What are my health insurance options?
Health insurance options vary depending on your individual or family health care needs and personal budget. With the changes in health care, insurance options are changing on a daily basis. One of the benefits of Health Care Reform is that everyone will be entitled to health insurance of some sort.
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Insurance options include private insurance, group insurance, and state or federal programs. Within these options are additional plan options. A full explanation of health insurance options can be reviewed in the article below.
What are my private insurance health insurance options?
Private health insurance can be purchased on your own for individual or family coverage. Often this coverage is the most expensive option, but for some it is the only health insurance option.
Individual or family private health insurance is usually purchased when you cannot purchase group health insurance, go on COBRA after leaving a job, or do not qualify for state or federal health insurance.
Private health insurance includes many different types of health insurance options. Within private health insurance, you can purchase many different types of health insurance plans. According to Life, a non-profit organization online, health insurance plans include:
- HMOs
- PPOs
- POSs
- HSAs
When you purchase private health insurance, you are responsible for paying the entire premium on a monthly, semi-annual, or annual basis.
What are my group health insurance options?
Your group health insurance options are usually up to your employer. The employer enters into a contract with one or more insurance providers. Then the employee chooses the health insurance plan that best meets his or her individual or family needs.
Group health plan options usually are:
- HMO
- PPO
- POS
- HSA
The employer contributes to the monthly health insurance premium as well as the policyholder.
Once you leave your employer, you can maintain your health insurance coverage through COBRA. Under COBRA, the policyholder takes over the amount the employer was paying but is able to maintain the same insurance coverage for up to 18 months.
Other group insurance plans include organizations, associations, and trade unions which offer coverage if you are a member of one of their organizations. Search memberships at wholesale clubs or by performing a search on the Internet like “Membership Organizations” or “Membership Benefits Health Insurance.”
What are HMOs?
An HMO or health maintenance organization mandates that you choose a primary physician within the plan that you see for all of your medical problems. If you wish to see a specialist, you will be required to receive a referral from the primary physician. There are established co-payments for visits to physicians, hospitals, emergency care, and laboratory expenses. You must see in network providers or the plan will most likely not pay for the services.
What are PPOs?
PPOs are a preferred provider organization, which permits policyholders to visit whichever providers they choose. However, the policy coverage will be greater for providers who are in-network than those that are out of network. Co-payments are established between the insurance company and providers.
PPOs usually have deductibles that the policyholder must meet before the plan switches to an 80-20 split between policyholder and insurance company. Depending on the plan, some insurance companies will begin to pay 100% of medical expenses once the deductible is met.
What is a POS?
POS plans are point of service plans. This plan is a combination between an HMO plan and PPO plan. A primary care physician is selected and recommended for all visits. However, there are approved physicians, which do not require referrals. Out-of-network visits will be covered at an agreed upon rate. Established co-payments and deductibles are also part of this plan.
What are HSAs?
HSAs are health savings accounts. These are usually used in conjunction with a high deductible insurance plan. The HSA allows policyholders to put pre-tax money away to be used towards medical expenses. There is a network of providers, but you have the freedom to see any doctor of your choice. However, for the payment to be made or to go towards your deductible, the provider must be in-network.
What are my state and federal options for health insurance?
State and federal options for health insurance are only eligible for people who meet the income qualifications or are over the age of 65.
For instance, programs that are available for people who need health insurance but cannot afford it can be found under Medicaid, which is regulated by each individual state. However, you can determine if you are eligible on the U.S. Medicaid website. Medicare is the health insurance provided by the federal government for individuals aged 65 and older.
Are there any other options for health insurance?
There are additional options for health insurance depending on your needs. If you are in between jobs, a recent graduate, or student, you may want to look into temporary health care coverage. There are plans available that only provide health insurance for a short period of time.
There are also specialty insurance products. These products include supplemental policies that are usually added onto a policy as a rider. Examples of supplemental policies include:
- Supplemental maternity health insurance policies
- Accident policies
- Accidental death and dismemberment
- Cancer policies
- Critical illness
- Critical care
- Long-term care
- Hospitalization policies
These policies usually pay for expenses that are not covered under traditional health care plans. The supplemental policies or riders may also make:
- Cash payouts
- Help with daily expenses
- Pay for transportation, lodging, or childcare
There are many options for health insurance. However, you have to figure out what the best plan is for your needs and your budget. Insurance budget calculators like the ones available at Money-zine, can be very beneficial in calculating what you can afford on a monthly basis.
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