There is a lot said about health care these days. With costs rising and no end in sight, there is a bigger need than ever for everyone to have the coverage of a health care plan. Health care plans are basically like insurance that helps you cover medical costs. Like any insurance, they are sometimes difficult to understand.
There are many types of health care plans available. Each type breaks down into two basic groups: group or individual. Group plans are the least expensive option. They are provided through an employer. Individual plans are offered through private companies and can cost much more than group plans because there are no group discounts to the provider. Within each group, there are a few different types of health care plans.
Fee for service plans are the most common and traditional forms of health care coverage. With a fee service, the covered individual gets many choices of doctors and hospitals. The insurance provider pays for a portion of your costs while you pay a fee. You pay both a monthly fee for coverage and fees based on the care you receive. Many times there is a deductible that must be met before the insurance provider pays anything. Most plans also have a maximum amount you will pay out of pocket. Once this figure is reached your costs are covered 100%.
Health maintenance organizations or HMOs are another type of health care plan. HMO’s charge a monthly fee. You are required to use certain doctors who are signed up with the HMO. You pay a fee for any costs you incur called a co-payment. The total costs of any medical care are negotiated between the doctor and the HMO so the costs are lower.
Preferred provider organizations or PPO’s are a combination of the fee-based plan and an HMO. There are limits on the doctors and hospitals you can choose, you make a co-payment for each service and you may have a deductible. You can, however, use a doctor that is not part of the PPO. You will still get coverage but you may end up paying a larger fee.
There are other forms of health care plans. The government offers two plans: Medicare and Medicaid. Medicare is a plan for people over age 65 or disabled. The coverage provided by Medicare often changes and can be confusing. There are different types of Medicaid. There is a free type and a fee-based type. Medicaid is another government offered plan. It is based on income. With Medicaid, all of your expenses are covered. New changes have made it so some care requires a very small fee. There are also variations in Medicaid. To find out information a person should contact their local government human services agency.
Health care plans can be very confusing. Talking with your provider will help ensure you completely understand how your plan works and what coverage is provided.