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In
this guide-
+
What types of health insurance plans are available?
+ What about short-term and catastrophic health insurance?
+ How to choose the best health insurance plan for me?
Health
insurance background
Health care and health insurance is a major political,
economic and social issue in America today. The costs
of health care continue to rise and companies and individuals
struggle to keep up with the rising costs. Many millions
of Americans simply cannot afford any sort of health care,
and are at risk to injuries and disease. This site was
designed to give you a basic understanding of how health
insurance works so that you know what to look for when
searching for health insurance for you and your family.
What
types of health insurance plans are available?
There are essentially two kinds of heath insurance - Indemnity/Fee-for-Service
and Managed Care. Although these plans differ, they both
cover an array of medical, surgical and hospital expenses.
Most cover prescription drugs and some also offer dental
coverage.
Indemnity/Fee-for-Service
Up until about 30 years ago, most people had traditional
indemnity coverage (these days, it's often known as fee-for-service).
Indemnity plans are a bit like auto insurance: you pay
a certain amount of your medical expenses up front in
the form of a deductible and afterward the insurance company
pays the majority of the bill. Under this type of health
coverage, you have almost complete autonomy when it comes
to choosing doctors, hospitals and other health care providers.
You can refer yourself to any specialist without getting
permission, and the insurance company doesn't get to decide
whether the visit was necessary.
On
the down side, fee-for-service plans usually involve more
out-of-pocket expenses. Often there is a deductible, usually
between $200-$1,000, before the insurance company starts
paying. Once you've paid the deductible, the insurer will
kick in about 80 percent of any doctor bills. Fee-for-service
plans often include a ceiling for out-of-pocket expenses,
after which the insurance company will pay 100 percent
of any costs. You may have to pay up front and then submit
the bill for reimbursement, or your provider may bill
your insurer directly. Under fee-for-service plans, insurers
will usually only pay for reasonable and customary medical
expenses, taking into account what other practitioners
in the area charge for similar services. If your doctor
happens to charge more than what the insurance company
considers reasonable and customary, you'll probably have
to make up the difference yourself. Traditionally, preventive
care services like annual check-ups and pelvic exams have
not been covered under fee-for-service plans. But as the
evidence mounts that preventive care
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