HEALTH INSURANCE

Health insurance is the most in-demand insurance today. With hospital expenses rises to an alarming rate, it pays to have a good health insurance plan, especially if you have children.

Types of Insurance
There are four main types of health insurance.

HMOs
With a health maintenance organization, you pay a monthly or quarterly premium to cover all your medical services. Often, HMO will give you a wide range of benefits, including preventive care. You choose a primary care physician, who must be affiliated with your plan, Any other doctors you see must have a referral from your primary care physician. Most of the time, your HMO will require that you use its network of providers - doctors, labs, Xrays, hospitals, because that is how they keep costs down.

POS
A point-of-service plan lets you use a primary care physician to handle your care (like in an HMO), or you can control your care at the "point of service." When you need medical care, you have options, depending on your plan:
1. Go through your primary care physician, with HMO-like guidelines (i.e., usually just a copayment will be required).
2. Get care through a PPO provider and the services will be covered similarly (i.e., usually a copayment and coinsurance will be required).
3. You can get care from a provider outside of networks. These will be reimbursed according to out-of-network guidelines (i.e., usually a copayment and higher coinsurance charge will be required).

PPO
A preferred provider organization (PPO) allows you to see any doctor, any time. A PPO negotiates discounts with doctors, hospitals and other providers, who then become part of the PPO network. If you see a doctor within the network, you make a copayment, usually a small fixed fee like $20 and pay some coinsurance. When you visit a doctor out of network, your coverage is at lower levels..Perhaps only 70% of your expense is covered. One advantage of a PPO is you can see any doctor you want, including specialists, without a referral. Also, premiums are usually lower than indemnity plans because of the negotiated provider discounts.

Indemnity Plans
With this plan, you choose whatever doctor you want to see, and a claim is submitted to your insurance company for reimbursement. You will only be paid for "covered" medical expenses, provided in your benefits summary. Most procedures are covered under an indemnity plan. Often the coverage is 80/ 20, where the insurance pays 80% of the expense and you pay 20% (which is called co-insurance.) Many indemnity plans have deductibles, which means you must pay up to that amount before the insurer will start reimbursing you for your medical bills. Typically, there are out of pocket maximum fees, which after you reach that point, the insurer will pay your medical bills. Specialists who charge more than the allowed amount may require you to pay the difference.