Nothing is more precious to us than having good health. Everyday people are getting more aware of the importance of having good health in order to be able to l8ive life to the fullest. But as the saying goes nothing is certain in this world, we will always have uncertainties and surprises good or bad in our life. We do get sick once in a while flu or even some major illness, or get ourselves involve in accidents. What ever the case may be these events when they happen to us could deplete our savings or even push us to bankruptcy. With the rising cost of hospital fees, laboratories and doctors’ fees it is now expensive and complicated. This is where health insurance could benefit us all. Yes, health insurance may cost a lot but having no health insurance at all cost more. Medical bills incurred from an accident could burn a hole in your savings. And in cases of cancer treatments, with all the doctors’ check ups, laboratory tests, and chemotherapy that one has to go through it could ruin you financially.
Health insurance could help you pay for the cost of a regular medical check ups, surgeries, contact lenses and glasses and even emergency treatments. There are two basic kinds of health insurance plan, the indemnity plan and the managed care plan. Indemnity plan is also called the fee for service plan. It has wider freedom and flexibility in the choices of the insured. He gets to pick the doctor, hospital and laboratory and other medical service provider of his choice. As long as the medical service is included in the health contract. But, the catch is the plan doesn’t pay for the entire charges, instead the insured shoulders the 20 % of the payment. This kind of plan covers only illnesses and accidents but preventive care like flu shots and birth control are not included. And coverage of the cost of prescription drugs and psychotherapy will depend on the policy and the company.
Managed Care Health insurance differs from the indemnity plan in a lot of ways. First, choice of doctors, hospitals, laboratories and other medical service provider is
limited to only those who have contracts with the HMO –Health Maintenance Organization–.Medical services is received only if authorized by the plan. If you insist on engaging on non authorized medical service provider then the cost of service or care provided will not be paid by the company. Preventive care and mental health treatment are covered by the plan.
Due to the rising demands for better and wider health insurance coverage, the health insurance is offering hybrid plans. Wherein, they combine the benefits of HMOs and indemnity coverage. The method is you can use the network of medical service providers that have contracts with the HMO but you are allow to choose someone outside of the network and pay for a higher percentage in the fee.. Managed Care plan also allows open access theory, where one can see a network medical specialist without any referrals from HMO.
You need to decide carefully in choosing the right health insurance plan for you and your family needs. You need to have a careful evaluation on what your family needs and extensive research for the right health insurance company that will provide for those needs. Keep in mind that the lowest premiums don’t really mean it’s the cheapest plan. Remember the cheapest plan is the policy that will give you the best benefits that your family really needs in case of emergencies and illnesses.
17 MarHealth Insurance
05 MayAbout High-Deductible Health Plans
So-called “high deductible health plans” are a lot like conventional (PPO/HMO) insurance plans, but they typically have higher deductibles (over $1,000 per year). The idea is that even though the deductible is high, you save so much money from the lower monthly premium costs that the HDHP is a better deal in the long run, when used in conjunction with a tax-free Health Savings Account (HSA).
Last year, in order to setup an HSA, you needed to find a High-Deductible Health Plans that met the following qualifications:
1.A minimum deductible of $1,000 for self or $2000 for family coverage.
2. A maximum out-of-pocket limit of $5,100 for individual coverage, and $10,200 for family coverage.
3. Preventive care can have first dollar coverage (i.e. without a deductible). Preventive care examples include: periodic health evaluations like annual physicals, screening services like mammograms, routine prenatal and well-child care, child and adult immunizations, tobacco cessation programs, and obesity weight loss programs. Prescription drugs taken to prevent the onset of a condition for which a person has developed risk factors for can be considered preventive care, like cholesterol-lowering medication. A general rule of thumb for what is or is not preventive care is the care does not include any service or benefit which treats an existing illness or condition. 4. The plan can use co-pays to cover preventive care. Higher out-of-pocket (co-pays and co-insurance) is allowed for out-of-network care.
5. The can’t cover prescription drugs before the deductible is met.
HDHP’s often offer a better value for money as compared to a lower deductible plan. HDHP premiums are significantly lower, and any out-of-pocket cost risk to can be minimized by funding an HSA to cover out-of-pocket costs up to your deductible. Also, HDHP premiums have not been subject to the kinds of rate increases that traditional health plans have seen over the last few years.
This is not true in all states and for all health plans.
Some have said that consumer-driven health plans, like the HSA+HDHP combo, works best for relatively healthy people. It is certainly true that if you’re healthy, and don’t use medical services during the year, you’ll save a lot of money with a high-deductible plan. But it’s also true that CDH plans, applied wisely, can result in savings and greater flexibility for consumers of all kinds. Individuals who are likely to make moderate or heavy use of medical services should be sure to understand the benefits covered under their plan, and should pay special attention to the co-insurance, maximum out-of-pocket, and any exclusions or carve-outs. Healthia’s health cost modeling tool can help you decide if a CDH plan will work for you.
Kurt Stammberger is VP, Marketing at Healthia Inc. Healthia was founded in 2005 to provide integrated comparison-shopping information on health insurance products and services for groups, individuals, families and small business employees.