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Health Insurance Aspects Overlooked By Public

Armen Hareyan's picture

The greatest contribution of health insurance is the fact that it protects you and your family from the cost of illness or injury. Yet in this time of expensive health care cost and the lack of affordable health insurance plans the above assertion comes into question.

There are three main types of health insurance plans the knowledge of which may help the individuals and families to make better decisions in making their health insurance more affordable: indemnity plans, health maintenance organizations and preferred provider organizations. You must be careful to choose the type of health insurance plan that would suit your health care needs. Individual medical policies are often times difficult to acquire, more expensive, and have more restrictions on their coverage compared to group health insurance. So it is important for those self-employed or not working in companies to make sure they investigate insurance plans carefully to ensure their credibility. There are times that you may get health insurance coverage through business, professional, or fraternal organizations and clubs.

Free-for-service health insurance requires you to pay monthly premiums, annual deductions and coinsurance, which is usually 20 percent of your health care bills. Likewise, HMO's or Health Maintenance Organizations require you to pay monthly premiums and co-payments every time you seek for a health care professional's services or when you go to the hospital. Choosing from a list of health care professionals and hospitals is important, and in many cases you must see your primary care physician for referrals to a specialist in cases when you would need their services.

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With POS (point-of-service) plans, in instances when your primary care physician would refer you or when you would decide to see a health care professional outside of the plan, the HMO would have to pay most of the bill. However, you still would have to pay more compared to sticking with seeing physicians who are part of the plan.

In most HMOs and PPOs, the physician usually accepts a full plan payment except for your co-payment. For example, if your physician charges you a professional fee of $80 and your insurance company's fee was set to $70, the remaining fee would have to be taken from your own pocket, and will not be deductible.

COBRA is a law that allows you to keep your group health insurance up to 18months after leaving an employer. And as part of your HIPAA (health insurance portability and accountability act), all insurance carriers are not allowed to cancel coverage unless premiums are not paid, payments are late, you commit fraud, or when your issuer no longer offers your particular type of coverage.

By Simon Bukai www.nyhealthinsurer.com/