The Types of Health Insurance can be divided in two main categories.
1st is the Traditional and 2nd is the Managed Care.
Among these two categories there are four fundamental types of Health Insurance Plans
- Free for service plan (Traditional indemnity plans)
1. Basic Medical
2. Major Medical
- Preferred Provider Organizations(PPO)
- Point-Of-Service plans (POS)
- Health Maintenance Organizations (HMOs)
Health Insurance Plans has all that flexibilities that one can expect. It has low cost plans that a middle class person can afford, there is a fee-for-service plan that offers some kind of freedom that every one wants during Health Insurance Cover. There are also plans that help you in your business. Let we know and understand about this Health Insurance Plans in Detail.
Free for service plan (Traditional indemnity plans)
Before 30 years, The Free for service plan was known as Traditional Indemnity plan. At that time most of People had bought this coverage and today also it is very popular. In this type of Health Insurance Plan, Insurance Company pays expenses of the policy holder. Policy holder or buyer has the option to choose any of recommended hospital and Doctors independently for their treatment. You can also consult any specialist without any getting any prior permission to the Health Insurance Company. Free for service plan offers this facility in some selected hospitals only.
Policy buyer has to pay some money to the Health Insurance Company before the Insurance compensation getting started. This amount is called as “Deductible” and “Out of pocket Expenses”. The amount of Deductibility is about $220 to $260 per person. And remember that your deductible amount is not counted for all your health expenses.
Once you had paid your Out of pocket expenses only then your policy will be activate and use the facility of sharing your Health expenses with your Health Insurance Company. This Facility is depends on for which duration you had paid your Deductible amount, if you had paid for a year then Health Insurance Company will give this facility for a year. Normally Health Insurance Company pays 80% of Health expenses of the Policy Holder’s total Health Expense Bill. The remained 20% is pays by Policy Holder; this remaining amount is also called as “Coinsurance”.
After you have paid your deductible amount for the year, you share the bill with the insurance company. For example, you might pay 20 percent while the insurer pays 80 percent. If you pay out of pocket expenses as per your Insurance Company than some Health Insurance Company pays 100% of your Health Expenses. This is the main reason that, this Health Insurance Policy is very popular and people like it very much.
At the time of getting payment, you have to fill some forms which the Health Insurance Company had given. With this form attach some required some documents like Hospital Bill, Medicine bills ect. Without this documents company will not give you payment and its your responsibility to keep that document.
Two Types of Free-for-service
1. Basic Medical
Basic Medical plan covers the basic cost, when you are hospitalized. It cover up general services of hospital, like X-ray, Laboratory tests, therapy, Surgery, medicines.
2. Major Medical
Major Medical plan covers all the benefits that the Basic Medical gives. Additionally it gives protection against all that illness and surgeries which is high expensed.
Managed Care
Managed care term is very popular in US. This plan is admitted in the Insurance Industries since 1930s. But it starts growing in last 11 to 12 years. There are lots of similarities between the Managed care plan and almost all other plans. The Managed Care policy holder should take an approval before admitted in to any hospital. If Policy Holder admits without taking any approval, then the Health Insurance Company has the right to not cover this Policy Holder’s bill. Policy Holder must select a Hospital for treatment from Health Insurance Company’s Network.
Health Maintenance Organization (HMOs)
HMO, Health Maintenance Organizations offers the complete care of you and your family. It is a kind of prepaid plan. HMO is a low lasted plan with limited flexibility Health Insurance. Less flexibility means there is a limited option to choice any Doctor or Hospital. In Case of any emergency before you admit for treatment you have to inform the insurance company, without getting clearance Insurance Company will not support. Although it provides you better services like X-Ray, Doctor-visit, Surgery, and Medical Test.
In this plan, the process of getting claim amount is very easy. If you have followed instruction as per your Insurance Company then there is less paper work and process that you do. Hospitals, Doctors and Insurance Company work together that why it is process.
The HMOs is cheaper than the Free-for-service. There is very low co-payment for their services. For doctor visit they charge approximately $5 and for Emergency charges about $20. It means that the charges of any HMOs is normal than the free-for-service plan.
The HMO is cheaper than the free-for-service health Insurance plan but it will take more time for meeting than the free-for-service. For Medical service like hospital stay and office visit there is no need of claim forms, in its place they use member cards. This member card is same like as debit or credit card. This facilities make HMO friendly.
Point of Service Plan(POS)
POS, the short form of Point of Service plans. This plan is same like as PPOs Preferred Provider Organization. In this Health Insurance Plan you have to choose Doctor and Hospital from Health Insurance Company’s network. In Case of getting transfer to any Specialist, you still go through your Primary Care Physician. And if you don’t do that process then you will get less financial support from your Health Insurance Company. But you follow Insurance Company’s Rules and Regulations then there is minimal paperwork and less repayment.
Point of Service plan will give you more services like Medical check-up Camps, Smoking ending programmers they will also gives you discount coupons of some health equipment stores and health clubs.
Preferred Provider Organization(PPOs)
The Preferred Provider Organization PPOs has mixed qualities of HMOs and free for service plan. This Health Insurance plan is a low cost Health Insurance plan, you should pay less fees. As Per HMOs there is a limited network of Doctors and Hospitals to select for Medical treatment. If you select a Doctor or Hospital for Medical treatment you have to pay very less amount from your pocket.
In PPO, there is no need to getting an approval to refer you to any specialist. But it is possible in Insurance Company’s network. Sometimes you have to pay a small amount as deductibility and Coinsurance for Doctor Visits. It is profitable for you to not to break any conditions of your Health Insurance Company. But if you broke it, then you will not get the benefit of paying less from your pocket, less paperwork and many other benefits.
Before you made up your mind to buy any Health Insurance Policy, it is good and safe to talk or discuss with the people who are already bought that type of Health Insurance Policy.
