Tuesday, September 27, 2011

What is Health Insurance?

26 Mar

Posted by: Cobra Help Center in: Health Insurance

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Health insurance gives assistance with paying medical bills for various health procedures, including surgeries and routine exams. Medical insurance can also aid in acquiring medical aids, such as wheelchairs, medications and a variety of health monitors. Insurance, by definition, is the avoidance of a unknown catastrophic loss for a known gain. In practice, you pay a insurance carrier a fixed premium for the assurance that if the worst should happen (Ex. A health condition that may cost thousands or tens of thousands of dollars), you are covered from a severe financial problem.

There are several types of health plans and it can seem daunting at first. An indemnity plan is the type of plan that is most flexible to meet a person’s needs. With this type of plan, you’re able to choose your own doctor and are able to see a specialist without needing to get a referral from your primary doctor.

A health maintenance organization, or a HMO plan, will cover your expenses if you go to a doctor or health care service that is within the company’s  organization. With an HMO, a recommendation from your primary doctor is needed to see a specialist. Patients must get approval from the HMO in order to go into a hospital or to receive any health care that is not an emergency.

Medical insurance provided by a preferred provider plan, or PPO, is less flexible than a traditional plan but more so than an HMO. You can see any doctor and specialist you’d like, but co-payments may be higher if the doctor is not a preferred provider. A PPO requires approval for hospital entrance, but they are more likely to file medical claims for you.

Health insurance given through a point of service plan, or POS, is akin to a HMO plan in that the doctors you are able to see are part of the service’s network. Some services with a POS are not available such as organ transplants, prescription drugs, mental health services and infertility treatments.

An exclusive provider plan, or EPO, is like an HMO however it is coordinated by the Department of Insurance. This type of insurance only covers expenses if the doctors are included in the network of the EPO.

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