The Absence of the One-Size-Fits-All Health Insurance Plan
Everyday millions of Americans visit hospitals and medical clinics for everything from routine check-ups to serious illnesses. The costs associated with such visits can be tremendous. A simple annual physical can be a couple hundred dollars while extended hospital stays can reach the tens of thousands of dollars. New technological advances and scientific breakthroughs allow for better treatment options, whether it involves prescription medication or laser surgery. People are getting treated for ailments like ADHD and erectile dysfunction that years ago were not recognized as illnesses. It is no wonder that health insurance is a 1.2 trillion dollar industry. Without a health insurance plan only a handful of people would be able to afford medical care.
Each individual is different. Family structures vary. Physical need and financial status differs among households. To compensate for this, there are and array of health insurance plans available to the public. People should carefully explore all of these options to get the best value for their hard-earned money and to ensure that the health insurance plan they choose best suits their medical needs.
Point-of-Service health insurance plans are the most extensive plans available. The insurance policy holder pays a specified deductible and premium. He may choose any physician and any healthcare provider he would like for the same rate. In other words, the insurance company agrees to cover the same percentage of the medical bill, whether or not the services are performed by preferred healthcare provider recommended by the insurer. While the insured person has the most wide-ranging options of any health insurance plan, they also must pay a higher price for coverage.
There is another health insurance plan that allows individuals to choose treatment from any healthcare provider. It is called a Preferred Provider Organization policy. The only difference between a PPO and POS plan is that the insurance provider covers a greater percentage of medical expenses if services are obtained by a preferred healthcare provider. With the PPO health insurance plan comes a list of physicians and hospitals that are contracted by the insurance company. The most common agreement is that in-network providers assure nearly 80 percent of medical expenses will be covered by the insurance company. The same company will only cover approximately 50 percent of services performed by out-of-network providers.
Health Maintenance Organizations provide health insurance plans at a much lower monthly premium. It is great for cutting back the costs of medical insurance. However, the trade-off is that policy holders have fewer healthcare options. The insured individuals may only seek treatment from the list of contracted physicians and hospitals. If they visit any out-of-network facilities, they will have to cover the full cost themselves. The only exception is when and in-network physician refers a patient to an out-of-network provider. This usually occurs when a patient must be treated for a very serious illness and there are no in-network specialists available.
The health insurance plans listed above are the most common. However, there are some newer plans that are rising in popularity. These plans are designed to fit consumers’ specialized needs and demands.
Self-employed people and those who want more control of the money they contribute to medical expenses can get a Health Savings Account. With this type of account, one can save tax-free income to pay for current and future medical expenses. It is combined with a health insurance plan with a high deductible. The advantage is that the individual chooses how he will finance healthcare. Flexible Spending Accounts take pre-tax dollars and put them towards medical expenses that many traditional health insurance plans do not cover. These services include prescription eyewear, orthodontia, and dental services.
Some people do not have health insurance through their employer. Others are considered by private insurers to be too risky to cover because of serious medical conditions. These individuals should consider joining a High Risk Pool. This state-sanctioned, health insurance plan is funded by tax revenues and monthly premiums. Currently thirty-two states offer the program. However, some states have put a cap on the amount of applications they will accept due to insufficient government funding.
Long-term care insurance is one of the most neglected health insurance plans. The policy ensures coverage for medical care that lasts for extended periods of time. For example, young and old disabled individuals often need home-healthcare. Regular health insurance plans do not cover this type of treatment. It also does not cover nursing home or retirement home expenses. Long-term care insurance provides the financial assistance needed to cover this type of medical care. It prevents people from having to pay these expenses out-of-pocket.
Each plan has its own unique benefits and is designed to meet a specific type of need. There is a health insurance plan to fit any individual and any family.