Health Insurance Plans

Living without a good health plan is not a good idea especially if you have a family with little ones running around looking for trouble.  Regardless of your employment status be it employed, self-employed or un-employed, having affordable health care coverage is critical in this day and age. Benefits and costs vary so much that you will not find one plan to fit all needs.  Health care coverage plans will vary depending on individual factors such as age, existing/pre-existing medical conditions, etc.  Shopping for good health insurance is like shopping for a car … know the coverage that best fits your needs … examine each health care plan and ultimate go for what you feel is right.

Searching the internet for affordable health insurance will yield many results, but finding the right one to meet your needs can be difficult.  Health insurance in many cases is similar to a contract between you and the health care insurance provider.  The contract/policy will ensure your medical bills are covered to some degree in the event you visit a doctor for any reason.  This includes a medical specialist, hospitalizations and various types of therapies including chemo.  Each contract/policy is littered with a bunch of rules and regulations so read carefully.

Two major types of insurance coverage follows:

• HMOs which stands for Health Maintenance Organizations.  HMOs can offer great savings to their members needing coverage for doctors, specialists and hospital stays.  HMOs provide in-network coverage meaning you must choose a doctor and/or specialist in their list of approved health care providers.

A major advantage to HMOs is that you do not have to pay any major up-front costs.  You may need to submit a minor co-pay but this is very reasonable considering the alternatives.  In addition, HMOs are typically cheaper and you will not need to wade through a bunch of paperwork.

A major disadvantage is that you must visit health care providers in their network of approved care providers.  In addition, HMOs tend to disapprove some treatments typically accepted by other plans.  If you want to visit a doctor out of network, not a huge problem but know that you will pay much more for their services.

• PPOs which stand for Preferred Provider Organizations.  This is where the insurance companies leverage buying power.  The buying power relates to the number of clients the given health insurance company has signed.  PPO is a form a managed care with a known group of doctors, specialists and hospitals.  Each group signs a contract with the insurance provider stating they will offer services at reduced rates.  Although PPOs are more costly compared to HMOs, they tend to offer more options.

A major advantage to PPOs is that they offer much more flexibility.  If you are in a PPO, you will have a larger network of medical professionals to service your needs.  Typically, you make the call regarding what specialists to visit.  The specialists does not have to in network although you pay a bit more for their services.  Unlike HMOs, a referral to a specialist if needed is not required.

A major disadvantage to PPOs is that they cost more than HMOs.  I had HMOs for years and loved them and then I was forced to select a PPO provider.  Now I see the difference.  In the end, choose the plan that is right for you.