Your Choices in Medical Insurance
August 5th, 2010 | 
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There are many options for you in medical insurance and you’ll find that there is no one plan that offers everything you will need. All plans differ in what is offered, what you have to pay, and how easy the services are to access. However, the following information will help you to determine what is the best medical insurance coverage for you and your family.
First of all, you will find that medical insurance plans are either that of indemnity, which are basically fee-for-service plans or managed care, which is basically an agreement to have a certain doctor look after your needs. Both of these plans have a different approach to your medical insurance.
With medical insurance under an indemnity plan, you’ll find that you will have much higher costs out of your pocket and how you pay the bill. Many of these types of medical insurance plans will not pay their share until they actually receive the bill from you. The best thing about this type of service is that you will have more options in your choice of doctors, including any specialists you may need during the course of any medical treatments you may need.
On the other hand, with managed care, you will have to pay less out of your pocket, but you are very limited in your choice of doctors. This type of medical insurance will have agreements with many different health care providers to give you service at a reduced cost. This, however, is one of the main reasons why many do not like the managed care plan of medical insurance. It does not necessarily allow one to have the doctor of their choice treating them.
As the medical insurance plans change, however, many of them become very similar. There are some types of medical insurance plans that are indemnity plans but offer managed care options, as well. Under managed care, you’ll find there are generally three different types:
The Preferred Provider Organization or PPO makes an agreement with health care providers to get lower fees for providing you with their service. You will have lower costs and you and your health care providers can refer yourself to another doctor should it be necessary. However, if you go outside for a referral, you will have to meet a deductible, instead of just paying for normal co-payment and you may pay a difference between the cost and what the provider will pay.
The Health Maintenance Organization or HMO is the oldest type of the medical insurance falling into the managed care plan. They offer many benefits, including preventive care, for one monthly fee. With this medical insurance, you will have to choose a primary care physician and you can only be referred to a specialist should your primary care physician deem it necessary. Some HMOs require a co-payment, while others do not. The downside to the HMO is that you can only receive coverage for services rendered by your primary care physician or a referral by them.
POS- The Point-of-Service plan is also under the HMO and allows the individual the ability to see a specialist, as long as they are an approved provider of the coverage. Your primary care physician can make a referral outside the approved provider list and you will be covered, but if you do this yourself, you will have to pay for the services provided by paying coinsurance.
The most important thing you can do when researching medical insurance options for you and your family is to ask questions and make certain you understand the coverage before you commit yourself to such an important part of your health care.
Watch the video related to medical insurance
President Obama shares the story of Natoma Canfield, a cancer survivor who had to drop her health insurance due to excessive rate hikes only to be diagnosed with leukemia, and tells the crowd in Strongsville, Ohio that cases like Natomas make it clear that the time is now for health insurance reform. March 15, 2010.
Help answer the question about medical insurance
What is the most affordable personal medical insurance carrier you have found?I know that no medical insurance is cheap, especially when you have to buy a personal policy not given thru your work. But, I have to get coverage for me and my husband. We just need basic insurance I guess….Like for medical and dentist visits. Have you found a more affordable insurance carrier? Or have any advice on what to look for in a new one? Thanks!
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Health Care is not an issue for just the poor.
The most common reason for personal bankruptcy in the US is sickness.
I don't understand how your payments can be more than when you were covered under the HMO. When I present an HSA option to a business client, I would never suggest it unless there were significant savings in premium. Also, I would never recommend it if the employer were not willing to make some contribution toward the deductible for the employees.
About 75% of all of my clients offer a HSA-qualified plan at least as an option. I have seen it work to control the ever-increasing cost to the employer and don't hear many complaints about coverage, especially if they are set up properly.
I would suggest that your husband contact the HR department and inquire about employer contribution to premium and deductible to make sure that he fully understands your responsibility.
BUDGET 4 THE WHITE STRIPS.
THEY R only $30.00, so take a break from BEER, or WEED, and FOCUS, plus…you can clip your own fingernails and buy ummm…VINEGAR or Baby Powder.
first
It is part of her character wanting government to control everything. She should run as a Socialist party candidate!
Good for you! Hey may be 'working' and not getting paid and that's one thing. The most important thing he is NOT doing is helping to support his family. I see the ultimatum in this situation very reasonable.
no it sounds like a dead end job to me
Yes, it can be so because it was. A lot more has yet to hit the Obama fan.
The USA has the … “BEST SPECIALISTS” … but our Health Care System stinks and is ranked as the Low 37th on a World Scale !! It’s like saying “THE USA WON THE MOST GOLD MEDALS IN THE OLYMPICS … SO THE ENTIRE AMERICAN POPULATION IS MADE OF TOP ATHLETES !!
When in reality we have an overweight & sick …(cancer~heart diseases~diabetic)… population, compared to other nations. Don’t buy into the Right-Wing propaganda. See My profile for ways to contact your representative. Thanks.
i agree with the other 2 posters.
auto does not have malpractice, but they have "bad faith" which is just as bad as malpractice if filed against the company and the company loses.
as for some insurers only accepting preferred customers that is true also, but there are many that only take the minimum limits and high risk only since they make more money. i have worked under both.
i agree if all policies could be 'standardized" like auto.
in auto you pick your coverage and limits . when you file a claim for your auto, it pays for the damages.
if you get injured, it pays the medical bills
if negligent, it pays so you don't get sued
if other party has no insurance or not enough, it pays that also.
the exclusions in most policies are basically the same so no surprises there. in some companies they will slip one in that no one has, but those are few.
after 3 years, most companies will void prior claim history and you start over, whereas have a preexisting condition precludes you from obtaining insurance in most states forever until you reach 65 and can get medicare.
most people will disagree with you, but i have thought for years if health insurance policies would follow the same basic rules as auto, that if you file a claim, they pay subject to your deductible and you can rest assured not going bankrupt.
but health insurance needs to be made mandatory for all.
Assuming each choice is lettered in successive order:
1.B
2.A
3.B
4.C
5.D
6.A
7.C
8.A
9.C
10.C
This is an idea that should be looked at very carefully by the congress before it starts trying to reinvent the wheel.