Frequently Asked Questions About Health Insurance


Why Should I Have Health Insurance? Why is it so Expensive? Should I Get A new Quote?

You pay a set monthly rate for Health Insurance basically to stop yourself from financial loss. Accidents can happen and if you were to be flown in a Helicopter plus spend one day in the Hospital it would be at least $26,000. The average day in the Hospital is $12,000.

What are the differences between a PPO and HMO?

PPO is Preferred Provider Organization: a list provided by each Insurance Company. In general, the higher the deductible, the lower the monthly rate. Each PPO has a different calender year deductible. Plans with a lower deductible have more generous prescription drug benefits and lower visit co payments. Overall all PPO’s will have a Maximum coverage the same approximately $5,000,000.

HMO is a Health Maintenance Organization. With an HMO you and your family must live or work in an area served by the plan. For instance, if you live on Catalina Island and the Hospital is in Los Angeles this would not be a ideal plan to choose.

Deductibles and how do they work? You must pay the deductible on your plan before coverage starts to kick in. Some plans have $0 deductible and go all the way to $4,000 deductible (Health Saving Accounts).

Co-payment is the fixed fee for visiting and using the services of in a network such as a doctor, Emergency Room, or filling a prescription. If your co-payment is $35, you pay tat every time you see a doctor and it does not go to your out of pocket maximum.

Coinsurance is the percentage the patient must pay. For example if the allowable amount is $100 for a visit and your coinsurance is 20%, you pay $20.

Out-of-pocket-maximum is a dollar limit on the total amount you have to pay for covered services in a calender year.

Best thing to do is ask yourself: How often do I visit the Doctor a year. If it is two times a year at about $100 per visit then get the lowest monthly plan such as a Health Savings Account so you will still have $5,000,000 coverage and will receive medical attention. If you have a family probably want HMO for the kids and PPO for the parents.


Source by Zahzel Rose

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