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Guide To Understanding Health Insurance

A guide to understanding health insurance is a valuable tool to have when looking to insure yourself and your family. Anytime you can put more knowledge on your side, you will inevitably make better decisions. Read on to learn how to find the best health insurance plan for you and your loved ones.

It takes very little time to review guides to understanding health insurance but it could make the difference between good coverage and bad coverage, and it could mean big savings for you.  So sit down comfortably and get started with this guide to understanding health insurance so you are armed with knowledge because knowledge is power.

When you are finished reading our quick and easy guide to finding cheap health insurance then use our free quote finder to compare health insurance rates from top companies. Simply enter your information in one time and then view offers from top insurance companies and agents side by side online.

Guide To Understanding Health Insurance Terminology

There are innumerable terms that health insurers like to use when giving quotes or just answering questions. It is imperative that you know what these terms mean or you may make some serious health insurance errors. Some common terms are below.

Deductible: the yearly amount of money the insured must pay before health insurance pays for 100% of health care costs (or the coinsurance amount up until the out of pocket maximum or stop loss limit specified in the policy).

Co-insurance: the percentage of costs the insured must bear after the annual deductible on a policy has been met. It is usually about 20% (example: 80/20 coinsurance means that the insurance company pays 80% of the bill for covered expenses and the insured pays 20%).

Co-payment: the amount an insured must pay every time he or she visits a healthcare provider for service.

Providers: anyone or any organization who provides healthcare services.

In-network/out-of-network: refers to whether providers and services have an agreement with the insurer. In-network providers have an agreement to offer services at a certain price to individuals who are insured by the company. Out-of-network providers are anyone else who provides healthcare. Out-of-network costs may be covered by certain plans at a reduced percentage or not at all.

Eligible expenses: anything that the insurance company is willing to pay for. Also referred to as “covered expenses”. They are spelled out in your health insurance plan and typically include doctors, hospitals, laboratory fees, physical and occupational therapy and much more. Limitations like networks and such also determine whether or not certain provider’s services are eligible or not.

Guide To Understanding Health Insurance Plans

There are numerous health insurance plans available. The most common ones are as follows.

Health Maintenance Organization (HMO) – An HMO gives you a list of providers to choose from. You must select a primary care physician (PCP) who will oversee your healthcare and provide referrals to any specialists you want or need to see. Coverage outside the network is not covered.

Preferred Provider Organization (PPO) -  PPOs are very popular because they provide greater flexibility. Like HMOs, they provide a list of preferred providers. If you decide to get healthcare from someone who is not on the provided list, the cost will still be covered, but your co-insurance will be higher. For example, you may need to pay 30% of the costs instead of 20%.

Point of Service (POS) – This type of plan is a combination of both HMO and PPO. In it, you get a list of preferred providers and it is strongly suggested that you get a primary care physician however if you need to go to the emergency room or get urgent care, you do not need to seek pre-approval.

Fee-for-Service – This is the traditional type of plan and the most expensive one available. There are no networks to choose from. When you get healthcare, you choose who you use, submit the receipts and get reimbursed. There is no worry with preferred providers and referrals.

Guide To Understanding Health Insurance Extras

Each company offers something slightly different. There are many things that are now offered that may be interesting to those looking for health insurance.

Health Savings Accounts (HSAs) – This system allows you to put pre-tax earnings into a special account that you can use for co-pays, deductibles, drugs and even some over-the-counter expenses. All money contributed into the account allows the taxpayer an “above the line” tax deduction (up to IRS limits), the money in the accounts grows tax free, and the money in the account can be withdrawn tax free (as long as the money is used for qualified medical expenses [if the account holder is age 65 or older then the money can be used for any purpose]).

Discount Plans: Many insurers now offer these. It is a card that gets you discounts with specific healthcare providers. It is a great way to save money and is usually free of charge to plan members. It will definitely help if you don’t have dental or vision coverage but should not be relied upon in lieu of a full comprehensive major medical health insurance plan. Discount cards and discount plans should be utilized as a supplemental resource only.

Health and Fitness Education: Insurers recognize the value of having healthy people on their plans. Therefore, they offer education on health and fitness. They also often offer discounts for weight loss programs and other healthy living options.

Guide To Understanding Health Insurance: Getting Quotes

Now that you have gotten the latest guide to understanding health insurance, you are well prepared to get quotes and feel comfortable comparing them.

Use our free quote tool to compare plans, rates, and quotes from competing insurance companies online.

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