How Do I Understand Health Care Insurance?
Trying to figure out health care insurance can be very overwhelming and confusing. There are different kinds of plans as well as different abbreviations. What do the abbreviations mean? What are the advantages of each plan? There are a few key components to remember in better understanding health care insurance.
- Compare the health plans available to you. Medicare and Medicaid are federally funded health care plans. Medicare is offered to senior citizens age 65 and over while Medicaid is offered to other people. These individuals must be considered low income, which is designated in the eligibility requirements. Private health insurance plans can be bought directly by an individual. Some employers provide health care insurance benefits to their employees.
- Learn about the various private or managed health care plans. There are three kinds, HMO, PPO, and POS. HMO means Health Maintenance Organization. This plan specifies you can only use the doctors in the network. There would be an out of pocket expense for doctors out of the network. PPO means Preferred Provider Organization. This plan allows you to utilize any physician in or outside the network. POS means Point of Service. Upon signing up for this plan, you will need to select a primary care physician. If necessary, your primary care physician would have to refer you to a specialist covered under the plan.
- Determine which one has a comfortable deductible amount for you. The deductible is the amount before the insurance company starts paying. Some insurance companies have a capped yearly amount.
- Know what the co-payment amounts are. The co-payment is the amount paid to the doctor's office, urgent care, or emergency room during a visit. These amounts vary.
- Found out what is covered. Regular doctor visits, physicals, immunizations, and ob/gyn doctor visits are usually covered. Mental health clinics, chiropractic care, drug rehabilitation services are sometimes not covered under health care insurance.