Health Insurance Basics
Author: Kevin Powell

Health insurance is a necessity for all individuals. This is
because even a minor illness can quickly become a life
threatening condition that you can cost thousands of dollars to
treat. Many illnesses have been financially devastating to many
people and families and having adequate health care can assist
you in covering those medical expenses as well as helps to
ensure that you can afford preventative medicine as well.

It is important to understand how health insurance coverage
works before you purchase a plan. The health insurance plan that
you choose must meet your needs as an individual or family.
There are several different types of health coverage available
and having an understanding of health plans can help you choose
the right one.

Health care plans will typically pay for most, and possibly
all, of the cost of treatment for illnesses and injuries. These
are usually classified as "managed care" or "fee for service."

Most people are familiar with "fee for service" plans and they
are often referred to as "indemnity plans." These are plans that
are sold by traditional insurance companies and you can go to
any doctor you want and you don't require a referral if you need
a specialist. A fee-for-service plan will often pay for most of
the costs of treatment for medical conditions that are covered
in the policy. In most cases, your healthcare provider will bill
the insurance company directly for the cost of your care, but in
some instances you may have to pay the bill and then file a
claim for reimbursement with the insurance company. With a
fee-for-service plan, you will be required to pay a premium,
deductible and coinsurance.

Co-insurance is the portion you have to pay once you have met
your deductible and the plan begins to pay benefits. Generally,
your plan will pay 80% after the deductible has been met, but
you are then required to pay the leftover 20%. The amount that
the insurance company pays depends widely on the state you live
in. As with a deductible, the higher you pay in co-insurance,
the lower your premiums.

Managed care plans use "networks." This means that you have to
choose from a specific list of doctors, clinics, hospitals and
health care providers. These providers are contracted with your
plan to provide services to members of the plan. Some managed
care plans will require that use only providers in the plan for
your routine care. Others will pay for care from any provider,
but offer you more financial incentives for sticking with those
in the network.

Managed care plans are usually a more affordable option.
Managed care networks provide healthcare professionals with
"built-in" clientele, thus allowing them to lower their rates.
These plans also emphasize preventative care to keep medical
conditions at bay. In general, the trade-off for these programs
is that you may not be able to use your doctor of choice, but
you will receive increased affordability.

There are three types of managed care plans including:

• Preferred Provider Organization Plans – These allow you to go
to any provider you wish, but you will save if you use providers
that are in the network. You do not have to select a primary
care physician for a PPO plan.

• Health Maintenance Organizations – These require you to only
receive care from providers within the network. There are
exceptions should a medical emergency occur. With a HMO, you
will have to choose from a "primary care physician" list. Your
physician will oversee your medical care and provide you with
referrals to specialists and other providers you may need.

• HMOs with a POS (Point-of-Service) – If this will allow you
to use a healthcare provider outside of the network, without
first having to receive a referral. However, you will pay more
for using those providers. A POS plan may also exclude the
option for out-of-network care in certain medical situations.


About The Author: Kevin Powell offers FREE Guide To Choosing
The Right Health Insurance Coverage that has helped people just
like you to get affordable health insurance. Check it out at
http://www.health-insurance-net.com