It's a fact of life — you need health insurance — and the time to get it is before you have an accident, suffer a serious illness, or discover you're pregnant. Insurance doesn't cover health care for medical problems or conditions that start before the moment you have your policy. Finding adequate coverage might seem overwhelming, but knowing the basics can help make your search less stressful.
Types of Coverage:
Fee-for-Service (or Indemnity) Plans
With this traditional plan, you can make an appointment with almost any medical provider. After your visit, you or your provider sends your claim to the insurance company. If you have met your deductible for the year, then the Fee-for-Service plan will pay a percentage of the bill – usually 80%. You pay for the other 20%, known as coinsurance. Few purchase this traditional type of plan. Why? Because it's expensive.
Managed Care:
This term refers to types of health insurance plans that provide health care services at a lower cost. The key to these lower costs? Members of managed care plans must adhere to certain rules designed to lower the cost of medical care.
Types of Managed Care:
HMO: HMO stands for Health Maintenance Organization. An HMO provides comprehensive health care by network physicians to enrolled individuals and families in a particular geographic area. It is financed by fixed periodic payments determined in advance. In an HMO, you need to access care through a designated Personal Physician.
PPO: PPO stands for Preferred Provider Organization. Blue Shield PPO plan members receive full coverage by using doctors and hospitals within the PPO network, or they can pay more to have the freedom to go outside of the network for care. In our PPO plans, contracted doctors and hospitals are called preferred providers.
Health Savings Account
Health Savings Accounts (HSAs) are a relatively new way for Americans to pay for their healthcare. Like an IRA, the money deposited into an HSA is completely tax-deductible. These accounts, however, can be accessed whenever individuals need them to pay for qualified healthcare expenses. In the meantime, their money earns tax-free interest for future medical costs.
CA Insurance License # 0B19732. AZ Insurance License # 878475. NV Insurance License # 206285.
