July 27, 2021

Health Insurance Plan Options

Many people do not realize or appreciate just how important their health is until it is too late. Therefore it is an important asset and as with all important assets, it should be insured.

Health insurance is defined as a policy that will pay a fixed amount of money for medical expenses and treatments and is basically a way to ensure protection against any sickness or injury. A number of different categories fall within the umbrella of health insurance like those for disability income insurance, dismemberment insurance, medical expenses and accidental death insurance to name only a few. This gives flexibility and a person can arrange specific types of cover depending on his or her needs.

Fee-for-service plans have been around for a long time and are the most basic of plans available in which the insurance company does not have to pay out unlimited amounts but only an agreed percentage or amount agreed at the time the policy is started. The problem with this plan is that before it can be started, a single payment known as a deductible has to made, then monthly premiums thereafter; fortunately fee-for-services plans are not that common anymore.

Another type of plan is that run by health maintenance organizations where the insured chooses a doctor but must use that doctor each time he has a health problem before he can be referred elsewhere; often know as gatekeepers. The idea behind this is that the insured and doctor will build up a relationship which should be of benefit t both and where the doctor can gain their trust and help to provide preventative advice for good health.

Preferred Provider Organization- is basically a combination of fee-for-service and Health Maintenance Organizations where you designate a network of hospitals and doctors by whichever insurance you buy the options are confined to that set of doctors and hospitals. Medical expenses are covered by the Preferred Provider Organization only when the insured person resorts to the preferred or network providers; however, if you visit a hospital or doctor outside your network, you will often pay an increased amount.

Becoming more commonplace is the Exclusive Provider Organization where health care providers both individual and groups enter into an agreement with the health insurance providers. All medical costs are met by the Exclusive Medical Organization providing it is with one of those in the network and any medical attention supplied outside of this will not be paid, but some exceptions do exist.

Now you have some of the health insurance plan options open to you it is worth talking to your health benefits manager where you work and discuss the best type of plan that will protect the health of your family and you. Of course a doctor is always a good person to ask as they are generally familiar with every type of health plan available.