Health Insurance Coverage

Finding the right health insurance coverage for you and your family is important because it will determine the doctors you can have, the costs you'll have to pay, and the process you'll have to go through in order to receive certain types of treatment. For this reason, you need to understand the options that are available to you.

Health Insurance Coverage Option 1: PPOs

PPOs (Preferred Provider Organizations) allow you to go to the doctor of your choice, but you may end up paying more out-of-pocket for doctors who are not part of the provider's network. For example, if you see a family physician in the network, you may only have to cover a co-payment of $10 to $20. On the other hand, if you visit a doctor outside of the network, you may end up paying 50% or more of the total bill yourself.

PPOs also have a deductible that you must meet before they will begin paying your medical expenses. The co-payments count towards your deductible. Once the deductible is met, you will still have to pay a portion of your medical expenses based on the provisions of your plan. For instance, many plans split the costs so you cover 10 or 20% of the expenses while the insurance picks up the other 80 to 90%. You can find more information about PPOs at the American Association of Preferred Provider Organizations' web site.

Health Insurance Coverage Option 2: HMOs

HMOs (Health Maintenance Organizations) are often a more affordable heath insurance coverage option but you sacrifice flexibility for added savings. HMOs work with only a small number of medical professionals, and you must use those professionals if you want the costs to be covered by your insurance. Additionally, you must select a primary care physician from the network. For any medical problem you have, this physician is your first contact. He or she will then have to refer you to another professional in your HMO network before your insurance will cover the costs.

On the positive side, HMOs don't require you to fill out paperwork regarding your insurance claims. Plus, you don't have to worry about deductibles or splitting your medical costs with the provider either. The majority of HMOs do not contain either of these provisions. However, most HMO health insurance coverage does require you to make co-payments which are generally $10 to $20 per visit. You can learn more HMOs by visiting the New York Consumer Guide to HMOs.

Other Health Insurance Coverage Options

If you're between health insurance programs or are unsure of what type of program to choose, you may want to opt for temporary health insurance.

Health Insurance Coverage Resources and References

Individual health insurance options vary by state and provider.
U. S. Department of Labor's web site contains an article full of helpful tips you can regardless of the the type of health insurance coverage you choose: "Top 10 Ways to Make Your Health Benefits Work for You"
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