Health Insurance

HEALTH INSURANCE
What is the most coveted possession of any individual? Is it his ability, intelligence, innovation or the single most asset-Health that enables him to use all other that he has. Health is undoubtedly the biggest and most crucial asset of any or every living being. Health encourages efforts, health motivates mind, and health grants you enjoyment. It is the wealth of health that gives the requisite potential to battle all odds and move ahead with life. Naturally, such an essential part of a person’s life needs special care and protection. The ideal way to secure an individual’s prized possession for him and his loved ones is Health Insurance.
Health insurance has the insurer and the insured playing their part like any other insurance. The insured pays premium to protect his health and the insurer is obliged to meet the expenses if the insured falls sick. However, certain diseases are not covered by health insurance which of course will be listed in the insurance document. Medical services, dental expenses, diagnostic expenses, surgeries, disabilities coverage are what are termed together as health insurance. The insurer bears all health expenses as long as the insured renews his policy by paying the premium. In simple, a health insurance policy is for financially assisting a person in case there occurs a setback to his health.

How to choose the right Health insurance plan?

So which insurance policy should you select? Unfortunate but obvious is that there is no black and white answer to this. As there exist innumerable plans with relatively more confusing benefits and risk factors attached to them, one has to be wise in choosing the right health insurance plan. Each person has his own little nuances and so no "one size fits all" health insurance plans available. Depending on the needs and demands of each individual there are several aspects to consider. Clear knowledge about company and plan, the credibility and service of the company, the precise benefits and risk factors, cost affordability etc., have to be thoroughly examined before you choose one.
What shall I look into?

To pick wisely from a plethora of benefits and plans exist, one has to clearly examine amount of Premium per term or per annum, Home care, medical bills, post-treatment care, Limit on the number of days on coverage or ceiling on amount, Coverage on ailment you have, Diseases not covered, contribution from your own pocket, Freedom of choosing the hospital/doctor of your choice, Health insurance cover during travel/outstation, and upgradation.
One has to understand that insurance has a lot of intricacies for a common man who is not acquainted with it. However, it is very important as the time and efforts spend now on analyzing health insurance may save your money and life some day.

How different are they?

No specific health care plan is better than the other. It all depends on your needs and preferences. Each the autonomy offered by fee-for-service plans, the low costs associated with closed-panel HMOs. The competition for business among insurers will soon fade distinctions among the types of plans.
•Traditional indemnity plans or Fee-for-service plans; • Preferred Provider Organizations [PPO]; •Point-Of-Service plans [POS]; •Health Maintenance Organizations [HMO] •Traditional Health Insurance
Till the recent past, most people had traditional indemnity coverage; now-a-days, known as "fee-for-service." This means the insured pays an up front payment towards medical expenditure, afterward the insurance company pays the majority of the bill.
Fee-for-service
After an initial payment of out-of-pocket expenses up to a ceiling, the insurance company will pay 100 percent of the medical expenditure incurred. The ceiling of course is usually pretty high. In simple, fee-for-service offers flexibility in exchange for higher out-of-pocket expenses.
Managed care, though an old one, became popular for the 3 basic types of managed care. As it grew, it evolved and emerged as a preferred plan. Today, the majority of people with private health insurance have some type of managed care.
Health Maintenance Organizations (HMOs)
A HMO is a health maintenance organization plan that works with a select group of doctors and hospitals within the network.
A primary healthcare physician is selected and for care that cannot be provided by that physician, you must obtain referrals. Lower office visit costs and prescription drug co-pays are the benefits of this plan. In addition, either no or limited deductible costs for hospital stays also can be availed. Depending on your coverage, there may also be no pre-existing condition cause limitations. It is also important to note that your choice of doctors and hospitals is limited with a HMO and you can’t have out of network services covered.
Preferred Provider Organizations (PPOs)
An advanced or extended managed care is the Preferred Provider Organization. With an established network of health care providers, PPOs made lower fees possible for the insured and it also gives a financial incentive for staying within the network.
An advantage with a PPO is that you can meet a specialist without getting approval and enjoy the same co-pay, so long as it's an in-network provider. Staying within the network means less out-of pocket expenditure and fewer formalities. Point to note is that preventive care services are not covered under a PPO. Exclusive Provider Organizations are PPOs that are similar to HMOs. EPOs raise the financial stakes. However, we should note that the insured alone is responsible for the entire cost of the visit for choosing a provider outside the network.
Point-of-Service Plans (POS)
Many HMOs offer an indemnity-type plan called a POS plan. The primary care doctors in a POS plan usually refer to other providers in the plan. The advantage with a POS plan is members can refer themselves outside the plan and still get the required coverage.
In case of a referral out of the network by the physician, the plan is designed to pay all or most of the bill. On the other hand, if the referral is by yourself to a provider outside the network and the service is covered by the plan, you will have to pay some premium towards coinsurance.
So, sit back and relax. Health insurance saves you from the huge medical bills. Health insurance helps us overcome all future dilemmas on thinking of how to pay the hospital bills. In the world where medical costs have been increasing alarmingly, our efforts of never compromising on the quality of medical attention; Health insurance thus is a financial risk management tool for peace and healthy living.