The following information helps explain what health insurance is and how to find the right coverage. A no obligation appointment can be arranged to discuss this information in complete detail
Health insurance helps you pay for certain medical services and sometimes includes prescription drug coverage. Once you buy insurance coverage, you and your health insurer each agree to pay a part of your medical expenses. These amounts are usually a certain dollar amount or percentage of the expenses.
You can have health insurance coverage through the following:
- a group coverage plan at your job or your spouse/partner’s job
- your parents’ insurance plan, if you are under 26 years old
- government programs such as Medicare, Medicaid, or Children’s Health Insurance Program (CHIP)
- Veteran’s Administration or TRICARE for military personnel
- your state, if it provides a health insurance plan
- you purchase on your own from a health insurance company or through the Health Insurance Marketplace
- Continuing Employer coverage from your former employer, on a temporary basis under the Consolidated Omnibus Budget Reconciliation Act (COBRA)
Types of Health Insurance Plans
When buying health insurance, your choices usually fall into one of three categories:
- Traditional fee-for-service health insurance plans are usually the most expensive choice, but they offer you the most flexibility in choosing health care providers.
- Health maintenance organizations (HMOs) offer lower co-payments and cover the costs of more preventive care, but your choice of health care providers is limited.
- Preferred provider organizations (PPOs) offer lower co-payments like HMOs but give you more flexibility in selecting a provider.
Choosing a Health Insurance Plan
When deciding among different health care plans, you will need to read the full policy and ask a lot of questions, such as:
- Do I have the right to go to any doctor, hospital, clinic, or pharmacy I choose?
- Are specialists such as eye doctors and dentists covered?
- Does the plan cover special conditions or treatments such as pregnancy, psychiatric care, and physical therapy?
- Does the plan cover home care or nursing home care?
- Will the plan cover all medications my doctor may prescribe?
- What are the deductibles? Are there any co-payments? Deductibles are the amount you must pay before your insurance company will pay a claim. These differ from co-payments, which are the amount of money you pay when you receive medical services or a prescription.
- What is the most I will have to pay out of my own pocket to cover expenses?
- If there is a dispute about a bill or service, how is it handled?