Commercial health insurance is another term for private health insurance or any health insurance company that is for profit and is not managed by the government. Most people have health insurance through commercial health insurance companies.
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Not all health insurance companies are created equally. There are some that are better than others. According to the National Association of Health Underwriters, about 45 million residents of the United States have no health insurance during some point of the year.
How can you get commercial health insurance?
Most people who have commercial health insurance get it through their employer. This is also known as group health insurance. In most cases, the employer requires the employee to meet certain criteria before enrolling them in their health insurance program.
Many times this can be a great way for people to obtain health insurance. The employer usually takes on some if not all the cost of the health insurance premiums for each employee. The employee is normally responsible for deductibles and co-payments on health insurance policies.
Some people apply for commercial health insurance themselves. They have to pay the monthly premium in full as well as the copayments and deductibles. For those who have been on group health insurance, the transition to paying the monthly premium themselves can be a shock.
What are the different formats for commercial health insurance?
There are three common types or models of commercial health insurance which are: Point of Service (POS) plans, Health Maintenance Organization (HMO) plans and Fee for Service or indemnity plans. Point of service plans allow the insured to choose their medical care from a specific list of providers. Within this network of professionals the insurance company covers a larger share of the medical expenses under the terms of contract specified in the policy.
HMO plans are a popular option that incorporates some of the point of service plan’s approaches. The network of professionals is used as well in an HMO plan; however, a customer can be referred to a specialist by a network professional if there is a need for it. HMO health insurance companies do not usually cover out of network claims, but do so on very rare occasions.
The fee for service plan is a little different than the above formats. This type of health insurance plan covers specific medical procedures as outlined in the policy. Customers don’t have to stay within a specific network of medical professionals. However, the plans can be very limited.
Most fee for service plans cover such things as routine doctor’s visits and procedures that are done in these offices. There are those fee for service plans that offer more coverage such as hospital care and other conditions, but the premiums are usually higher for those plans.
How do you search for a commercial health insurance company?
For people who just need an individual health insurance policy the plans are straightforward and the premiums tend to be lower. Those who need coverage for both their household and themselves might incur some added expenses.
Anyone who is searching for commercial health insurance on their own should definitely use a couple of resources to help evaluate health insurance companies. Check out rating companies such as Standard and Poor’s. This website can provide you with vital information on a company’s financial situation which will help you to make an informed decision.
It’s also a good idea to research what other customers think of these health insurance companies. Websites such as Better Business Bureau or even your state’s insurance department such as Texas’ Department of Insurance complaint website can be useful when looking for dirt on an health insurance company.
It’s important to weigh the pros and cons of each top individual health insurance company after you’ve created a list of potential insurers. Knowing what you need for insurance and which companies can cover most if not all of your needs is beneficial.
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