Obtaining a health insurance for yourself sometimes could be tricky and confusing. You have to decide what type of insurance plans must be taken, and examining things like premiums, co-pay and deductibles by yourself.
If you are an employer who works in a company that provides a health insurance cover for employers or usually called employer’s liability insurance, then you probably won’t have to go through all the difficulties of obtaining yourself with the right health insurance. But if you are a self imployed person, or maybe you are an employer who is not satisfied by the insurance cover provided by your employer, then you would have to be able to find the proper kind of cover for you and for your family too.
One of the most confusing things to choose is the type of policy that suits your need best. Generally there are two kinds of health insurance policy / plans, fee for service and managed care. Both have their own benefits and weaknesses. To make the best choice you have to make a comparison between the plans, examining the plus and minus points so you can decide what kind of policies would be the right one for you.
This type of plans sometimes also called indemnity plans. Fee for service is known as the oldest type of health insurance plans. In these types of plans, the insurance company pays fees for the medical services provided to you, and you are also given the most flexibility and choice of doctors and medical service providers. Fee for service policies could be the right choice for you If having the greatest flexibility in choosing a health care provider is important to you. The freedom of choosing the medical service provider is also a good thing for people who travel a lot in case they need a medical treatment during their trip. It also attract people who have cancer to have fee for service plans cover, since they need a long time treatment by specialists or doctors they trust.
Beside that, fee for service plans also provide more coverage for medical tests and prescriptions than many managed care plans provide.
Just like other insurance policies, these plans require you to pay for monthly a premium, deductibles, and coinsurance after your deductible is met.
although fee for service plans offer lots of benefits, but today these type of policies are becoming less popular than the managed care policies. That’s because fee for service policies in many ways cost a lot higher than managed care, and This type of insurance usually requires you to pay the medical service provider up front for the services, and then submit forms to the insurance company to be reimbursed. This could be a problem if you suddenly need a medical treatment when you are having some financial problems.
With fee for service plans, the person insured usually have a high deductible, and after the deductible is paid the policy will usually cover 80% of the medical expenses up to the cutomary amount that has been set for each type of medical expense, the rest 20% of the medical expense should be paid by the person insured. If the charges are higher than a usual and customary amount then the person insured would have to pay the difference.
Today this type of health insurance policy has become more and more popular than the fee for service plans. Most of the employers today give this type of plans to cover their employees. A lot of people choose this type of health insurance plan because it doesn’t worsen them with many extra costs though it has some limitations for the person insured.
In managed care, plans a person’s health care is managed by the insurance company, and In order to receive the highest level of coverage they must obtain services from the doctors, hospitals, labs, imaging centers, and other providers affiliated with their managed care plan.
If the person insured wish to have some medical services from doctors or hospitals which are not affiliated with the plan, then usually it would require an approval from the insurance company and usually in this situation the coverage given is much less compared if the person takes medical treatments from doctors or hospital affiliated with the plan. Approvals are also needed for some services, including visits to specialist doctors, medical tests, or surgical procedures.
These limitations sometimes could be difficult for people who travel a lot, or for a person whose having one of the family member has to go out of town for college, or for people who has cancer. People who have cancer that considering to have managed care plan should really check what kind of coverage would they get if they are taking medical treatments from unaffiliated providers, since sometimes they would have to go to a specific medical service provider such as cancer centre to get a medical treatments.
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