Health Insurance 101:
Getting Educated About Health Insurance

Getting as much information as possible about health insurance before you purchase a health insurance plan is absolutely the best way to ensure the most affordable health insurance premium. Read on and we will shed some light on many of the tough questions about health insurance.

What different types of managed care are available?

• Preferred Provider Organization (PPO): If you choose a PPO, you will have access to a hugh network of health care specialists. However, you will more than likely be required to choose a health care provider from within your network to get the best level of coverage. If you use a non-network health care provider then will you usually pay more for the same types of services. One exception is in the event of an emergency. Most PPO health plans allow for out-of-network coverage at the same level as using an in-network provider in the event of an emergency situation.
  
  
• Health Maintenance Organization (HMO): HMO health plans require co-payments to in-network physicians. However, an HMO will not pay for services you receive outside of the network. You are required to choose a primary care physician who will become the gatekeeper for your health care options. They must refer you to another doctor if you need specialty care.
  
  
• Point of Service (POS or Open Access HMO):This type of insurance plan allows you to use out-of-network services. But you will not be reimbursed for the entire cost of these services. The insurance company will usually only pay 50 to 80 percent of the cost.
  
  
  

What is an HSA?

HSA stands for "Health Savings Account". This is a type of bank account that is partnered with a High Deductible Health Plan (HDHP).

If you choose an HSA health plan , you have the opportunity to save money in a tax-sheltered savings account. When you get sick or you are injured, you can use this money to pay for your medical care. This money can also be used for other health related items suck as medications and vitamins. If the cost your health care services exceeds your HDHP deductible, the most HSA health plans will pay 100% of the ramining cost for your health care for the rest of the calander year. Your deductible usually resets at the beginning of each calendar year.

This is a great way to save money on health care because your monthly premium will be lower than a traditional health plan. However, if you have a health condition or partake in dangerous hobbies, you are probably better off with a traditional health insurance plan.

Premium, Deductible, Co-payment, Co-insurance, and Stop-Loss defined.

• Premium: The total monthly or annual amount that you pay for your health insurance policy.
  
  
• Deductible: The amount that you are required to pay before your health insurance plan begins to pay for anything toward your health care expenses.
  
  
• Co-payment: The amount that you are required to pay when you receive health care. This amount will vary depending on your health plan and whether or not you use an in-network provider.
  
  
• Co-insurance: After you have met your deductible, this is the percentage of the total cost of services that you are required to pay for your health care. The typical co-insurance amount is 20%. Co-insurance will usually have a stopping point (Stop-loss). The most common stopping point is $5000.
  
  
• Stop-loss: The point at which your health insurance plan starts to pay 100% for the cost of your health care.
  
  
  

What is a pre-existing condition?

A pre-existing condition is a health issue for which you were already being treated before appplying for a new health insurance plan. A pre-existing condition may or may not be covered by a new insurer. And you may be declined for health coverage all together for some pre-existing conditions. If you are approved for a health plan, a pre-existing health condition may be excluded entirely, however, many are covered after a specific amount of time. A few pre-existing conditions are covered from day one. If you have a pre-existing condition, this will no doubt raise the premium of your health insurance plan. The Health Insurance Privacy And Portability Act (HIPPA) guarantees coverage for pre-existing conditions if you are applying for new individual health insurance or a new private health plan. However there are limits; You must apply within eighteen months of having previous employer group coverage. Most employer group health plans allow for any pre-existing conditions.

Will my health insurance pay for my prescriptions?

You will have to pay a co-payment for prescriptions in most cases. Certain types of prescriptions may not be covered at all. Some example of such medications are oral contraceptives and hormone replacement medications. It is always best to opt for the generic version for your prescriptions, you will pay a significantly lower price for a comparable product. Many private or individual health insurance plans do not cover any cost toward your medications. However, in these instances, they do provide for signifigant discounts at the pharmacy.

Will my health insurance rates increase as I grow older?

It is a fact that an individuals risk for certain health conditions increases as they age. For example, women are more susceptible to breast cancer after the age of 40. Insurance underwriters take these statistics into consideration when determining health insurance rates. As health care technology increases certain types of conditions will no longer raise your health insurance rates.

How can I find the right health insurance at an affordable price?

Individual health insurance can be rather costly compared to having employer group coverage. This is because most employers pay for a part or in some instance all of your health insurance premium. If you are self-employed or your employer does not offer group coverage, your best bet is to shop around and compare health insurance quotes from multiple insurance companies. We suggest that you simply request multiple health insurance quotes from top insurance carriers by clicking here!