MEDICAL INSURANCE

MEDICAL INSURANCE

Choosing the right medical insurance can be a difficult and confusing endeavor The primer below is designed to give you a basic overview of what to look for in an insurance plan

How to Obtain Medical Insurance

If you are fortunate enough to get health coverage through your job your premium payments are most likely deducted from your check Many companies offer basic coverage including emergency room costs doctors visits prescriptions xrays lab tests and chiropractic care cheap insurance,general insurance,health care insurance,insurance companies,insurance policies,insurance policy,life insurance,medical insurance, car insurance Additional health insurance is often available to cover dental vision and longterm conditions This type of supplemental insurance will most likely involve additional fees

If you freelance or are a small business owner you may need to purchase an individual medical insurance policy This can be accomplished by contacting an insurance carrier or by contacting an insurance broker The benefit of using an insurance broker is that a broker is not tied to any one carrier and can provide you with a variety of different rates

However a note of caution about choosing an individual medical plan be sure to check the rating of your company with A M Best which evaluates the fiscal health of various insuring agencies If the carriers rating is less than A you need to keep searching for other options

Types of Health Insurance

There are two main types of medical coverage fee for service plans and managed care Under fee for service plans you will need to submit a claim for each medical cost You are then reimbursed for each covered expense

Under managed care certain rules and regulations apply to keep healthcare costs as low as possible Preferred Provider Organizations PPOs and Health Maintenance Organizations HMOs are two types of managed care plans With PPOs you have the option to see any doctor within the PPO network You may also be referred by a PPO doctor to another doctor outside the network and still receive the lower cost However if you decide to see a PPO doctor outside of the network without a referral your bill may be significantly higher

HMOs stipulate that you must visit a doctor within the HMO network with the exception of emergencies HMOs are excellent for covering routine medical costs such as checkups flu shots and hearing tests However although HMOs are considerably easier on the pocketbook they offer much less flexibility than PPOs

Policy Checklist

Whether comparing programs offered through your job or shopping for medical insurance on your own you should take the following into consideration

Your overall health and the health of your family

Does anyone in your family smoke

How the medical insurance plan handles fundamental care

Outofpocket costs to you

When investigating an insurance carrier you may want to ask yourself the following questions

How often will you need to see a doctor Do you or any family members require specialized care

Will the plan cover the basics beyond annual office visits How does the medical plan handle maternity care prescriptions surgery hospitalization lab costs and other medical fees

Is there a deductible or amount of money that you need to pay before the medical insurance plan begins to extend coverage What is the copay if any A copay is the difference between what the carrier covers and what you pay out

How much will it cost to see a doctor outside of your plan

All of these factors need to be carefully considered before choosing a health insurance plan

Supplemental Medical Insurance

Beyond basic medical coverage you may wish to investigate supplemental coverage such as vision care dental care disability insurance and longterm care insurance For instance many plans cover dental cleanings and eye exams but do not cover more extensive procedures Disability insurance pays out an income if you are unable to work and long term care insurance can cover costs associated with an extended illness such as at home care and physical therapy

Health Insurance Plan

Insurance Finding the Right Health Insurance Plan

When it comes to fee for service and managed care most people will choose an HMO Health Maintenance Organization as a health insurance plan With HMOs there are lower premiums and minimal copays for all covered services In addition with this type of health plan there are no claim forms to fill out The catch with HMOs is that seeing an out of network doctor can result in a higher outofpocket cost to you Although less flexible than other health plans HMOs can provide excellent medical coverage for both you and your family

Avoid Health Plan Pitfalls

Finding a great medical insurance policy can be a definite boon but choosing from the myriad of options available can be confusing Being an educated consumer can definitely protect you against health insurance fraud You dont have to be an expert but knowing the terminology of your plan can help you to make the best decision Be familiar with terms such as copay the difference between what the health insurance plan covers and the doctor charges premium what you pay before your benefits kick in and fee for service a type of health insurance in which you submit claim forms and are reimbursed for covered procedures If you are not sure what something means be sure to ask your agent or broker to explain it to you in simple and clear language

Some indicators of a bogus health insurance plan may include the following

You are billed for services that you never requested or received

You do not receive a copy of your health insurance policy at the time of purchase

You fail to receive a receipt for cash premium payments

The paperwork for your health plan is so hopelessly complicated that you cannot even understand the basics of coverage

Any one of the aforementioned situations should lead you to question your carrier or maybe even take legal action

Protect Yourself from Health Insurance Fraud

Here are a few ways to protect yourself from health insurance fraud and get the best plan

Request written copy of your health plan You should automatically receive a copy of your paperwork at the time of purchase and a receipt of payment Fully review all terms of the health insurance plan before putting pen to paper

Make sure the insurance company is licensed as an insurance carrier in the state in which it operates and in your state An insurance company can be set up as a legal corporate entity but still not have the licensure to operate as an insurance provider

Ask to see a copy of your broker or agents license It is required by law that agents and brokers carry proof of licensure at all times If you are not sure check with the Insurance Licensing Bureau to verify qualifications

Do plenty of comparison shopping between health insurance plans and verify your carriers financial status with rating companies such as Standard and Poorsand A M Best The carrier should have a rating of A or higher for the company to be considered as a sound insurance provider