Tag Archives: Health
Different Types of Health Insurance in California
Different Types of Health Insurance in California
Whether you buy group or individual health insurance in California, the options you have regarding the different types of health insurance are generally the same. In some groups you can even choose from available plans. These different types are traditional health insurance, health maintenance organizations (HMOs), and preferred provider organizations (PPOs).
California goes beyond the Federal requirements for offering health insurance to its residents. Examples of this include Industry Advantage plans (IAHP), short-term health policies, Insurance for high risk Individuals and special plans for children and teens.
Additional Health Insurance in California
The traditional health care delivery system is based on a fee-for-service type of arrangement. In a fee-for-service system, you pay or each itemized medical service you receive. In the days of the frontier, “Doc” often received a chicken as payment. Today, physicians are paid with money, lots and lots of it. Fee-for-service health insurance recognizes this practice and is designed to reduce or even eliminate your duty to pay directly for your medical care. Traditional health insurance comes in three parts:
California has four basic options for choosing a health care plan:
- 1. Health through an employer or association
- 2. Health Insurance through Income eligibility such as Medicaid
- 3. Health care for high risk individuals such as those that have had cancer or a heart attack
- 4. Private Insurance
Hospitalization
Hospitalization covers defined expenses incurred while in the hospital. Generally, the insurance will pay for all of the covered services rendered by the hospital staff. However, if the insurance benefit is an indemnity payment, the payment will be for a fixed sum regardless of the actual expenses incurred. This fixed sum will usually be far below the daily charge actually made by the hospital.
Medical/surgical
This part of a traditional health plan covers the expensive costs of medical care other than the bill from the hospital. Services such as doctor visits, treatment charges, etc., are covered here. Medical/surgical usually has a deductible and requires co-payments by the insured (payments you make for charges not covered by the insurance), typically 20 percent of the doctor’s fee.
Catastrophic or major medical
There are usually lifetime maximum payments that hospitalization and medical/surgical plans will pay, after which the well runs dry. Unfortunately, these maximums may not be sufficient to pay for all of the care required if a major illness or injury should strike, since such afflictions can eat up hundreds of thousands or even millions of dollars worth of health services. Thus, catastrophic coverage adds to your umbrella of protection in an amount sufficient to protect you from the horrendous expenses of such serious and prolonged illnesses. These policies also fill in some of the gaps not covered by hospitalization or medical/surgical.
Health Maintenance Organizations or Private Insurance in California
The health maintenance organization (HMO) is a relatively new player in the health insurance game, although it has been around in a limited fashion since the 1930s. The idea behind an HMO is to pay one premium and receive all of your health care at no or a nominal additional cost. The point is to save money compared to traditional health plans that cost more to purchase and require more out-of-pocket payments from the insured. What you, the insured, give in exchange for reduced cost is a substantial loss of your freedom to choose who will take care of your health needs.
Preferred Provider Organizations
Preferred provider organizations (PPOs) seek to give both the benefits of traditional health plans and the money savings of HMOs. They do this by paying higher benefits as a reward for your using the doctors or hospitals they preselect for that purpose.
Disability Insurance
Disability insurance does not pay for health care; rather it pays for lost wages caused by a disabling injury or illness.
How Health Insurance Is Priced
Ask anyone how health insurance is priced and you will get a simple answer: expensively! Beyond that, there are underwriting criteria used by health insurance providers, whether they are for-profit or, like Blue Shield/Blue Cross, nonprofit.
Underwriting Criteria
Age
The older you are, the more likely you are to get sick; therefore, the higher your health insurance premiums will be.
Number of people covered
Many people buy family coverage rather than individual policies. This means that there will be adults as well as minor children protected by the same plan. Some companies will charge based on the size of the family. Others charge a basic family rate without regard to the number of members.
Gender
Unlike life insurance, where women get the better end of the bargain than men, in health insurance women often pay higher premiums. This is based on health insurance industry statistics which indicate that the female of the species tends to need medical care more often than the male.
Health history
Insurance operates on statistical probabilities. If you have had a poor health history, statistically you are more likely to have a more expensive health care future. This, in turn, means that you will pay higher premiums-if you can get health insurance at all.
Occupation
The more likely you are to suffer injury or illness because of the work you do, the more likely the health insurance industry will be to charge excessively for benefits. This may be well and good for professional deep-sea divers. But the industry has begun to stretch the concept into areas that have nothing to do with the inherent danger of the work.
Lifestyle
In your application for health insurance you will be asked questions about your personal habits. Your answers will have a lot to do with the cost of your premiums. If you smoke, you will probably pay more for health insurance. If you drink to excess, you will probably pay more for health insurance. If you are known to be under a great deal of stress, you may pay more for health insurance. California does reward the health care Insurance consumer with lower premiums if they have practiced good health policies.
One of the most important things you can do as a health care consumer is to engage in preventive care. Not only will you be able to spot serious diseases at an early stage, thereby increasing your chances of effective treatment and cure, but you should be able to save money as well, since it is usually far less expensive to treat a disease when it’s a molehill rather than a mountain.
About The Author:
Medical-Ins.com is a leading broker of health insurance in California. We provide detailed information and cost breakdowns of Blue Cross, PacifiCare California and many more. Visit our site for a free quote and to help sort through the various health insurance plans to find the more affordable option for your family.
Maximize Your Health Insurance With These Easy Tips! (2)
Maximize Your Health Insurance With These Easy Tips!
Health insurance. They aren’t dirty words – at least, they don’t have to be. If you spend a little time learning how to get the best health insurance you can reap surprising benefits. Every buyer and every insurance company is different, but here are a few general ideas that can apply to almost every health insurance situation:
Before purchasing health insurance, take your own needs into consideration. You do not want to be stuck paying for health insurance that does not help you with the care you need. For instance, if you plan on starting a family soon, get a health plan that covers pregnancy and delivery costs.
Your health insurance needs change as you move through life. Periodically, take a look at your health insurance coverage to make sure it meets your needs, particularly if you have a family. Does it still make sense to stay on your work’s health insurance policy, or does your spouse’s policy offer better coverage for this time in your lives?
When your doctor prescribes you a drug, ask him if there is a cheaper version, or an over-the-counter option, which you could use instead. For example, my husband had a stomach parasite which required three drugs to treat. The doctor was going to prescribe him a combination pill which would have cost literally ten times as much as if we got each drug separately!
A great health insurance tip that can save you a lot of money is to start getting your doctor to prescribe you generic drugs. Generic drugs have the same ingredients as brand name drugs, and you won’t have to pay an arm and a leg to get them either.
Here is a great money saving tip for health insurance. When shopping around for health insurance, see if you can find insurance companies that offer a free trial. This allows you to try out the insurance for a certain period of time, and if you are not satisfied with the service they offer, then you can get a refund.
It is helpful if you know what type of health insurance you are looking for before you make a decision. Consider the size of your family, and if you have young children, remember that they tend to go to the doctor often, so you will want a plan that has a lower co-pay to save some money.
Low priced health insurance plans usually cover a portion of major health problems and do not cover preventative treatment. Expensive plans cover almost every health need you may have. To decide on the best plan, figure out what your family’s current needs are and how much you can afford.
Buying health insurance is not that different from staying healthy. The time to act is long before trouble comes up. Insurance buyers who learn all they can and prepare themselves well can get the health insurance they need for significantly less money. And once the policy is bought, smart research will help the holder get the most out of it.
Tips for Shopping Health Insurance and Life Insurance Online
Tips for Shopping Health Insurance and Life Insurance Online
If you’ve found your way here, you’ve no doubt decided you need to purchase a new insurance policy or add to your existing level of insurance. It can be a little confusing deciding just what you need. So let’s cover some of the most popular types of insurance.
Critical Illness Insurance
Heart disease, stroke and cancer are just a few of the critical illness that bring a chill to your spine when you are diagnosed. The good news is that with the advances with modern medicine many illness that even recently were almost always fatal can now be treated and life goes on as normal. However, in a worst-case scenario, critical illness insurance helps you cope with the expense of your illness while you are treated and helps your loved ones to go on unencumbered by the financial burden left by a long illness should you lose the battle.
Disability Insurance
One of the most popular forms of supplemental insurance, Disability Insurance pays you a percentage of your income as a benefit should you become disabled. You use these benefits to help with out of pocket expenses not covered by your major medical policy and to pay your household bills while you recover from a temporary disability or a lump sum payment or a life long benefit in the case of a permanent disability.
When shopping for a Life Insurance quote, Term Life Insurance and Whole Life Insurance are the two most popular choices. Let’s explain each of these:
Whole Life Insurance
When shopping for a Whole Life Insurance quote you will find that, the policy remains in force during your entire lifetime as long as the premiums are paid. The type of life insurance also builds what is commonly called a cash value that you borrow under certain circumstance after a period of time.
Term Life Insurance
When shopping for a Term Life Insurance quote keep in mind that this insurance will cover you for a specified time only such as five years. Your premiums do not increase during the term of your policy but will likely increase once it is time to renew the term. Term Life Insurance does not build a cash value.
Term life is generally cheaper if you are younger in age and a good starting point for a safety net for a young family until you’re ready to invest in long-term whole life insurance.
Now you’re fully informed to make the right choices as to just what new or additional insurance to choose for yourself and your family.
Tips For A Successful Experience With Health Care 3
Tips For A Successful Experience With Health Care
Knowing what you want out of a health insurance policy and company narrows down your search and makes it easier for you to find what you’re looking for. Health insurance is a vital form of insurance to have for a myriad of reasons pertaining to your overall health. Accidents and health issues can both happen in which case health insurance can help you. The numerous tips below can serve as great help to you in your search for the perfect health insurance.
When signing for health insurance, it is extremely important to make sure you’ve filled out all paperwork completely and accurately. If you’ve made a mistake or provided false information, the insurance company might declare your policy void when you need to use it, and refuse to pay for anything.
Consider your current, as well as, your future needs when you are shopping for health insurance. You may find that you will need maternity care or insurance for children down the road. If you can find a policy with a good health insurance coverage when you are starting out, it will be much easier in the future for you.
Check with your state to find out if you qualify for government health insurance or some type of subsidy for health insurance. Some states offer health insurance plans or subsidies for low income families or for children that come from low income families. Check out all your options to see if this applies to your situation.
If you find that the health insurance your employer offers is too expensive or otherwise unacceptable, one thing to check is the insurance from your spouse’s employer. You might find that coverage for two on one policy is more advantageous than each of you being covered separately. Policies vary widely, so be sure to check coverage as well as the cost.
A good health insurance tip that can save you a lot of money is to simply take better care of your teeth by properly brushing and flossing regularly. Though it’s good to take care of your teeth in general, you can actually save money because you won’t need to get as many x-rays done.
Look to see if your health insurance company has made any changes to your plan before you re-enroll. These revisions could affect how much you pay, and you might decide it is better to switch plans rather than continue with your current coverage. Healthcare costs continue to rise, so this situation happens fairly often.
Before you go out and choose your health insurance plan or carrier, make sure that you shop around and learn what everyone has to offer. There are tons of health insurance providers out there at this exact moment and you want to be sure that you find one that is a good match for you and your family.
Health insurance is something that is useful in providing for you when you’re in an accident or caught off guard by something else. It is important for you to know exactly what you want out of your policy and company to ensure that you are getting what you’re looking for. Apply the tips from the article above to guarantee your success in finding good health insurance.
Useful Tips For Choosing A Health Insurance Policy 3
Useful Tips For Choosing A Health Insurance Policy
The costs of healthcare have been rising rapidly in recent years. If you don’t have health insurance, and you suffer an illness or injury, you could find yourself deep in debt. Health insurance is vital to protecting both your health and your finances. Read this article for some important advice about your health insurance.
With an employer-sponsored health plan insurance plan, your company has to accept you, despite your health status or pre-existing conditions. Without one, you have to seek private policies, which means your health will be rigorously evaluated. Many states have private health insurance policies that are underwritten about your medical history, smoking status, weight, and age.
Consider high deductible health insurance policies. If you are young and healthly with no family history of serious health problems, a high deductible health insurance policy could be suitable for you. These policies make health insurance coverage much more affordable, but make should that you are aware of medical problems which aren’t covered by the policy.
When considering a new health insurance policy, learn all you can about what a deductible is and how it can affect your costs. Many policies have one. It’s basically a set amount that you will have to pay out of pocket before your coverage starts and before the insurer has to share costs. They vary from policy to policy and they have ranges. Higher deductibles can sometimes clash with coverage that has a greater percentage, but not always.
Honesty is the best policy. Once you have found a suitable health insurance plan, take care when filling it out, and be honest. If you make mistakes, or are found to have filled anything dishonestly, your coverage will probably be denied. The best thing to do is take things slowly and think about how you answer each question.
It is important to shop around and request quotes from numerous health insurance providers before purchasing a policy. Comparing rates is the easiest way to ensure that you are paying the lowest rate available. Even if you currently have insurance, you should compare rates at least once a year to see if additional savings are available.
Create a plan of action for handling your deductible in the event of a health related incident. These situations are normally few and far between, yet you should set aside a few dollars each pay period until you reach your deductible amount. If it is not easy to save on your own, look at a health insurance savings plan which will be deducted from your paycheck.
Make sure you keep your health insurance documents handy at all times. This is not only important when you see a doctor or get a prescription filled. If you develop a health condition, you will need to see immediately what kind of coverage you have and what else you need to do.
As mentioned above, health insurance doesn’t only protect your health, it protects your wallet, too. Health insurance gives you the freedom to take care of yourself when you need to. With the advice from this article, you should be more informed about health insurance and ready to make decisions regarding your status.