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US Five Basic Types of HI plans

US Five Basic Types of HI plans

There are so many Health Insurance (HI) out there that you can choose from. You might get yourself a bit confused because they offer so many health benefits especially when you ought to talk to Insurance brokers in which their main goal is to sell the insurance in charge to them. You may think of buying all health insurance out there for you to have help on any health problems you might encounter but that would be impractical as these health insurances are costly. What you have to do is to find the one that will suit you best considering health issues of the past and possible health problems in the future. With this, you may have to consider the five basic types of health insurance plans.

  • Managed care plans are health insurance plans that have a contract with health care providers and medical facilities to provide medical care at special prices (lower costs). These providers form the plan’s network. The network will have rules, which stipulate how much of the care the plan will pay for. Normally if you consulted to a doctor not under the network, the health insurance will have no obligation or will cover less to the overall coverage.
  • Indemnity Plans do not pay for all of the medical and surgical services. They typically pay for at least 80% of the customary and usual costs, while the insured is liable for the remaining 20 or so percent. The insured is also liable for any excess charges. On the good side, insured can choose any doctor he/she wants. The doctor, hospital or the insured submits a claim for reimbursement to the health insurance company. Also, be keen in looking for some terms that are involved under these plans such as deductibles, out of pocket money, and lifetime charges.
  • Health Maintenance Organizations (HMO) deliver care directly to the insured. They are the cheapest among the health care insurance plans. The insured goes directly to an HMO’s medical provider to see health care professionals. The insured does not pay for each individual service that is received. A set premium is paid to the HMO, which in return offers a range of services, including preventive care. A primary care physician (general practitioner, GP, or family doctor), who is affiliated with the insured’s plan usually coordinates the care.
  • Preferred Provider Organization (PPO) is in many ways similar to an indemnity plan. The insured can see any doctor whenever they like. The Preferred Provider Organization gets together with health care providers, health professionals and laboratories and negotiates preferential prices. The providers that come to agreed deals with the PPO then become part of its network. In short, they make a deal with the doctors you want and make them part of their network and agree with a certain fee for them to cover.
  • Point of Service Plan (POS) is like a combination of HMO and PPO. The insured can chose to either have a general practitioner coordinate their care, or opt to go directly to the “point-of-service”.

Health Insurance is now a requirement for all people in the US. It is done to benefit its people in assessing their health needs. This is not to burden people on paying premiums. In availing, what you should do is to know all necessary facts before availing a certain insurance plan. Read their policy and coverage and find out what really suits your health needs.

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