worker share of health insurance risingPhiladelphia Inquirer

all 419 news articles »

Read more...


Retiree plan shows health act benefits - TheDay.com


WHTC

Retiree plan shows health act benefits
TheDay.com
Thousands of early retirees who would either have to pay exorbitantly for individual health insurance policies or live without insurance and the fear that ...
Government gives BU $200G for early retirees' health costsDanville News
HHS to Begin Paying Employers for Early Retirees' Health InsuranceMedPage Today
2000 groups approved for 'early retiree' health-care claimsWashington Post
Champaign/Urbana News-Gazette (blog) -Sunshine State News
all 104 news articles »

Read more...


Discovery forecasts UK upswing as SA boosts profit - Business Day


Discovery forecasts UK upswing as SA boosts profit
Business Day
UK private health insurance levels are at their lowest since the 1970s, both on the individual and employer-funded front, according to a July 19 report in ...

and more »

Read more...


Life Quotes: Some Life Insurance Rates Remain at All-Time Lows; Great Deals ... - PR Newswire (press release)


Life Quotes: Some Life Insurance Rates Remain at All-Time Lows; Great Deals ...
PR Newswire (press release)
According to the Life and Health Insurance Foundation for Education (www.lifehappens.org), the cost of basic term life insurance has fallen by about 50 ...

and more »

Read more...


United States Insurance Report Q4 2010 - New Market Report Published - OfficialWire (press release)


United States Insurance Report Q4 2010 - New Market Report Published
OfficialWire (press release)
We have added the net health insurance premiums identified by the American Council of Life Insurers (ACLI) in its annual statistical publications. ...

and more »

Read more...


Key California Health Reform Bills - California Progress Report


Smart Business Network

Key California Health Reform Bills
California Progress Report
Up for a final floor vote in the Senate are the following measures: * REGULATING AND APPROVING HEALTH INSURANCE RATES: AB 2578 (Jones) would require ...
MHIP launches federal high-risk health coverage programBaltimore Business Journal
Promoting Affordable Health Coverage To All New YorkersMedia Newswire (press release)

all 114 news articles »

Read more...


Nursing to hit insurers - JoongAng Daily


Nursing to hit insurers
JoongAng Daily
Current private health insurance policies were designed without nursing costs in mind, and if nursing costs are deemed as a health care cost to be covered ...

and more »

Read more...