Health Insurance 101

Everyone understands the importance of health insurance; there are many types of health insurance making it more confusing which coverage is the best option for you and your family.  Let’s look at the various types of health insurance policies.

HMO

The first type we will go over is an HMO.  An HMO is a health maintenance organization plan that works with a specified group of doctors and hospitals within the network.  You must select a primary healthcare physician is selected and you must obtain referrals to see a specialist for care that cannot be provided by that physician.  Some benefits of this type of plan are lower office visit costs and premiums as well as prescription drug co-pays.  Additionally, there may be either no or limited deductible costs for hospital stays.  With Obamacare plans, there are no pre-existing conditions.  Be aware that your choice of doctors and hospitals will be limited with an HMO and if you see doctors outside of your network services covered may not be approved and will cost you more.

PPO / POS

A PPO or Preferred Provider Organization works like an HMO; however, the major difference is that you are not required to select a primary care physician.  In addition to the benefit of being free to choose your own physician without worrying about a referral you also gain the benefit of limited or no deductible costs for hospital stays.  You also have a larger selection of physicians available than with an HMO.  Out of network services may also be covered; however, for a higher charge than in network services.

A POS, or Point of Service, is also like an HMO in that you select a primary care physician. The difference is that you are free to choose out of network treatment if you’re willing to pay a higher out of pocket cost.

Additional Options

Another option is what is known as a traditional coverage policy. This type of policy will have a higher monthly premium as well as deductibles. In addition, you will generally be required to pay for services out of your own pocket up front and then submit claim reimbursement forms.

You may also wish to consider various types of disability plans, which cover a percentage of your income if you experience an illness or accident that prevents you from working for a period.  A short-term disability plan will provide benefits from the first day of an accident or the eighth day of an illness up to 26 weeks. Generally, this type of plan will cover 66% of your weekly income.

Long term disability will begin after short term coverage has expired and will provide coverage for a variable term, depending on the policy you select. Some policies are limited to providing coverage up to two years while others will cover you up to the age of 65.

Contact me for all your health insurance needs.  I will find you a suitable plan based on your needs and budget.