Whether it’s a minor sickness, injury or a major disease, visit a doctor and the inflated medical bill will jolt you into looking for health insurance ASAP. Survey the market and you will find that there are two major individual health insurance plans, managed care health insurance plans and fee-for serviced plans.
The managed care health plans can be further categorized under the preferred provider organization (PPO) and the HMO. The highlight of the managed care plans is that these insurance companies manage your choice of health provider. They have a list of doctors and hospitals and only if you restrict your visits to the service providers in the list, then only will the plan cover your medical costs. This is not say, that you have no choice regarding the health provider. Under some managed care health plans, you can visit a doctor of your choice, but the financial benefits provided, you visit a listed doctor, are far greater.
Also, if you opt for the managed care health plan, you will need the nod of approval of a listed doctor, in case you have to visit a specialist. You must also keep in mind that usually there are many alternative ways to a treatment, and if a situation so arises, the general tendency of the insurance providing company would be to settle for the option that is the least expensive.
Fee-for-service plans: These are the traditional health insurance plans, and they are also known as the indemnity plans. They are costlier than the managed care plans, but their major advantage is that you can visit a service provider of your choice. This plan is especially suitable for those who are suffering from an illness and have faith in their own doctor only.
Apart from the above, the state of Texas also provides coverage to pregnant women and people with special disabilities.
There are also the Texas Health Insurance risk pool health coverage plans, which cover families whose income is high enough to exclude them from Medicaid, but at same time not high enough to buy private insurance. In act, the Texas Legislature also provides for two plans to provide health coverage to children between 0 to 19 years. These are the CHIP and children Medicaid program.
The aim of both these programs is to provide health coverage to children in terms of check-ups, immunization, preventive health care, labs tests and doctor visits.
By: Peter Emerson
Posts Tagged ‘Health Plans’
How To Choose Good Health Insurance
March 4th, 2010
In this day and time, not having health insurance might one day lead to the decimation of lifetime savings. Many people receive health insurance through their employer, therefore they usually have just a few choices between plans, such as an HMO or PPO. Others, like those who are self-employed, might need to purchase a health plan on their own, so they will have to do some research before selecting a plan.
If you are among those who have to decide which health insurance is the best for your circumstances, consider the following:
1) Your current health care needs and medical expenses
2) Medical needs and expenses of your family members
3) Medical services that are most important to you
When looking at health plans, compare benefits, monthly premiums, deductibles, co-pays, coverage for physicals and immunizations, preventive care, etc. Depending on your family’s present and long-term needs, you might want to explore coverage for infertility, mental health services, or long-term care.
But don’t stop there. Learn how the plans you consider work:
1) Is your current health care provider in the network?
2) How much does it cost to see somebody out-of-network?
3) Are referrals needed to see a specialist?
4) What is the referral process?
5) How easy is it to get a referral?
6) What hospitals are in the network?
7) Are benefits limited to pre-existing conditions?
Decide what’s important to you. Do you want to be able to see the health care provider of your choice? Are you concerned with convenience of the clinic’s location, covered benefits, or meeting a monthly budget? While deciding which factors are essential to you, consider checking out the report card for America’s best health plans, as well as the recognized physician directory available online at: http://www.ncqa.org/tabid/60/Default.aspx
By: Ed Stein
