Health Insurance

What kinds of health insurance are there?
There are essentially two kinds of health insurance: 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.

1. Fee-for-Service
   these plans generally assume that the medical professional will be paid a fee for each service provided to the patient. Patients are seen by a doctor of their choice and the claim is filed by either the medical provider or the patient.
    
2. Managed Care
   more than half of all Americans have some kind of managed-care plan. Various plans work differently and can include: health maintenance organizations (HM0s), preferred provider organizations (PPOs) and point-of-service (POS) plans. These plans provide comprehensive health services to their members and offer financial incentives to patients who use the providers in the plan.

Managed Care is what most of us are accustomed to. They include a Co-Pay Plan with a deductible where there are low co-pays to the Doctors office with each visit and High Deductible Health Plans (HDHP) with or without the inclusion of a Health Savings Account (HSA). 

The Co-Pay Plan is very common but is not as affordable as it once was. Premiums are made on a monthly basis and Co-Pay is made at Point of Service (POS). Prescriptions can be included and are generally priced on a tiered level based on cost of the drug. This is still popular in many Group Plans and not as popular in Individual Health Plans due to no sharing of premium cost.

High Deductible Health Plans (HDHP's) have become more popular in recent years and I suspect that they will continue to be as Americans assume more responsibility for their own health care. HDHP's will typically have higher deductibles and lower premiums when compared to a Co-Pay Plan. There are laws stipulating the minimum and maximum deductible and participation by the insured within the plan based on the number of members on the plan. For healthy families the HDHP has much to offer. The premium savings can be put into a Health Savings Account (HSA) and left to grow and accumulate interest tax free. The savings in the HSA can be used for a very liberal list of medicines and for the deductible in time of need. The HSA savings can also be used for COBRA premiums. Many Insurance Companies will overlook some pre-existing conditions with higher deductible HDHP's allowing coverage that otherwise, might not be available.

It is always a good idea to consult an experienced, licensed agent to discuss any pre-existing conditions as they are all handled differently by the various companies. Assistance can prevent a "Decline" that has to be explained for years to come and raises flags with the underwriters.