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Understanding Coverage and the Four Options to Choose From in a Health Insurance


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When you shop for a health insurance you don't necessarily go to the first provider that offers you the services. This is true for the individuals who don't receive the Medicare or the Medi-Cal. For those shopping for a plan, a very important thing should not be forgotten- the health insurance coverage. It is imperative that the person looking for a plan should double check the type of coverage extended to emergency care.

For most of the plans that are now available in the market, the coverage is pegged at 80 percent of the expenses incurred. For some medical plans, the coverage will be a paltry 50 percent. For this reason verification should be done to get the best deals. In your shopping for your family's health insurance, what you are really after is the kind of coverage that would be most beneficial to the needs of your family. For the shoppers, let it be known that there are four basic types of plan that will be available to you. The challenge for you is to choose the one that suit your needs and circumstances. Understanding first these all four choices is a big step towards the selection of the proper insurance.

The first type is the indemnity insurance which is called as the Fee-for-Service. This is the most basic and the ones known by the majority in the population. This kind of plan will pay for almost all of your health issues. But don't expect this plan to pay for preventive care like check-ups and physical examinations. This type of health insurance plan will not pay for the whole cost of medical expenses. The coverage of this plan is only a fraction of the total billed amount. In terms of your monthly obligations, the premium here will be a bit higher than the other types of plan. But the good thing about the indemnity insurance is that you will be given the leeway to choose and see the doctor and the hospital that you want.

The next option for shoppers of a medical insurance is the health maintenance organizations. This HMO is helpful in a sense that this covers almost all of your healthcare needs. Coverage of the HMO will include check-ups, immunization and hospitalization. Interested consumers should expect a minimal co-payment which can range between $5 and $40. The Exclusive Provider Organization will work in a similar manner.

The third option for health insurance seekers will be the PPO or the Preferred Provider Organization. In this kind of medical plan, you get to choose from a list of preferred providers and you will be charged with a minimal per-visit fee. If you want to have your own doctor, then you can opt for this option but you will pay for the greater fraction of the bill and you may need to pay for the deductible.

Your last option for the insurance is the Point of Service where you will be given two options. Option one is to use the plan ala-HMO wherein you are in charge of the co-payment, choosing of doctors from list and for obtaining authorizations for services and the referrals for specialists. The other option is to work the plan like the indemnity plan. Knowing all these four types of insurance and having a basic understanding of the coverage will ensure that you get to have the most appropriate health insurance for yourself or a family health insurance.

George Foerstel is a Human Resource officer for a large company. He has worked for several companies and has gained vast amount of information regarding health insurance and other subjects. He resides in New York, New York presently and focuses on sharing his knowledge to other people through writing.


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