Choosing Health Insurance
When deciding on the type of health insurance coverage to get, there are several option. Most options have various premium prices, deductibles, coverage and restrictions. Not all health insurance is right for all people so it is important to understand the differences between each type so you can make an informed decision as to what type of health insurance will be best suited to you and your family. If you have health insurance benefits available through your employer you may or may not have a choice as to the type of coverage. If you do not, it is advisable to take advantage of any type of health insurance coverage available as it will highly benefit you from both a financial and health perspective.
Fee For Service Health Insurance
A fee for service health insurance plan is the oldest and most traditional type of plan available. It allows you to get health care any time you want it, from any health care provider, at any location. There is a monthly fee or premium attached to the health insurance plan as well as a deductible. The deductible amount needs to be met each year before the insurance kicks in to pay for services. The deductible is an out of pocket expense. Once the deductible is met, the health insurance covers a percentage of continuing care for the year based on a coinsurance amount, typically 80/20. This means that after the health insurance deductible is met, if you have a hospital bill the health insurance will cover eighty percent of it while you pay twenty.
Health Maintenance Organizations or HMO's
An HMO is a type of prepaid health insurance plan. You pay a monthly premium for the health insurance and this allows you access to a network of physicians, hospitals and healthcare workers for your medical needs. Most times, you will also have to pay a co pay for services but this is a fairly low amount. For example, you may have to pay five dollars for an office visit. You will only be able to obtain medical services under this health insurance plan, though, from approved medical personnel who have an agreement for services at a fixed rate with the HMO. Emergency treatment at non network medical facilities may be an exception in some HMO health insurance plans.
Point of Service Health Insurance or POS
A POS health insurance plan is very similar to that of the HMO. The difference though, is that patients have access to the network or medical professionals under the health insurance plan but can also go outside the network. People in a POS plan will choose a primary care physician and if ancillary medical care is needed, a referral from the primary care physician must be obtained before health insurance benefits are approved for payment. However, if the patient chooses to bypass this or go to a medical professional outside the network without a referral, they will still get medical coverage but at a lesser rate. If a primary care physician gives a referral outside the network, full health insurance coverage will be applied.
Preferred Provider Organizations or PPO's
PPO's are a cross between an HMO and a Fee for Service health insurance plan. Similarly to an HMO there is a network of health care professionals from which to choose. Your medical expenses are covered if using those providers. However, if you choose to opt out of the network for particular services you will get health insurance benefits but you will also have a higher out of pocket cost for the services.
Depending on your needs and budget, the type of health insurance coverage that is best suited may vary from person to person. Some people like a low cost plan with predictable expenses. Some people prefer to have the flexibility of choosing their own medical care without having to be limited to a particular network. Regardless, make sure you understand the types of insurance that are available and weigh the advantages and disadvantages as they pertain to your individual needs before making a decision. The important part is that you and your family are covered under a health care plan that suits you so you can take advantage of emergency care, wellness visits and typical medical care for illnesses that may crop up.
