Finance Tips

When it comes to insuring ones health there’s no denying the fact that this form of insurance is a must for everyone even though it’s not legally required and is purely optional. It’s hard to imagine the current healthcare system without insurance because otherwise people couldn’t afford most medical services and doctors wouldn’t get their high salaries, which are among the highest all over the world. Thanks to insurance both customers and service providers are pleased, and everyone’s getting the thing they want. Among many types of insurance available managed care plans are the most widespread, so let’s take a closer look at some of the most common forms of insurance offered by insurers:

Health Maintenance Organizations (HMO)

This is the most common form of managed care plans as it provides the lowest price and a wide range of services included. It’s main drawback is the lack of flexibility in what concerns the places you get care from. Under HMOs you are limited to a network of facilities and specialists you may get care from and covered to the full extent. If you choose to get your services from someone outside the network your costs won’t be covered at all. Moreover, you are required to choose a primary care physician who will refer you to all the required specialists, so there’s more paperwork involved with this type of plans. Yet, you usually pay lower premiums for that so it’s really worth the effort.

Preferred Provider Organizations (PPO)

Preferred Provider Organizations offer more flexibility but for a higher price if compared to HMO plans. You are still limited to a network of providers to get care from, however if you choose to go out of network there will still be some part of your bill covered only to a lesser extent compared to in-network services. And you aren’t obliged to choose a primary care physician so there’s not so many office visits to do under this type of managed care plans. If you have the additional money and want more flexibility with your health insurance this plan type will definitely appeal to you.

Point Of Service (POS)

Point Of Service plans are often referred to as a mix of HMO and PPO plans as they provide the benefits of both these forms of health insurance. You gain the flexibility of PPO in what concerns the places you get services at, yet you still have to choose a primary care physician and have a network of providers to work with. One of the greatest benefits is that you may choose your family doctor as a primary care physician even if he or she doesn’t make part of the insurer specified network, which is definitely appealing to those who have long term relations with their family doctors. PPO plans may vary in price so it’s really recommended to shop around if you want to get the best rate possible.

As you see, managed care plans come in different forms with the sole purpose of giving you exactly what you need. So it’s really important to assess your individual health insurance needs before choosing the plan type to address them adequately.

There’s a strange contradiction about insurance. It’s an annoying burden every month when the time to pay the premium comes around but, if the worst should happen, it’s a wonderful thing to have had that insurance policy in place. With the family budgets really tight as the recession shows little sign of going away, the monthly bank statement shows the insurance instalments disappearing. You look at your own health. That’s great. You have never had a day of serious illness in your life. It’s the same for your partner. You cannot avoid feeling a little resentful. All those dollars, every month. And then there’s an accident or one of you does unexpectedly fall ill. It’s then you discover whether that plan you have been paying into is actually worth the money.

The market for health plans is divided in a slightly complicated way. It’s really to ensure the insurance companies make a profit as the cost of treatment keeps on rising way faster than inflation. So it reflects a balancing act between allowing the patients some say, and denying them any real control, over access to treatment. The plan most popular with the insurance industry is Managed Care. This requires you to get the insurer’s permission before you attempt to access treatment. The first contact doctor must be from an approved list, and he or she must refer you on for further diagnostic tests or treatment. Failure to get this referral usually means the insurer will refuse to pay. The second option is a Fee For Service Plan where you pay a lump sum at the beginning of each year, followed by monthly instalments. This covers you for the medical services listed in your policy. Basic plans only cover consults with your doctor and a simple set of tests. More expensive plans have a better range of coverage but there are usually co-payments.

Health Maintenance Organizations (HMOs) are networks of healthcare professions. If you stay within the network, your medical needs are covered although, in most plans, co-payments will be required. The next step up is a Point of Service Plan (POS). This is a variation on the HMO and allows a networked doctor to refer you to an outside expert. Finally, there are Preferred Provider Organizations (PPOs) which offer more choice than an HMO or POS both in the doctors you can access and the treatments you can have, e.g. usually include preventative medicine.

Because the service offered by this site is free, you can get as many health insurance quotes as you like for each of the main types of plan. This gives you more information on which to make your decision. But it’s fair to say the decision is not an easy one unless you read the detail of each plan with some care. With all the health insurance quotes available, you are often forced to balance coverage against cost, i.e. you buy the amount of coverage you can afford. This makes the choices something of a gamble. Do you pick emergency care in the event of an accident or focus on a list of the most common diseases or disorders? Do you include long-term care against the possibility you might be more permanently disabled by whatever happens? There is no right or wrong answer to these questions. In the end, it all comes down to what you can afford and what helps you to sleep best at night.

The widely-discussed reform of healthcare industry in the US owes much of the stir around it to the simple fact that having your health insured in our country isn’t affordable for millions of people of different demographic groups. In other words, it’s just too expensive to be within the family budget of most US citizens. But how much does it cost to get your health insured these days, anyway?

This strongly depends on several factors that may vary your cost significantly. Things like your health condition, age, workplace, location, income and other live factors play a very important role in shaping your final rates. Not to mention the provider you’re getting your coverage from. The form in which you get your health insured also plays a crucial role, because getting your insurance in a group from your employer usually costs less than if getting it on your own.

But what comprises the final insurance costs?

Many people get confused by the fact that there are more elements to insurance costs than just the rates you seen when quoting your price. Here are the most important of them:

Premiums

Premiums are periodic fees (usually, monthly) that have to be paid to the insurance company for receiving any medical services under your plan. If you have an individual plan then you are paying your premiums on your own. If you are covered under a group plan at work, your employer pays the premiums, usually requiring you to pay a small part of this amount. Premiums depend on your health condition, your age and your income status. Premiums also vary significantly between insurance companies, so you’d better spend some time on comparing health insurance quotes before you sign your plan.

Out-of-Pocket expenses

Out-of-pocket expenses are all the additional costs of health insurance plans that are extended beyond premiums. These usually include deductibles, co-payments and co-insurance. With some plans these expenses can be limited to a maximum amount, while other plans have no limitations at all, so be on the lookout for that.

Deductible is the amount of money you have to pay on an annual basis before your actual coverage kicks in. You will most commonly encounter them in PPO plans for the services received outside the network. And as with other types of insurance products, you will have to pay lower premiums if your deductible is higher.

Coinsurance is the part of the medical cost you have to meet after paying the annual deductible. It is usually 20-30% of what you pay for the services when going to the doctor.

Co-payments represent a fixed fee for certain services within your plan. In many HMO and PPO insurance plans co-payments are set for things like doctor’s visit or prescription medications.

And what are the average costs?

• Across the US, the premium is $2,985 for individual health insurance and $6,328 for a family plan.
• The annual premium differs significantly between states. If a family in New York had to pay $13,296 as an annual premium, the very same plan in Iowa was worth $5609.
• The amount of deductible paid has a strong effect on the annual premium. A family plan that had no deductible had a premium of $12686, while a $10,000 deductible shed this amount more than in half, with $5380 to be paid.