Examining Potential Health Care Plans
With all of the different health care plans available, people may find themselves wondering what plan is best for them. A few simple tips can help people find a medical plan that suits them.
There are 3 major types of health care plans offered by insurers. These include:
- Consumer choice or consumer directed
- Fee for service
- Managed care
Consumer directed plans typically use an individual fund for each policy holder to pay for medical expenses. The policy holder will pay into their individual fund and medical expenses will be drawn from their fund. The money that isn’t spent ,will often rollover from year to year.
A fee for service plan compensates the medical company or provider each time their product or service is bought. Fee for services plans may also be labeled indemnity or traditional plans by some insurers.
Managed care plans attempt to encourage policy holders to use medical companies, products, or services in their network of providers. Policy holders may find it difficult to use an out of network medical provider without paying for the entire cost out of their own pocket. HMOs and PPOs are considered to be managed care plans.
Questions that potential health plan clients should consider might include:
- How much are co-pays?
- How much do prescription drugs cost?
- How many insurance claims are denied each year?
- How many patients drop out of the plan each year?
- Is there a coverage limit?
- What are the exclusions?
- What is the cost to see and use an out of network doctor?
- What products, services, and treatments are covered?
Examining the answers to these questions can help a person decide what medical plan is right for their needs.
For clients who have pre-existing medical conditions, finding a medical plan can be even more difficult. Clients with pre-existing medical conditions need to specifically look for their condition on the lists of insurers’ exclusions. Also examine the exclusions lists for any treatments related to their conditions, no matter how trivial.
Insurers may handle pre-existing medical conditions differently depending upon the policy. Some may restrict such clients to buying certain medical policies, while other insurers may put a coverage limit upon treatments related to the pre-existing condition. A few insurers may refuse to insure clients with certain kinds of pre-existing medical conditions at all because of the high expenses that can result.
For people with access to employer-sponsored health plans, these may be a better option than an individual plan. Employers can buy bulk plans, which allow the price per plan to be lower. An employer may also help pay some of the costs associated with a health plan, such as co-pays or premiums.
People who live in a rural area should investigate what doctors and specialists are in the insurer’s network. Some networks may only consist of doctors in a certain geographic area. People who travel frequently should be aware of what the costs could be if they choose to visit a doctor while traveling.
Although healthy people may mistakenly believe that they can go without a health plan, choosing to do so can risk financial ruin. One illness that requires hospital treatment for more than a couple days can easily wipe out a person’s savings.
Taking the time to examine available health care plans can help a person make the right decision for their financial situation and health. With all of the options in the market, people should be able to find a plan that fits their needs. When it comes to picking a medical plan, take the time to study each option carefully before making a final decision.