Health Insurance Guide
So much information, so little time...
HealthInsurance.com understands busy schedules. With that in mind, here is a no-frills,
easy-access guide to health insurance.
Understanding Health Insurance
No single plan will cover all costs associated with medical care...but some cover more
than others. Want to unlock the difference between plans? Here's your key...
Types of Coverage: Fee-for-Service (or Indemnity) Plans
With this traditional plan, you generally pick any medical provider you want to see, and
then make an appointment. 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." Many employers do not offer this traditional type of
plan. Why? Because it's expensive to both employers and employees.
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 plan rules, designed to lower the cost of medical care.
Types of Managed Care: Health Maintenance Organizations or HMOs
With an HMO, you receive a range of health benefits for a set fee. Generally, there are no
deductibles – but most plans require a small co-payment per office visit (around
$10-25). You must choose a primary care physician from the plan's list. This doctor
becomes your "gatekeeper" for all your medical needs. This is the doctor you
call or see when you are sick, and the one responsible for referring you to a specialist
and other providers within the HMO network. With most HMOs you will not receive benefits
if you go out-of-network, except for emergency care.
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