Types of family health insurance plans
Reader question:
What kinds of family health insurance are there?
Maria
Good question.
Not everybody has the good fortune to work at a job where they have extensive health insurance coverage. Some people do have medical health insurance from their job, but that insurance only covers themself. If you have medical health insurance that only applies to you, then what are you supposed to do when you need family health insurance? If you find yourself in a situation like this, then you need to begin considering taking out a family health insurance plan.
There are several types of family health insurance. One of the main ones is fee for service family health insurance. This is a traditional indemnity sort of plan. This is a very loose and allowing type of health insurance claim, because for the most part you can act first and think later. Fee for service family health insurance lets you go to a doctor of your choice, and then make a claim, the amount of which is then taken out of your total maximum coverage. Not everything is covered, so make sure you know what is before you get treated.
Another type of family health insurance is a health maintenance organization, of HMO. These are new to the family health insurance plan roster, but they’re very well liked because they are extremely cheap, unlike the fee for service family health insurance, which tends to be expensive. HMOs are more strict, though, as you have to go to a health care professional within their network. If you get treated from someone on the outside, then you’ll be paying for everything.
There are a few other family health insurance plan types available, especially considering that HMOs are so limiting and fee for service costs so much. One is PPO, which is a mix of the two, having both a network in which you must stay to get the best prices and the option for you to go outside the network for less coverage.
Cheers,
Fashun Guadarrama.
What is point of service medical health insurance?
Reader question:
What is point of service medical health insurance?
Maggie
Great question.
A point of service medical health insurance program is kind of like a mix of both traditional indemnity insurance and health maintenance organization insurance. It has some of the qualities and cons of both, and while it has some of the flexibility of the traditional indemnity plan, it also contains the requirement of the HMO plan that you must pick a primary care provider and go only to them without a very good excuse. It’s like being both free yet organized if you pick a point of service medical health insurance plan.
If you have a point of service medical health insurance plan, then you have to choose your primary health care provider and hospital from a network chosen by the health insurance company. This isn’t a strict arrangement. If you go to a physician or hospital within the network, then you will be covered or have to make a co-payment in order to be treated for your sickness or injured part. But there is also the option of choosing a physician or hospital outside of the network to go to. If you do this, you must then file a claim with your POS.
The Good:
- Most of the point of service medical health insurance plan allow you to receive your health care outside of the network that they provide. This sounds nice and flexible at first, but it has its drawbacks. While you can get good coverage within the network, it drastically decreases once you move outside of it.
- Point of service health insurance plans are very good on things like preventive medicine and services. Not only are you covered for things like pap smears, but you even get things like cheaper rates for gyms and classes to help quit smoking.
The Bad:
- Like in an HMO, point of service medical health insurance plans require that you choose a primary health care provider, and you are then required to use that provider if you want the best rates.
- Yes, you are allowed to go outside of the network to see a doctor or specialist, but that doesn’t mean that it will be easy to get covered. If you do it without a referral from your primary health care provider, then you have to send in the bills all by yourself and might not get a check back at all, and if you do it will be a small one.
Cheers,
Fashun Guadarrama.
What is HMO medical health insurance?
Reader question:
What is HMO medical health insurance?
Miriam
I’ll tell you.
The main benefit of getting an HMO, or health maintenance organization medical health insurance plan, is that this most popular of employer provided health insurance plans also tends to be the cheapest medical health insurance plan. It’s more designed for group health insurance, which is why it finds such popularity among companies insuring their employees. HMO medical health insurance is also one of the few health insurance plans that puts a lot of emphasis on preventive care.
The reason they put so much emphasis on preventive care is because, the way HMO sees it, is that preventive care can help reduce risks in an insurance pool by decreasing the likelihood that its members will develop a medical conditions, and thus it reduces medical costs. That is why it is the best to help someone stay healthy, not just to help them out if something goes terribly wrong.
The Good:
- The main thing is preventive care, which lowers both their costs and yours. HMOs also require less paperwork, and when you make a co-payment on something it will cost far less than it would with another medical health insurance plan.
- The insured under a health maintenance organization just pay a little fee each time they go to the doctor, and that is considered their co-payment.
- The coverage goes wide, with such things as outpatient services, extended medical treatment, short term mental health treatment, hospital stays, and emergency room visits.
The Bad:
- Picking and choosing the physician that you go to isn’t as easy as with traditional indemnity. Instead, you are only able to pick one provider, and that is who you must go to once he is listed on your insurance.
- The doctor you must pick has to be within the HMOs network. If you go to a hospital or physician outside of the network, then you won’t be covered at all.
- If you want to go outside of the network to see a specialist and still be covered, then you have to have a referral from your primary care provider.
Cheers,
Fashun Guadarrama.
What does all that medical health insurance jargon mean?
Say you’re going to be traveling to a country where English isn’t the official language. If you want to be understood and to understand, and don’t want to be completely confused while you’re over there, the least you want to do is learn a few key phrases, right? You might not be able to become fluent in the language over night–that only comes with experience–but to a certain degree you can at least be able to get by and not be lost in a such a foreign place.
The same basic principle applies to medical health insurance. These medical health insurance policies often come full of crazy jargon that is not explained and that you don’t understand, and so it makes choosing a health insurance plan difficult because you don’t understand what it means. There are many kinds of medical health insurance, such as:
- FFS, which means indemnity fee for service.
- HMO, which means health maintenance organization
- POS, which means point of service
- PPO, which means preferred provider organization
All of these plans is very unique and individual, and you should consider all of its features before you make a decision on what kind of medical health insurance plan that you want. The last three are considered to be more managed, and the care for yourself and your family is more organized, although it is also more restrictive.
Cheers,
Fashun Guadarrama.
Kinds of group health insurance
Reader question:
What kinds of group health insurance are there?
Richard
Great question.
There are four kinds of group health insurance, although the most popular ones these days are the HMO and the PPO. There have been a lot of changes in employment based medical insurance in recent years, and the employee has come out the winner, with more and more benefits as well as lower premiums and better options than ever before.
- Traditional group health insurance.
In 1988, the majority (74%) of group health insurance was provided in the traditional way. Well, things have changed quite a bit, and as of 2003 that number has dropped to only 5%. The best thing about traditional group health insurance is that it has room to move around in. You can pick any doctor you want, go to any hospital you want, and see a specialist without having to get a referral, among more things. The main reason that you don’t see traditional group health insurance around anymore is because this amount of freedom meant high costs, both for company and employee.
- HMO group health insurance.
HMO means Health Maintenance Organization. This was the first group health insurance type to offer an option other than the traditional kind. This is the cheapest group health insurance option, but only because it has so many limits. A network of doctors and hospitals is created so that you can choose from among that list, and can only go anywhere outside of it and still be covered is if you get a referral from a doctor on the list. If you go to a doctor or hospital not in the network, you’ll be paying out of pocket.
- PPO group health insurance.
PPO means Preferred Provider Organization. This is the most oft-used type of group health insurance these days. It’s similar to both traditional and HMO group health insurance, because you can go within a network or outside. If you go within the network, then you’ll get very low prices and most often won’t have to co-pay anything. If you go outside, you’re still covered, it will only cost more, but still less than if you had no coverage.
- POS group health insurance.
POS means Point of Service, and is also called an open-ended HMO. This is very similar to PPO because there is a network of doctors which the insured must visit and get referrals before going outside the network if they want to be fully covered. They can still go outside the network without referrals, but it will cost them more, though they will still be covered.
Cheers,
Fashun Guadarrama.