There’s nothing fun about needing to go to the doctor, or even the hospital, but it’s even worse if you don’t have health insurance coverage. Even if money is tight, you should always protect yourself, and your loved ones, by purchasing the necessary health insurance. In fact, you could argue that especially when money is tight, you should be sure to have health insurance coverage, as it will save you more than it costs in the long run.
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There are many different types of health insurance, and you might be confused as to what coverage to purchase:
- Long-term health insurance
- Short-term health insurance
It’s enough to make your head spin! Nevertheless, fear not – we’re here to help! Read on for some insight into the types of health insurance and what coverage you might need.
What are the standard types of health insurance?
Most people get healthcare coverage through their employer, which means they don’t usually have a choice as to the type of health insurance. Employers most often choose from three basic plans: PPOs, POS, and HMOs. All are managed care plans.
PPO or Preferred Provider Organization health insurance is the most flexible of the three types of medical plans. PPO plans give subscribers a network of preferred providers from which to choose. If the subscriber goes to the doctors and other healthcare providers in the network, the service costs are fully covered by the insurance plan. There might be a small co-pay on the part of the policyholder. If the policyholder chooses to see a doctor or specialist out-of-network, they still have insurance coverage, but often have to pay a percentage of the cost.
With POS, or Point of Service plans, policyholders need a referral from an in-network doctor in order to see a specialist outside of the provider network. Most PPOs don’t make the referral necessary, but it is a requirement with a POS plan. If subscribers choose to just see an out-of-network specialist on their own, they will have to pay much, if not all, of the cost themselves.
HMO health insurance policies are the cheapest of the three plans, and the least flexible. HMO stands for Health Maintenance Organization, and it is the purpose of a HMO to help maintain your good health, but within its strict parameters. More so than the PPO and POS plans, HMO policies are narrowly focused on preventative healthcare. They often don’t cover any treatments not seen as necessary.
How do I get health insurance coverage?
If you work for a company–especially a large one–chances are very good that your employer will offer you health insurance coverage under a company group insurance policy. Usually, employers just have one or two types of plans from which to choose.
As the employee, your coverage may be fully paid for by your employer, or you may have to contribute some set amount or percentage of your salary towards the policy. If you choose to add your spouse, partner, or children to your policy, you will have to pay a bigger chunk of the cost–usually anywhere from 40%-100% of the bill.
Costs for medical coverage are often higher for employees at smaller companies, especially in this time of financial crisis.
Many individuals who are self-employed or unemployed choose to purchase individual health insurance directly from an insurance provider. You may also be able to purchase medical coverage at a reduced rate through a membership organization, professional association, or other affiliation.
Some people, depending on their age, potential disability, and military service, qualify for government-funded health insurance plans such as Medicaid and Medicare. The U.S. government also funds a low-cost health insurance plan for underserved children, called The Children’s Health Insurance Plan or CHIP.
What other kinds of health insurance coverage do I need?
Besides basic and comprehensive health insurance coverage, you should also think about purchasing dental, vision, and pharmacy prescription medicine insurance.
Dental insurance helps cover the cost of routine dental visits twice a year, including teeth cleaning and checkups, as well as x-rays on an annual basis. It may also pay a percentage towards more expensive orthodontic procedures such as braces and root canals.
Vision insurance plans help pay the cost of annual eye exams. The usually also pay a portion of the price of:
- Contact lenses
- Eyeglass frames
- Sunglass frames
- Prescription lenses
Many major medical health insurance policies also include some type of prescription drug coverage. If yours doesn’t, you should look into purchasing a prescription plan or, at the very least, getting a prescription card through the AAA, AARP, or other organization of which you’re a member. While these cards won’t cover the entire cost of a prescription, they will get you an immediate discount on their costs.