Easy As 1-2-3: Obtaining Health Insurance

Many people are often concerned about obtaining health insurance. They are confused about their options or about how to obtain the best health insurance for them or their family. There are several ways to obtain health insurance, though, and some of them are not always obvious, but can be quite easy in the end.

The most important thing to look for is coverage. More often than not, insurance will cover physician visits and fees. Your health insurance should also cover hospital expenses such as room and board in case you are kept overnight or longer for observation or treatment. Good health insurance should also cover surgeries and any expenses associated with surgical treatment. Beyond these typical items of coverage, health insurance plans can diverge greatly.

With people living longer, health insurance companies began to look for more ways to reduce their costs, developing different health plans such as PPOs. PPOs are plans which will cover nearly all of your medical expenses as long as you stay within a preferred network of physicians or hospitals. This network creates a “preferred provider” list that you can choose from. Treatment outside this network of providers is covered but only at a reduced rate, meaning you end up paying more to see a physician outside the network. By limiting the physicians and hospitals covered in their network, the insurance company can control, to an extent, their costs and lower your premiums. POS plans work like PPOs, but require you to have a primary care physician through whom you can receive referrals for specialists. If you need to see a neurologist or a dermatologist, you must first visit your primary care physician for an initial diagnosis in order to receive a referral to a specialist for a more thorough diagnosis. POS plans also have a preferred provider network, and if you choose to visit a specialist or physician outside that network, your coverage will be limited.

HMOs combine a stricter version of PPOs and POS plans. HMOs have a defined list of physicians, often much smaller than PPO networks, which you may see. You will not be covered at all if you see a physician outside your HMO network. Furthermore, you must also get a referral from your primary care HMO physician to see any specialist. However, these restrictions mean that you pay an extra low or no monthly premium.

Another item you should definitely consider is if your current physicians or specialists are included in the health insurance company’s preferred provider network or if you have the opportunity to choose any physician (often the case only with indemnity or traditional health insurance plans). If you would like the freedom to choose your own doctor, traditional health insurance plans or preferred provider organizations may offer more attractive plans – though these also cost a little more.

There is also federal health assistance available depending on certain criteria. If you are over the age of 65 or if you have a disability or specific condition (detailed by the government), you are eligible for Medicare. Medicaid is another government health insurance program that is based on income. Overall, it is simply important to be covered, no matter how you go about doing it. Research your options of coverage and speak with a professional to find out more about the health insurance options available to you.

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Written by Yuni N. Collier on October 21st, 2009 with no comments.
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